Alzheimer’s Disease and Autism Paper

Autism spectrum disorder (ASD) and Alzheimer’s disease (AD) are neurodevelopmental and neurodegenerative disorders respectively, with devastating effects not only on the individual but also the society. Collectively, a number of factors contribute to the expression of ASD and AD. It is of utmost curiosity that these disorders express at different stages of life and there is an involvement of certain susceptible genes.Alzheimer’s Disease and Autism Paper This genetic basis makes the background of common associations like memory deficits, cognition changes, demyelination, oxidative stress and inflammation, an integral part of both disorders. Modern technology resulting in genetically modified crops and increase in gadgets emitting electromagnetic frequencies have resulted in enhanced risks for neurological dysfunctions and disorders like ASD and AD. Subsequent advances in the psychological, pharmacological, biochemical and nutritional aspects of the disorders have resulted in the development of newer therapeutic approaches. The common clinical features like language impairment, executive functions, and motor problems have been discussed along with the patho-physiological changes, role of DNA methylation, myelin development, and heavy metals in the expression of these disorders. Psychopharmacological and nutritional approaches towards the reduction and management of risk factors have gained attention from the researchers in recent years. Current major therapies either target the inflammatory pathways or reduce cellular oxidative stress. This contribution focuses on the commonalities of the two disorders.Alzheimer’s Disease and Autism Paper

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Autism spectrum disorder is a neurodevelopmental condition that affects a person’s ability to communicate, interact and behave appropriately with others in social situations. Approximately 1 in 68 children in the United States has autism, and the condition is about five times more common in boys than in girls, according to the Centers for Disease Control and Prevention (CDC).

Autism is characterized by impairments in social skills, communication, and restricted and repetitive behavior such as hand flapping and an insistence on sameness. Many children also have unusual sensory responses, and may shy away from bright lights or may not notice if their clothes are rough and twisted.

Earlier versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the American Psychiatric Association’s guide for diagnosis, listed autistic disorder, Asperger syndrome and pervasive developmental disorder-not otherwise specified (PDD-NOS) and childhood disintegrative disorder as separate diagnoses. In the latest edition of the DSM, however, experts combined these conditions into one group called autism spectrum disorder because they all appear to be varying degrees of the same disorder, the association reported.Alzheimer’s Disease and Autism Paper

At a psychological level, Alzheimer’s disease (the most common form of dementia) and Autism Spectrum Disorder both have a number of features in common. These features include catatonic state, disrupted sleep, attention transition issues and difficulty with balance and language comprehension.

However, to better understand the similarities between ASD and dementia in young people, we first need to understand the symptoms that are evident in both.

Autism Spectrum Disorder

Autism spectrum disorder (ASD) is the name given to a group of developmental disorders that include a wide range of symptoms and levels of disability. People who are autistic generally have these characteristics:

Social problems which include difficulty in interacting with others.
Limited interests or activities as well as repetitive behaviors.
Symptoms that hurt a person’s ability to function at various areas of life such as socially, at school, or at work.

Mostly, ASD symptoms are recognized in the first two years of life. Some people are mildly impaired, whereas, others are severely disabled. 1 in 68 children in America are diagnosed with some form of ASD, according to the Centers for Disease Control and Prevention (CDC).Alzheimer’s Disease and Autism Paper

Dementia

Dementia is not a specific disease, rather a wide range of conditions can cause dementia, of which Alzheimer’s is the most common. Types of dementia include mixed dementia, vascular dementia, and lewy body dementia.

Those who have dementia exhibit at least two impaired brain functions, such as impaired judgment and memory loss. Some of the most common symptoms of dementia include memory loss, difficulty in communicating and planning, struggling with complex tasks, loss of motor functions, personality changes, inappropriate behavior, paranoia, hallucinations and lack of reasoning.

A myth about dementia, however, is that only seniors develop it. Although it is more common amongst elderly people, cases have been reported where individuals as young as 30 have developed dementia. For example, brain trauma caused by a head injury could also cause dementia.Alzheimer’s Disease and Autism Paper

Since there are many possible causes of dementia, individuals who are affected with it have varying ages. Hence, the answer to the common question ‘Is dementia hereditary?’ is not yet established as dementia can be caused by various factors.

Definition and incidence of ‘young people’ with dementia

Since the bulk of the population that has dementia is elderly, that is people above the age of 65, the definition of ‘young onset’ of dementia does not mean children, teenagers or young adults are prone to developing it. Instead, ‘young onset of dementia suggests that people of a working age, usually between 30 and 65 years old have higher chances of having it. No wonder, it is also referred to as ‘working-age dementia and ‘early-onset dementia.

In the UK, it is estimated that there were 42,325 people with early-onset dementia as per the 2nd edition of Dementia UK by Alzheimer’s Society in 2014. They represent about 5% of the population that has dementia, however, because of all the difficulties of diagnosing this condition, this figure could be closer to 6-9%.

Dementia that affects younger people can be rare and hard to recognize because young individuals are very reluctant to accept that there is anything wrong with them, when they are otherwise healthy.Alzheimer’s Disease and Autism Paper

Therefore, they may put off going to a doctor. People with early-onset dementia are likely to be diagnosed with its rarer forms and have higher chances of having a genetically inherited form of it.

Hereditary

Though all forms of dementia are not hereditary, research suggests that there is a high prevalence of inherited dementia’s in younger-age groups. Thus, In about 10% of all people with early-onset dementia, the condition seems to be inherited from a parent.

Twins and family studies suggest that some people also have a genetic disposition towards ASD. In studies with identical twins, if one is affected then the other one also has between 36% to 95% of chances of being affected as well. Hence, in families with one autistic child, the risk of having a second child with the disorder also increases. This suggests that ASD may, to some extent, be hereditary.

Down syndrome

People with a learning disability, such as Down syndrome, are at a greater risk of developing dementia at a younger age. One in 50 people with Down syndrome develop Alzheimer’s disease between the age of 30 to 39, one in ten aged 40 to 49, and one in three people with Down’s syndrome will have Alzheimer’s in their 50s.Alzheimer’s Disease and Autism Paper

Similar to early-onset dementia, an increasing number of children with Down syndrome are being diagnosed with Autism. Studies suggest that 16-19% children having Down syndrome also have ASD and 8-9% have Autism (the higher end of symptoms of ASD).

Genetics

Studies conducted on psychiatric and neurodevelopmental disorders have indicated that there is a genetic overlapping between Autism and Alzheimer’s disease. Patients of both have significantly similar abnormal findings in their brain including extreme deposition of metal ions such as mercury, existence of viral or bacterial infections, reduced Acetylcholine (neurotransmitter) and an increase in ß-amyloid (1-42).

Though caused by divergent mechanisms, there are many genes common to both Autism and Alzheimer’s disease, which include  Fragile X mental retardation protein (FMRP), catechol-O-methyltransferase (involved in degradation of catecholamines such as dopamine, epinephrine, and norepinephrine), major histocompatibility complex, class I, A (HLA-A), Phosphatase and tensin homolog (PTEN), and Solute carrier family 6 member (SLC6A4, neurotransmitter transporter, serotonin).

Epilepsy

Epilepsy is a neurological disorder. In an epileptic episode, certain brain nerve fire abnormally and cause effects that the person experiencing the episode has no control over. However, the type of epilepsy that most people are familiar with is one where the individual loses consciousness, falls to the floor and experiences uncontrolled convulsions.Alzheimer’s Disease and Autism Paper

Other symptoms of epilepsy include loss of consciousness with only minor muscle effects, partial seizures where only part of the body is affected and the individual remains conscious during the episode; seizures during sleep and twitches such as that of the eyes or eyelids. Some people also experience unusual smells or experience fear or anxiety.

Epilepsy is more common in individuals with ASD than it is in the general population. However, the overlap works both ways, which means that people with ASD are more likely to have epilepsy and people with epilepsy have higher chances of having ASD. Children whose language skills regress (a symptom of ASD) before age 3 appear to have a risk of developing epilepsy. Similarly, about 20 to 30% of children with ASD develop epilepsy, by the time they reach adulthood.

Likewise, epilepsy is more common in cases of dementia than in the general population. A UK based study found that 11.8% of patients with epilepsy, above the age of 64, also had a comorbid diagnosis of dementia. This type of dementia was significantly higher than the 1.9% comorbidity rate in the non-epilepsy older group. A Canadian study also found higher incidence of dementia in patients with epilepsy.

Autism and dementia share a lot of common attributes including lethargy, loss of intellectual abilities, sensory overload, judgement issues, difficulty with language and comprehension. People with either or both ailments can give little or no response to stimuli or need more time to respond.Alzheimer’s Disease and Autism Paper

On the other hand, similarities between early-onset of dementia and ASD include the possible hereditary nature of both. The higher likelihood of early-onset of dementia and/or Autism in patients with Down syndrome is also another common factor. Genetics and epilepsy play a possibly significant role in ASD as well as dementia.

Autism, Alzheimer’s, Parkinson’s, depression, memory loss and other neurological dysfunctions are a reflection of poor brain functions. Thus, addressing issues like adequate oxygen delivery, inflammation, blood sugar, hormonal imbalance, cerebrospinal fluid flow, and neurotransmitter imbalances can have profound effects on brain functions and alleviate some of the symptoms of these disorders and diseases.

There are many likenesses between seniors and children. Both cannot do without help from others while taking of themselves. Both require adults to guide them in matters of daily life. Both have difficulty learning new things.

So, when things go wrong in the brains of both, the very old and the very young, the cause is more often than not, the same. Brain disorders. In children, the result is frequently autism. In seniors, it’s dementia.

Both conditions take a huge toll on the families involved. Dementia occurs in about 8.8% of adults above the age of 65, whereas an estimated 1 in 68 school-aged children have been identified with autism spectrum disorder. Let’s take a look at what these conditions are:Alzheimer’s Disease and Autism Paper

What is autism?

Autism is a lifelong developmental disability that affects how people perceive the world and interact with others. It is not an illness or a disease, rather it is a spectrum condition because of which autistic people share certain difficulties.

Learning disabilities and mental health issues are some of the challenges that autistic people often face. There are around 700,000 people in the UK living with autism; that is more than 1 in 100 people.

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Autism Criteria

The Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 (American Psychiatric Association, 2013) has three criteria for autism:

(1) Impairment in social interaction

(2) Impairment in communication and

(3) Restricted repetitive and stereotyped patterns of behavior, interests, and activities that come under two domains:

persistent deficits in social communication and social interaction
restricted, repetitive patterns of behavior, interests, or activities
What is Dementia?

Dementia is a set of symptoms that are linked to disorders and their negative effects on the brain. Those who suffer from dementia exhibit at least two impaired brain functions which include, but are not limited to, memory loss, impaired judgment, difficulty communicating, struggling with complex tasks, difficulty planning, and loss of motor functions. Though often confused with Alzheimer’s or Parkinson’s, dementia is not a specific disease, rather a wide range of conditions can cause dementia.

However, dementia is not a disease in itself. It is a disorder that develops as you age, due to damaged nerve cells in the brain and can be linked to anything from head trauma to Huntington’s disease. In some cases, such as in the case of Alzheimer’s, it cannot be reversed and symptoms progressively worsen over time.Alzheimer’s Disease and Autism Paper

The Missing Link

Though there is no conclusive evidence, it is believed that Autism is a highly heritable disorder and that genetic susceptibility interacts with environmental factors. Many of the genes found to be associated with autism are involved in the function of the chemical connections between brain neurons (synapses). Though, the symptoms of autism may be the same as those of dementia, the root cause of autism and dementia may differ as do the treatments for both.

Symptoms and treatments aside, autism and dementia may share similarities at the gene level. For example, evidence suggests that emotional disorders such as schizophrenia (which has hallucinations as one of the symptoms, similar to dementia) occur more frequently than average in the families of people with autism.

It is true that at a psychological level, both autism and Alzheimer’s share a number of features including, catatonic state, and disrupted sleep, difficulty with balance and language comprehension, and attention transition issues. Studies conducted on neurodevelopmental and neuropsychiatric disorders develop a strong belief of genetic overlapping between Alzheimer’s and autism.

The researchers point out that autism is an extremely complex disease with a wide spectrum of behavioral manifestations and it is likely that other genes or environmental factors are involved. However, their sophisticated genetic analysis has for the first time suggested that a phenomenon known as genetic imprinting is at work in autism and that it appears to be an important factor in the disorder.Alzheimer’s Disease and Autism Paper

Genetic imprinting is a process by which a gene’s expression is governed solely by which parent donates the gene copy, rather than by the classic laws of Mendelian genetics, in which genes are either dominant or recessive. Imprinted genes typically become inactivated, or turned off, during the development of egg or sperm cells, or shortly after fertilization.

“Autism is not a simple genetic disease, caused by the presence or absence of a single gene,” said Allison Ashley-Koch, a post-doctoral fellow at Duke’s Center for Human Genetics. “We’re finding that it is much more complex.”

Ashley-Koch prepared the results of the Duke study for presentation Friday at the annual scientific sessions of the American Society for Human Genetics. The autism research is sponsored by numerous grants from the National Institutes of Health.

“We’ve always known that imprinting exists – there are examples in less complicated organisms,” said Margaret Pericak-Vance, director of Duke’s Center for Human Genetics (CHG) and senior autism researcher. “Now, with the new technologies in genomics, we can look at more complex inheritance patterns in human disorders. These findings suggest a possible mechanism behind the underlying genetic cause of autism.”Alzheimer’s Disease and Autism Paper

The researchers examined 82 families who had at least two family members afflicted with some form of autism. By applying the latest genetic sleuthing techniques, the researchers were able to demonstrate that imprinted genes may be at work. Specifically, they found preliminary data suggesting a paternal effect on chromosome 7 and a maternal effect on chromosome 15.

Genetic imprinting has recently been shown to be involved in several rare human disorders, including Prader-Willi Syndrome and Angelman syndrome, which both can produce autism-like symptoms. All are considered neurodevelopmental disorders.

“Many children with these syndromes have altered genes in the same region of chromosome 15 that we are looking at in autism,” Pericak-Vance noted. “This area of chromosome 15 is highly unstable and prone to genetic rearrangement.”

Autism is a complex disease that affects two to 10 per 10,000 people, making it the third most common developmental disability – almost as common as Down syndrome. But because of the broad differences in severity of the disease, doctors have difficulty diagnosing it with certainty. Some children simply talk later than normal, while others have severe withdrawal and self-destructive patterns of repetitive head banging and difficulty sleeping or other manifestations.Alzheimer’s Disease and Autism Paper

Doctors believe that the disorder begins during development of the brain, possibly even before birth, and that the change prevents affected people from properly processing sensory information from their environment.

“Once we better understand the genetic factors involved in autism, genetic testing can theoretically be offered to families at risk,” Ashley-Koch said. “In addition, identification of such genes will pave the way for development of therapies to improve the quality of life for these children.”

Autism Spectrum Disorder (ASD) is a developmental disorder that involves impairments in social interaction and communication, challenges with sensory processing, and repetitive behaviors. The term “spectrum” reflects the fact that symptoms vary across different individuals, ranging in type and severity.

ASD is an umbrella diagnosis in the DSM-5, replacing the four pervasive developmental disorders described in the previous edition — autistic disorder, Asperger’s syndrome, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified. Individuals display ASD symptoms on a continuum, or spectrum, showing ranges of mild to severe symptomatology. Those on the mild-to-moderate end of the spectrum are sometimes colloquially referred to as having Asperger’s syndrome, though this is no longer a formal diagnostic category.

People with autism may appear indifferent and remote and can have difficulty forming emotional bonds with others. They may have unusual responses to sensory experiences — the noise of a leaky faucet, for example, might become extremely disruptive.Alzheimer’s Disease and Autism Paper

Autism is found in many different countries and across racial, ethnic, religious, and economic backgrounds. Its prevalence has been estimated at roughly 1 percent of the world population. In a study by the Centers for Disease Control and Prevention (CDC), 1 in 59 U.S. children were identified as having ASD. The earlier the disorder is diagnosed, the sooner a child can be helped through treatment interventions.

I’d like to give you a quick task. How do you make a cup of tea? Describe it out loud. Whilst this could lead to some controversies (milk in first, or last?) it seems fairly simple. But what if I told you that this task could help diagnose Alzheimer’s disease?

A person receives a diagnosis of dementia, of which Alzheimer’s is the leading cause, every three minutes in the UK – that’s one in the time it takes a kettle to boil. In Alzheimer’s the hippocampus – the part of the brain we need to form and hold on to memories – starts to shrivel. Abnormal proteins build up in and around brain cells, killing them. Memories start to fade. And so does language.

This process is a slow one. We now know that by the time a person goes to their doctor with concerns about their memory, Alzheimer’s could have been lying undetected for 10 years. Complex tests, brain scans and lumbar punctures can give a good indication if someone has Alzheimer’s at this stage, but it’s too late. How can we bring the diagnosis forward?

Brain scans are getting more advanced, but they’re expensive. We need something that’s sensitive to change, cheap and readily available – like a blood test. Something that will help us detect who is in the earliest stages of Alzheimer’s, give medications sooner, and stop the disease in its tracks.Alzheimer’s Disease and Autism Paper

Language. There’s more information contained in language than we could ever imagine. The words we use can reveal our gender, how much power we hold, whether we’re angry, sad or happy. It’s a mirror to our inner selves, and very difficult to mask. And, language can also reveal signs of Alzheimer’s.

Ground-breaking studies have found changes in what people say, or how they say it, years before they’re diagnosed. President Ronald Reagan was diagnosed with Alzheimer’s after
he left office, but showed signs that his brain was already changing in speeches made six years earlier.

Researchers could tell from essays written by nuns which of them would go on to develop Alzheimer’s. Fans and critics alike panned Iris Murdoch’s final book, which was later found to have used language very differently from novels written earlier in her career. She was diagnosed with Alzheimer’s at 76.

This is what my research is doing. Finding clues in language that show the brain is changing. Building a method for detecting Alzheimer’s before the memories start to fade, and the disease starts to spread.

The vast majority of us aren’t presidents, nuns, or famous authors, though. We need to study the language of ‘everyday people’. So, I’m analyzing the language of volunteers diagnosed with early Alzheimer’s disease or Mild Cognitive Impairment (MCI), where people experience some of the symptoms of Alzheimer’s and are at a higher risk of developing it later.Alzheimer’s Disease and Autism Paper

I ask these volunteers to name as many animals as they can in one minute, to describe a picture, tell me a story and to describe how they make a cup of tea. I record their speech, and then search through the hundreds of features hidden in their language, and over one year follow them up to see how this changes.

But searching through these hundreds of features is like looking for a needle in a hay stack. This is where Artificial Intelligence comes in. AI relies on Machine Learning, where a computer is given lots of data and learns something useful.

Take your spam email filter: it’s been trained to recognize spam compared to real emails, by searching through the characteristics, or features, of each. Perhaps spam emails contain more website links? Or real emails tend to be longer? Once it’s seen enough emails to learn what is different about the two groups, when you get a new email it knows what to look out for, and can banish that spam to the right folder.

This is how I will compare the language of my volunteers with Alzheimer’s and MCI to the language used by people ageing healthily, and find the needle in the haystack of spoken words. I will train a computer to learn which features are important for identifying disease, so we know what signs to look for. For example, I’m looking at how common the words used by each group are. Is speech affected by Alzheimer’s more predictable?

Blood tests look for biological markers of disease. I’m looking for a marker in language. Just like a blood test, it’s sensitive to change, cheap and readily available, and could reveal Alzheimer’s years before other symptoms start to show. With the help of AI, I hope that in the future diagnosing Alzheimer’s will be quick, inexpensive and painless – as simple as making a cup of tea.Alzheimer’s Disease and Autism Paper

Autism is a neurological disorder (a “brain” disease) characterized by the presence of severe communication, language and social deficits in affected persons. It is the most well known of several pervasive developmental disorder (PDD) diagnoses which begin in early childhood and continue throughout life, affecting most every aspect of life along the way. While autistic peoples’ cognitive (thinking and language) and social skills are typically developmentally delayed compared to their peers, their motor (movement) skills develop in a more normal fashion.

Specific social interaction, communication and behavioral deficits must be present before the diagnosis of autism is appropriate. Though all people with Austim people show the same specific pattern of impairments, the severity of these impairments vary from case to case, with some people demonstrating relatively mild impairments and others demonstrating severe impairments.Alzheimer’s Disease and Autism Paper

From a very early age, children with autism demonstrate a fundamental difficulty in properly orienting towards other people and in processing social and non-verbal forms of communication, such as eye contact and facial expression. For instance, a typical infant is generally responsive to adult caregiver facial expressions and will imitate those expressions. If a parent smiles at an infant, that infant is likely to smile back. This is not the case with infants with autism, who often lack the ability to appreciate faces or socially conveyed feelings. Children with autism are also typically delayed (sometimes severely so) in their development of spoken language and conversational skills.

Individuals with autism also tend to demonstrate odd and socially inappropriate behaviors. They frequently act with indifference towards others, and remain isolated from their surroundings. Many obsess or fixate on certain objects or on particular topics they find personally interesting. They may insist on talking about a topic they find fascinating even when others around them are not interested. They may act out odd stereotyped movements and gestures. They may demonstrate an intense need for order and sameness with regard to their environment, and react with temper tantrums when their prized order is disturbed. In general, people with autism’s lack of social awareness makes it difficult or impossible for them to successfully navigate through everyday situations.

Symptoms of autism are not present from birth. Most children with autism appear to develop typically during the first year of life. Symptoms of autism become apparent between eighteen and thirty-six months of life. Forty percent of cases are diagnosed by age three. Autism is an equal-opportunity illness; No particular race or social class tends to get it more frequently than another. However, it is far more likely (four to five times more likely) to occur in males than it is in females.Alzheimer’s Disease and Autism Paper

Once established, autistic symptoms continue into adulthood. The symptoms range in severity (across individuals) from relatively mild to severe and debilitating. In all but mild cases, autism interferes with typical development and makes it difficult or impossible for affected adults to live and work independently. Though intervention cannot reverse the course of autism, it can result in symptom improvement and a greater capability for independence. For intervention to be maximally successful, however, it must be delivered early in the developmental process, shortly after the diagnosis of autism is first made.

Autism appears to be occurring more frequently than was the case in the past. The prevalence (rate of occurrence) of autism has risen from five in every ten-thousand in the mid 1990’s to one in every one-hundred and sixty-six in 2005. The numbers are leveling off and seem to be on the decline, but the rise in the number of cases of autism is staggering. There is no known reason for the dramatic increase, but awareness may play a significant role. Many more children who have mild forms of autism may be being diagnosed simply because parents and pediatricians have become more familiar with the symptoms of autism.

By 2050, the percentage of people over 65 will increase to 20 percent of the population, or 88 million people. If the trend of dementia diagnosis continues, that will mean 8.8 million of those people will suffer from dementia, much of it caused by Alzheimer’s disease, an incurable condition that already is the 6th leading cause of death in America.

As distressing as death can be, for many families who have an older member with Alzheimer’s and dementia, the struggle leading up to it can be the most debilitating part. The Alzheimer’s Association estimates that, in 2015 alone, almost 15 million private individuals devoted more than 18 billion hours in uncompensated care for Alzheimer’s patients… feeding, clothing, and managing a devastating disease that progressively robs both memory and physical function from its victims.Alzheimer’s Disease and Autism Paper

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Applied behavior analysts work with families and healthcare providers to use techniques of ope rant conditioning to ease the process of managing those patients.

Behavioral Issues Dominate Symptoms of Dementia

Dementia, whether caused by Alzheimer’s or other age-related infirmities, is primarily expressed and diagnosed through abnormal behaviors. Dementia patients exhibit:

Severe memory loss, particularly of short-term memory
Decreased logic and reasoning skills
Difficulty communicating
Depression and anxiety
Inappropriate behavior and personality change

All of these issues can be successfully addressed through the use of applied behavior analysis techniques, either applied individually or as part of comprehensive systemic adjustments in the environment of care facilities.

Applied behavior analysts view these behaviors through the so-called ABCs of ABA:

Antecedent – The prompt, or initial situation, leading to a behavior.
Behavior – The action or behavior in response to the antecedent.
Consequence – The reinforcement mechanism associated with the behavior.Alzheimer’s Disease and Autism Paper

Although the short-term memory issues that usually accompany dementia can make consequences irrelevant to shaping future behaviors (the patient cannot remember them), a clear understanding of antecedents can still help caregivers adjust environmental factors to make life easier for dementia patients.

Adjusting the antecedents can even be directly focused on coping with memory problems. In one experiment, the use of personalized shadow boxes helped some dementia patients find their rooms easier in a long-term care facility. The ABA treating the patients recognized that short-term memory failure made it difficult for the patients to remember their room numbers in the unfamiliar facility. But long-term memories are often preserved. By taking personal items and pictures that the patients were long familiar with and using those to mark the rooms, patients were more easily able to identify their rooms.

Solving these types of issues not only addresses the immediate problems facing dementia patients, but also serves to reduce the frustrations of their daily lives. This can solve secondary issues arising from dementia, including:

Depression
Anxiety and agitation
Verbal outbursts and aggression

To determine what antecedents apply and how to alter them, ABAs perform a study of the patient or situation called a Functional Behavior Assessment (FBA). This can involve looking at records of patient care from other providers, reviewing health records, making direct observations of the patient, and interviewing the patient directly.

The FBA will provide the basis for creating a behavior intervention plan, or BIP. The BIP will include the specific accommodations or treatments to be offered to the patient. ABAs or other professional caregivers may implement the specific details of the BIP directly, as can the patient’s family. In cases with particularly high-functioning patients, the patient plays an active role themselves. The ABA will continue to assess and observer through the course of treatment, adjusting the BIP as necessary to accommodate unforeseen issues or to handle improvements in behavior.Alzheimer’s Disease and Autism Paper

ABAs may also engage in group therapies, working with multiple patients in long-term care facilities. They might work with facility staff to help organize activities and routines to better reinforce acceptable social behaviors, or to improve the moods and attitudes of patients. In one study of a token economy implementation in an 80-patient geriatric care facility, behavioral outbursts among patients were reduced and increased vigor and physical activity were observed.

Common ABA techniques used in dementia cases include:

The Montessori Method, a technique originally developed for young children, which involves a great deal of environmental interaction designed, for dementia patients, to invoke intact long-term memories over defunct short-term memories.
Spaced Retrieval, a differential reinforcement method that has proven successful in improving short-term memory skills in some patients.
Token economies, a technique usually used in multi-patient settings to control asocial behavior by offering token rewards that can later be exchanged for items of value to the patients.

These systems all serve to make patients more at ease and more manageable as their physical and mental capacities decrease.

Some Dementia’s are Curable and Some Patients Can Be Retrained Using ABA Techniques

Applied behavior analysis is not only for coping with the long, inevitable slide of incurable Alzheimer’s patients, however. There are a number of causes of dementia that are potentially reversible, including:

Infections and immune disorders
Brain tumors, strokes, and traumatic brain injuries
Metabolic reactions and adverse reactions to medication

In these cases, ABAs not only work to help dementia patients cope with life impacted by memory loss and confusion, but actively help to retrain their brains to learn forgotten skills as the underlying causes of their dementia are corrected.Alzheimer’s Disease and Autism Paper

Although the patients may be older, the methods used for recovering dementia patients are often the same as those used in schoolchildren with Attention Deficit/Hyperactivity Disorder or Autism Spectrum Disorders (ASDs).

These include:

Discrete Trial Training (DTT) – Involves breaking down complex behaviors into a number of elements, which are separately and sequentially reinforced to build up into the desired behavior.
Pivotal Response Treatment (PRT) – Rather than targeting specific behaviors, PRT involves a holistic examination of motivations and responsiveness in the patient.
Preparing for a Career as an Applied Behavior Analyst Working With Dementia and Alzheimer’s Patients

A master’s degree or higher is required to become an ABA working with dementia patients. Almost all positions in long-term care facilities, hospitals, or with private clinics specializing in geriatric disabilities require a Board Certified Behavior Analyst (BCBA®) certification from the Behavior Analyst Certification Board.

The BCBA® certification requires a master’s or better degree in psychology, education, or applied behavior analysis. However, other advanced degrees may also be accepted if an approved course sequence in applied behavior analysis is also taken, and a strong medical background can be an asset when applying for positions in hospitals or geriatric care facilities, where most dementia patients will also be coping with a host of unrelated medical issues. An advanced degree in biology, pre-medicine, or gerontology in combination with a BCBA® may be the ideal approach.Alzheimer’s Disease and Autism Paper

It’s also a good idea to gain some experience in the field before investing the time and money required to obtain an advanced degree. Many hospitals and geriatric care facilities offer volunteer positions to individuals who hope to obtain hands-on experience with dementia patients. Although a direct application of applied behavioral analysis techniques might not be part of these positions, they will still provide good exposure to the realities of working in geriatric medicine.

Working in any sort of medical environment will usually require passing a criminal background check, so it’s a good idea to keep a clean record, too!

Further Resources for Applied Behavior Analysis in Dementia Treatment

American Psychological Association Mental and Behavioral Health Issues in Older Americans – A compendium of issues, studies, and treatments researched by the APA for the care of geriatric populations, including dementia cases.

Behavior-Analytic Research on Dementia in Older Adults – A review of studies and publications in scientific literature relating to applied behavior analysis as applied to dementia cases.Alzheimer’s Disease and Autism Paper

The Alzheimer’s Association – Founded in 1980, this non-profit seeks to advance research into Alzheimer’s disease and dementia while improving care for those living with the disease.

The National Institutes of Health Alzheimer’s and Dementia Resources for Professionals – The NIH publishes best practices and other informational resources for professionals dealing with Alzheimer’s and dementia patients.

Association for Behavior Analysis International Special Interest Group – The ABAI has a Behavioral Gerontology special interest group for ABAs practicing with elderly and dementia patients to connect and share feedback and resources.

Autism is a developmental disability that appears in children during their first three years of life. Autism affects the development of social and communication skills. About one in every five hundred children will be diagnosed with Autism. This paper will discuss the diagnosis and treatment of Autism, some major characteristics of children with Autism, and why this topic interests me.
Parents begin to notice the autistic characteristics when their child is antisocial, has behavioral problems, and avoids interaction with others. Since there is no real test to diagnose Autism, different professionals have different ways of diagnosing. Since many of the characteristics of Autism are shared with other disabilities, tests for those disabilities are performed, to rule out those possibilities. Children are also diagnosed by a group of doctors usually containing a neurologist, psychologist, speech therapist, developmental pediatrician, a learning consultant, and the use of parental input about the child’s abilities and behaviors. Once diagnosed the professionals can help the families design an appropriate treatment plan. Treatment plans may contain any or all of the following: medication (there is no specific drug made for Autism), behavior modification, special educational programs, and therapy. There is no cure, though, for Autism.Alzheimer’s Disease and Autism Paper
Characteristics of Autism vary in each child due to the severity of the case. Children can exhibit the behaviors in different combinations and different degrees of severity. One main characteristic is behavioral problems such as aggressive or self-injurious behavior. The child may
be either over active or passive. They may exhibit odd or ritualistic behaviors such as rocking back and forth or waving their hands. They may also have a resistance to change in normal routines. Sometimes the child may have an extraordinary talent in art, music, math, or some other area.

I once thought autism meant a lot of inabilities: cannot talk, cannot switch topics, cannot give eye contact, cannot handle transitions or new routines, cannot read social cues, cannot control motor movements, etc. And I once thought some of the can-dos were not necessarily “adaptive” (as they say in the psychological and educational literature):Alzheimer’s Disease and Autism Paper perseverates on the same activity or conversational topic, gets anxious in uncertain situations, uses aggressive and/or destructive behavior, engages in self-injurious behavior.  In my early days as a professional, I assumed – as too many people still do – that intellectual disability was a part of the package. So what happened to change my views on all of this? I got to know some autistic people who had acquired the ability to communicate, verbally or through pictures/typing, as well as some who did not yet communicate in any kind of traditional manner. I read the writings of autistic people. I listened to parents who said that, despite the testing results, they KNEW that their child was smart and understood what was going on. I listened to them say that their child was not only empathetic, but almost preternaturally so. I began to “presume competence” rather than make assumptions on face value. And I paid attention (or at least tried) in order to interpret meaning from the point of view of the people I met, not just from my own neurotically point of view. There are still too many people who make important life decisions FOR autistic children and adults based on limited understandings and prejudicial attitude. Too many professionals have not really known, loved, or spent personal time with an autistic person; but rather base their authority on their professional training alone. Non-autistic people need to know and be helped to understand that our life experiences cannot be used to judge or value the behavior, appearance or needs of an autistic person. So that brings us to self-advocacy. We non-autistic people MUST listen and learn from those who are autistic. We must do what we can to support self-advocacy and dispel the myths about autism in the public and professional communities. The Autistic community must remain vigilant in its outreach, community education, insistence on “nothing about us without us,” and demand for inclusion in public policy decisions. Awareness of what it means to be autistic is still lacking for the world at large. Acceptance of autism as a natural condition in the human experience is necessary for real dialogue to occur.

It is thought that 4.5 million Americans suffer from Alzheimer’s Disease at the present time. The numbers are expected to increase to 14 million by the year 2050. After the age of 65 the likelihood of developing this disease significantly increases every five years. By the time people reach their mid 80’s the increases seem to level off, all of this according to the National Institute on Aging (NIA). With the diagnosis of Alzheimer’s disease a long process of decline occurs, usually slowly, that has a terrible impact on the patients with the disease and their families. Slowly but surely a person with Alzheimer’s disease loses their memory and ultimately, their entire identity and the ability to care for themselves. It is said that these losses occur backwards from the way they were acquired form birth until adulthood, with memory being destroyed first and the ability to dress or know who you are lastly. What is this disease and how does it impact on everyone?

Alzheimer’s disease is one form of dementia but not its only form. Dementia refers to the loss of the ability of a person to think and reason due to some type of brain disease. Alzheimer’s is one brain disease causing dementia but there are others. For example, there is something called a Multi Infarct Dementia. In this type of brain disease mini strokes occur that gradually destroy brain cells. A person is not aware of having these types of strokes because they are minor and occur without perception. Yet, each time it occurs the individual loses more of their mental capacities.Alzheimer’s Disease and Autism Paper

Alzheimer’s disease gradually deteriorates the brain and has the same effect as multi infarct dementia in that the ability to think and reason is lost. While both types of dementia’s usually occur after the age of 65, it can occur at any age with the result that there are unfortunate individuals who suffer this fate as early as age 50 and even much younger, but those are more rare cases.

During the early stages of Alzheimer’s the patient is usually aware that something is wrong. Their recent and short term memory is deeply affected so that they constantly misplace and cannot find items such as their household keys, wallet, pocket book, cell phone and other types of commonly used items. They also experience difficulty finding ordinary words when they are talking with friends and neighbors.

As the individual becomes aware that they are not functioning as well as they did formerly they become depressed. This depression probably results from an awareness that something is being lost that will never be regained.

It is at this point that a combination of the elderly individual and their family members consult a physician about what is going on. Patients may be brought to a psychiatrist for depression or to their family physician because there are concerns about deterioration in functional abilities on a daily basis.Alzheimer’s Disease and Autism Paper

Diagnosis of Alzheimer’s disease is not easy because it cannot be done without studying samples of brain tissue. Obviously, this cannot be done while the individual is alive. Therefore, a combination of neurological and psychological tests is given for symptoms of dementia. The psychological tests include a combination of memory, perceptual and mathematical tests to determine the patient’s short term and long term memory. In the early stages of Alzheimer’s disease, long term memory is intact while recent information, such as day, time and season may be forgotten or confused.

Patients undergoing these types of tests are often anxious because they are well aware that Alzheimer’s is under consideration. The examining physician must keep this in mind while doing the assessment as anxiety and depression are each capable of interfering with memory and thinking. Therefore, if all other factors are ruled out and the patient does poorly during the evaluation the Alzheimer’s diagnosis can be made.

Sometimes the question is asked as to why tell the patient they have Alzheimer’s disease if there is not cure? There are several compelling reasons for informing both the patient and family members:

Today, there are new medications that can slow the dementing process allowing the patient and family more quality time.Alzheimer’s Disease and Autism Paper
Although this diagnosis is unpleasant patients have a right to plan for their future. Such plans include where they want to live during the later stages of the illness, who in the family gets power of attorney to make financial and other decisions, and how they want their medical care to be decided for especially with such issues as whether or not they would want extraordinary measures to be taken to prolong their life at the end.
Patients also have a right to decide where they want to live while they are still in the early stages of the illness. Most elderly people feel comfortable living in their own home and prefer to not make themselves a burden on their children and grandchildren. During the middle stages of the sickness, there is often home help available for dementing patients including attendance in day programs for those with Alzheimer’s.

The Family:

This disease has a powerful effect on family members whether they are the healthy elderly spouse or the children of the patient. Either way, the dementing process puts a burden on the caretakers in the family that will open up the most terrible and wrenching emotional experiences that it is possible to imagine. Why and how is this?Alzheimer’s Disease and Autism Paper

It is surreal for loved ones to watch their wife or husband of sixty years or their mother or father disappear in front of their eyes even though this person continues to live and breath. The way in which family members react to caring for the patient depends a lot on what kind of history both patient and family member had together whether it’s a spouse, son or daughter.

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A hypothetical example:

Example: A daughter (Irene) is caring for her mother who is 60 years old and was diagnosed with Alzheimer’s two years ago. The mother (Martha) lives alone in her apartment in Brooklyn New York. The patient is a widow and has been for five years now. The daughter, who is married and has teenage children who are in High School in Westchester, is torn between her responsibilities to her husband and children and to her mother. The trouble is that she and her mother have never gotten along with one another.

Irene experiences her mother’s behavior as maddening and stubborn, just as she always has.Alzheimer’s Disease and Autism Paper From as far back as she can remember, her mother was controlling, stubborn and unreasoning. Because her mother cannot remember where she places her house keys, Irene bought her a small wooden box with a door and hooks and mounted it on the wall next to the exit to the apartment. She showed her mother how to store the key and made her promise to use it. Despite repeated reminders her mother “refuses” to use the new key box when she comes home and loses her keys. In fact any arrangements she has made to make her mother’s life easier ends up being undone. Irene feels nothing but exasperation and rage at her mother. They get into yelling matches which is no problem for her mother who was always argumentative and seems to be more so these days. Why does Irene get so exasperated? Every time that Martha loses something she calls Irene, desperate, confused and angry that she cannot find what she is looking for. At the very same time, Martha feels treated like an infant by her daughter just because she asks her for a little help.

Irene knows that her mother has dementia. But racing down to the Bronx to help her mother cope with her life is just too much when she has so much of her own life to take care of. when she suggests to her mother that they move her into her (Irene’s) house in Westchester and that the kids and her husband would love to have her, she flatly refuses and that also exasperates Irene.

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This example is merely a mild case of what happens between patient and family. I could also point out that Irene has three brothers none of whom will help in any way. However, all three brothers are very concerned that Mom’s money not be spent “frivolously” on social home services. They want to be sure that get their full inheritance and that neither Mom nor Irene do nothing dumb to threaten the estate they expect to inherit, especially since, in their view, that estates comes from their late Dad.Alzheimer’s Disease and Autism Paper

The situation with Martha will worsen as the dementia deepens. She will begin to forget where she lives and get lost even when she walks around the corner from her home. She will find it increasingly difficult to remember her address as well as Irene’s telephone number. In fact, she has already had a couple of potentially disastrous consequences when she boiled water for tea and forgot to turn the burner off. She even cooked something in the microwave and forgot that tin foil coverings should not enter the microwave as anything metal can cause a fire.

Ultimately, Irene will be faced with two alternatives for her mother: 1. place her in a nursing home for her own safety or 2. get 24 hour home care for her mother, either in the apartment in the Bronx or in her own home in Westchester. In the end, if her mother begins wandering out of her apartment during the day and night and gets lost there will be no other choice but to have her placed in a nursing home. This idea fills her with guilt and with dread for having to deal with her unsympathetic brothers.

Treatment Options:

Progress is being made in discovering the causes and treatment of Alzheimer’s disease and, perhaps either a cure or effective treatment to stop further deterioration will be available. As stated above, there are now medications that can slow the dementing process and give people more quality time. Anti depressant medications are also used to slow or stop the depression experienced by these people in the early and middle stages of the disease. Later on anti depressants will make no difference. So, what else is available?

Music therapy: In the context of the nursing home music therapy has been found to be an effective treatment for dementing patients. Music therapy is calming and soothing. In addition, effective music therapists select music selections that appeal to the ethnic background and history of the particular patient. It has been reported that even at the late stages of the disease, music reawakens lost memories of days gone by and even the most demented patient is able to indicate significant responses because something in the music has stirred the brain cells.Alzheimer’s Disease and Autism Paper
Art Therapy: Art therapy can be calming and soothing for patients still able to hold paper and pencils. For those who cannot, looking at works of art of all types and kinds can stir memories, feelings and evoke positive reactions, besides being very soothing.
Pet Assisted Therapy: There is a wealth of anecdotal evidence as well as accumulating research evidence that the presence of pets in both the homes of patients as well as in their nursing homes has great beneficial effects. One study showed that the presence of an aquarium in the nursing home dining room resulted in patients eating more food than before. In addition, having people bringing therapy or comfort dogs to visit patients in nursing homes increases their socialization and responsiveness as compared to not having such visits.

In the end, there is no cure for Alzheimer’s disease, at least no yet and not for a long time. Among those who need a lot of emotional support and psychotherapy are the care takers of these patients, whether they are caretaking family members or at home professional and semi professional staff who visit the homes of such patients. Alzheimer’s patients, in their agitation and anger, can become quite verbally and even physically abusive, especially at the later stages of the illness.

The type of person these patients were during the course of their lives does not seem to matter. The intellectually gifted, kindest and gentlest people undergo profound and tragic changes as the disease causes them to spiral down into oblivion.

It can take up to twenty years for a person to die as a result of this dementia. There are many who pass away a lot sooner than that.

Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills, and, eventually, the ability to carry out the simplest tasks. In most people with Alzheimer’s, symptoms first appear in their mid-60s. Estimates vary, but experts suggest that more than 5.5 million Americans, most of them age 65 or older, may have dementia caused by Alzheimer’s.Alzheimer’s Disease and Autism Paper

Alzheimer’s disease is currently ranked as the sixth leading cause of death in the United States, but recent estimates indicate that the disorder may rank third, just behind heart disease and cancer, as a cause of death for older people.

Alzheimer’s is the most common cause of dementia among older adults. Dementia is the loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities to such an extent that it interferes with a person’s daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person’s functioning, to the most severe stage, when the person must depend completely on others for basic activities of daily living.

The causes of dementia can vary, depending on the types of brain changes that may be taking place. Other dementia’s include Lewy body dementia, frontotemporal disorders, and vascular dementia. It is common for people to have mixed dementia—a combination of two or more types of dementia. For example, some people have both Alzheimer’s disease and vascular dementia.

Alzheimer’s disease is named after Dr. Alois Alzheimer. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior. After she died, he examined her brain and found many abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary, or tau, tangles).

These plaques and tangles in the brain are still considered some of the main features of Alzheimer’s disease. Another feature is the loss of connections between nerve cells (neurons) in the brain. Neurons transmit messages between different parts of the brain, and from the brain to muscles and organs in the body.

Changes in the Brain

Scientists continue to unravel the complex brain changes involved in the onset and progression of Alzheimer’s disease. It seems likely that changes in the brain may begin a decade or more before memory and other cognitive problems appear. During this clinical stage of Alzheimer’s disease, people seem to be symptom-free, but toxic changes are taking place in the brain. Abnormal deposits of proteins form amyloid plaques and tau tangles throughout the brain. Once-healthy neurons stop functioning, lose connections with other neurons, and die. Many other complex brain changes are thought to play a role in Alzheimer’s, too.Alzheimer’s Disease and Autism Paper

The damage initially appears to take place in the hippocampus and the entorhinal cortex, parts of the brain essential in forming memories. As more neurons die, additional parts of the brain are affected and begin to shrink. By the final stage of Alzheimer’s, damage is widespread, and brain tissue has shrunk significantly.

Signs and Symptoms

Memory problems are typically one of the first signs of cognitive impairment related to Alzheimer’s disease. Some people with memory problems have a condition called mild cognitive impairment (MCI). In MCI, people have more memory problems than normal for their age, but their symptoms do not interfere with their everyday lives. Movement difficulties and problems with the sense of smell have also been linked to MCI. Older people with MCI are at greater risk for developing Alzheimer’s, but not all of them do. Some may even go back to normal cognition.

The first symptoms of Alzheimer’s vary from person to person. For many, decline in non-memory aspects of cognition, such as word-finding, vision/spatial issues, and impaired reasoning or judgment, may signal the very early stages of Alzheimer’s disease. Researchers are studying bio markers (biological signs of disease found in brain images, cerebrospinal fluid, and blood) to detect early changes in the brains of people with MCI and in cognitively normal people who may be at greater risk for Alzheimer’s. Studies indicate that such early detection is possible, but more research is needed before these techniques can be used routinely to diagnose Alzheimer’s disease in everyday medical practice.Alzheimer’s Disease and Autism Paper

Mild Alzheimer’s Disease

As Alzheimer’s disease progresses, people experience greater memory loss and other cognitive difficulties. Problems can include wandering and getting lost, trouble handling money and paying bills, repeating questions, taking longer to complete normal daily tasks, and personality and behavior changes. People are often diagnosed in this stage.

Moderate Alzheimer’s Disease

In this stage, damage occurs in areas of the brain that control language, reasoning, sensory processing, and conscious thought. Memory loss and confusion grow worse, and people begin to have problems recognizing family and friends. They may be unable to learn new things, carry out multi step tasks such as getting dressed, or cope with new situations. In addition, people at this stage may have hallucinations, delusions, and paranoia and may behave impulsively.

Severe Alzheimer’s Disease

Ultimately, plaques and tangles spread throughout the brain, and brain tissue shrinks significantly. People with severe Alzheimer’s cannot communicate and are completely dependent on others for their care. Near the end, the person may be in bed most or all of the time as the body shuts down.Alzheimer’s Disease and Autism Paper

What Causes Alzheimer’s?

Scientists don’t yet fully understand what causes Alzheimer’s disease in most people. In people with early-onset Alzheimer’s, a genetic mutation may be the cause. Late-onset Alzheimer’s arises from a complex series of brain changes that occur over decades. The causes probably include a combination of genetic, environmental, and lifestyle factors. The importance of any one of these factors in increasing or decreasing the risk of developing Alzheimer’s may differ from person to person.

The Basics of Alzheimer’s

Scientists are conducting studies to learn more about plaques, tangles, and other biological features of Alzheimer’s disease. Advances in brain imaging techniques allow researchers to see the development and spread of abnormal amyloid and tau proteins in the living brain, as well as changes in brain structure and function. Scientists are also exploring the very earliest steps in the disease process by studying changes in the brain and body fluids that can be detected years before Alzheimer’s symptoms appear. Findings from these studies will help in understanding the causes of Alzheimer’s and make diagnosis easier.

One of the great mysteries of Alzheimer’s disease is why it largely strikes older adults. Research on normal brain aging is exploring this question. For example, scientists are learning how age-related changes in the brain may harm neurons and affect other types of brain cells to contribute to Alzheimer’s damage. These age-related changes include atrophy (shrinking) of certain parts of the brain, inflammation, vascular damage, production of unstable molecules called free radicals, and mitochondrial dysfunction (a breakdown of energy production within a cell).

Alzheimer’s Disease is one of the biggest concerns many of us have as we get older. While you may have been told that all you can do is hope for the best and wait for a pharmaceutical cure, the truth is much more encouraging. Promising research shows that you can reduce your risk of Alzheimer’s and other dementias through a combination of simple but effective lifestyle changes. By leading a brain-healthy lifestyle, you may be able to prevent the symptoms of Alzheimer’s disease and slow down, or even reverse, the process of deterioration.

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Can Alzheimer’s and dementia be prevented?

The thought of developing Alzheimer’s disease as you get older can be a frightening prospect, especially if you’ve witnessed a loved one affected by the disease. Researchers across the world are racing towards a cure, but as prevalence rates climb, their focus has broadened from treatment to prevention strategies. What they’ve discovered is that it may be possible to prevent or delay the symptoms of Alzheimer’s disease and other dementias through a combination of healthy habits.Alzheimer’s Disease and Autism Paper

By identifying and controlling your personal risk factors, you can maximize your chances of lifelong brain health and take effective steps to preserve your cognitive abilities.

Alzheimer’s is a complex disease with multiple risk factors. Some, like your age and genetics, are outside your control. However, there are six pillars for a brain-healthy lifestyle that are within your control.

The more you strengthen each of the six pillars in your daily life, the longer—and stronger—your brain will stay working and the more likely you’ll be able to reduce your risk of developing dementia.

Pillar #1: Regular exercise

According to the Alzheimer’s Research & Prevention Foundation, regular physical exercise can reduce your risk of developing Alzheimer’s disease by up to 50 percent. What’s more, exercise can also slow further deterioration in those who have already started to develop cognitive problems. Exercise protects against Alzheimer’s and other types of dementia by stimulating the brain’s ability to maintain old connections as well as make new ones.

Aim for at least 150 minutes of moderate intensity exercise each week. The ideal plan involves a combination of cardio exercise and strength training. Good activities for beginners include walking and swimming.

Build muscle to pump up your brain. Moderate levels of weight and resistance training not only increase muscle mass, they help you maintain brain health. For those over 65, adding 2-3 strength sessions to your weekly routine may cut your risk of Alzheimer’s in half.

Include balance and coordination exercises. Head injuries from falls are an increasing risk as you age, which in turn increase your risk for Alzheimer’s disease and dementia. Balance and coordination exercises can help you stay agile and avoid spills. Try yoga, Tai Chi, or exercises using balance balls.

Tips for starting and sticking with an exercise plan

If you’ve been inactive for a while, starting an exercise program can be intimidating. But remember: a little exercise is better than none. In fact, adding just modest amounts of physical activity to your weekly routine can have a profound effect on your health. Choose activities you enjoy and start small—a 10-minute walk a few times a day, for example—and allow yourself to gradually build up your momentum and self-confidence. It takes about 28 days for a new routine to become habit, so do your best to stick with it for a month and soon your exercise routine will feel natural, even something you miss if you skip a session.Alzheimer’s Disease and Autism Paper

Protect your head

Head trauma at any point in life may increase your risk of Alzheimer’s disease. This includes repeated hits in sports activities such as football, soccer, and boxing, or one-time injuries from a bicycle, skating, or motorcycle accident. Protect your brain by wearing properly fitting sports helmets and trip-proofing your environment as you exercise. Avoid activities that compete for your attention—like talking on your cell while walking or cycling.

Pillar #2: Social engagement

Human beings are highly social creatures. We don’t thrive in isolation, and neither do our brains. Staying socially engaged may even protect against Alzheimer’s disease and dementia in later life, so make developing and maintaining a strong network of friends a priority.

You don’t need to be a social butterfly or the life of the party, but you do need to regularly connect face-to-face with someone who cares about you and makes you feel heard. While many of us become more isolated as we get older, it’s never too late to meet others and develop new friendships:

Volunteer
Join a club or social group
Visit your local community center or senior center
Take group classes (such as at the gym or a community college)
Reach out over the phone or email
Connect to others via social networks such as Facebook
Get to know your neighbors
Make a weekly date with friends
Get out (go to the movies, the park, museums, and other public places)
Pillar #3: Healthy diet

In Alzheimer’s disease, inflammation and insulin resistance injure neurons and inhibit communication between brain cells. Alzheimer’s is sometimes described as “diabetes of the brain,” and a growing body of research suggests a strong link between metabolic disorders and the signal processing systems. By adjusting your eating habits, however, you can help reduce inflammation and protect your brain.

Cut down on sugar. Sugary foods and refined carbs such as white flour, white rice, and pasta can lead to dramatic spikes in blood sugar which inflame your brain. Watch out for hidden sugar in all kinds of packaged foods from cereals and bread to pasta sauce and low or no-fat products.Alzheimer’s Disease and Autism Paper

Enjoy a Mediterranean diet. Several epidemiological studies show that eating a Mediterranean diet dramatically reduces the risk of cognitive impairment and Alzheimer’s disease. That means plenty of vegetables, beans, whole grains, fish and olive oil—and limited processed food.

Avoid trans fats. These fats can cause inflammation and produce free radicals—both of which are hard on the brain. Reduce your consumption by avoiding fast food, fried and packaged foods, and anything that contains “partially hydrogenated oils,” even if it claims to be trans fat-free.

Get plenty of omega-3 fats. Evidence suggests that the DHA found in these healthy fats may help prevent Alzheimer’s disease and dementia by reducing beta-amyloid plaques. Food sources include cold-water fish such as salmon, tuna, trout, mackerel, seaweed, and sardines. You can also supplement with fish oil.

Stock up on fruit and vegetables. When it comes to fruits and vegetables, the more the better. Eat up across the color spectrum to maximize protective antioxidants and vitamins, including green leafy vegetables, berries, and cruciferous vegetables such as broccoli.Alzheimer’s Disease and Autism Paper

Enjoy daily cups of tea. Regular consumption of great tea may enhance memory and mental alertness and slow brain aging. White and oolong teas are also particularly brain healthy. Drinking 2-4 cups daily has proven benefits. Although not as powerful as tea, coffee also confers brain benefits.

Cook at home often. By cooking at home, you can ensure that you’re eating fresh, wholesome meals that are high in brain-healthy nutrients and low in sugar, salt, unhealthy fat, and additives.

Supplements that may help prevent dementia

Folic acid, vitamin B12, vitamin D, magnesium, and fish oil may help to preserve brain health. Studies of vitamin E, ginkgo biloba, coenzyme Q10, and turmeric have yielded less conclusive results, but may also be beneficial in preventing or delaying Alzheimer’s and dementia symptoms.

Always talk to your doctor about possible medication interactions.

Pillar #4: Mental stimulation

Those who continue learning new things and challenging their brains throughout life are less likely to develop Alzheimer’s disease and dementia. In essence, you need to “use it or lose it.” In the groundbreaking NIH ACTIVE study, older adults who received as few as 10 sessions of mental training not only improved their cognitive functioning in daily activities in the months after the training, but continued to show long-lasting improvements 10 years later.

Activities involving multiple tasks or requiring communication, interaction, and organization offer the greatest protection. Set aside time each day to stimulate your brain:

Learn something new. Study a foreign language, practice a musical instrument, learn to paint or sew, or read the newspaper or a good book. One of the best ways to take up a new hobby is to sign up for a class and then schedule regular times for practicing. The greater the novelty, complexity, and challenge, the greater the benefit.

Raise the bar for an existing activity. If you’re not keen on learning something new, you can still challenge your brain by increasing your skills and knowledge of something you already do. For example, if you can play the piano and don’t want to learn a new instrument, commit to learning a new piece of music or improving how well you play your favorite piece. Or if you’re a golfer, aim to lower your handicap.Alzheimer’s Disease and Autism Paper

Practice memorization. Start with something short, progressing to something a little more involved, such as the 50 U.S. state capitals. Create rhymes and patterns to strengthen your memory connections.

Enjoy strategy games, puzzles, and riddles. Brain teasers and strategy games provide a great mental workout and build your capacity to form and retain cognitive associations. Do a crossword puzzle, play board games, cards, or word and number games such as Scrabble or Sudoku.

Practice the 5 W’s. Observe and report like a crime detective. Keep a “Who, What, Where, When, and Why” list of your daily experiences. Capturing visual details keeps your neurons firing.

Follow the road less traveled. Take a new route, eat with your non-dominant hand, rearrange your computer file system. Vary your habits regularly to create new brain pathways.

Pillar #5: Quality sleep

It’s common for people with Alzheimer’s disease to suffer from insomnia and other sleep problems. But new research suggests that disrupted sleep isn’t just a symptom of Alzheimer’s, but a possible risk factor. An increasing number of studies have linked poor sleep to higher levels of beta-amyloid, a sticky brain-clogging protein that in turn further interferes with sleep—especially with the deep sleep necessary for memory formation. Other studies emphasize the importance of uninterrupted sleep for flushing out brain toxins.Alzheimer’s Disease and Autism Paper

If nightly sleep deprivation is slowing your thinking and affecting your mood, you may be at greater risk of developing symptoms of Alzheimer’s disease. The vast majority of adults need at least 8 hours of sleep per night.

Get screened for sleep apnea. If you’ve received complaints about your snoring, you may want to get tested for sleep apnea, a potentially dangerous condition where breathing is disrupted during sleep. Treatment can make a huge difference in both your health and sleep quality.

Establish a regular sleep schedule. Going to bed and getting up at the same time reinforces your natural circadian rhythms. Your brain’s clock responds to regularity.

Be smart about napping. While taking a nap can be a great way to recharge, especially for older adults, it can make insomnia worse. If insomnia is a problem for you, consider eliminating napping. If you must nap, do it in the early afternoon, and limit it to thirty minutes.

Set the mood. Reserve your bed for sleep and sex, and ban television and computers from the bedroom (both are stimulating and may lead to difficulties falling asleep).

Create a relaxing bedtime ritual. Take a hot bath, do some light stretches, write in your journal, or dim the lights. As it becomes habit, your nightly ritual will send a powerful signal to your brain that it’s time for deep restorative sleep.

Quiet your inner chatter. When stress, anxiety, or negative internal dialogues keep you awake, get out of bed. Try reading or relaxing in another room for twenty minutes then hop back in.

Pillar #6: Stress management

Chronic or persistent stress can take a heavy toll on the brain, leading to shrinkage in a key memory area, hampering nerve cell growth, and increasing the risk of Alzheimer’s disease and dementia. Yet simple stress management tools can minimize its harmful effects.

Breathe! Quiet your stress response with deep, abdominal breathing. Restorative breathing is powerful, simple, and free!Alzheimer’s Disease and Autism Paper

Schedule daily relaxation activities. Keeping stress under control requires regular effort. Make relaxation a priority, whether it’s a walk in the park, playtime with your dog, yoga, or a soothing bath.

Nourish inner peace. Regular meditation, prayer, reflection, and religious practice may immunize you against the damaging effects of stress.

Make fun a priority. All work and no play is not good for your stress levels or your brain. Make time for leisure activities that bring you joy, whether it be stargazing, playing the piano, or working on your bike.

Keep your sense of humor. This includes the ability to laugh at yourself. The act of laughing helps your body fight stress.

Other tips to reduce the risk of Alzheimer’s

Just as what’s good for the body is also good for the brain, so too is the converse: what’s bad for the body is bad for the brain.

Stop smoking. Smoking is one of the most preventable risk factors for Alzheimer’s disease and dementia. One study found that smokers over the age of 65 have a nearly 80% higher risk of Alzheimer’s than those who have never smoked. When you stop smoking, the brain benefits from improved circulation almost immediately.

Control blood pressure and cholesterol levels. Both high blood pressure and high total cholesterol are associated with an increased risk of Alzheimer’s disease and vascular dementia. Improving those numbers are good for your brain as well as your heart.Alzheimer’s Disease and Autism Paper

Watch your weight. Extra pounds are a risk factor for Alzheimer’s disease and other types of dementia. A major study found that people who were overweight in midlife were twice as likely to develop Alzheimer’s down the line, and those who were obese had three times the risk. Losing weight can go a long way to protecting your brain.

Drink only in moderation. While there appear to be brain benefits in consuming red wine in moderation, heavy alcohol consumption can dramatically raise the risk of Alzheimer’s and accelerate brain aging.

What is Alzheimer’s disease?

Alzheimer’s disease is the most common form of dementia, affecting up to 70% of all people with dementia. It was first recorded in 1907 by Dr Alois Alzheimer. Dr Alzheimer reported the case of Auguste Deter, a middle-aged woman with dementia and specific changes in her brain. For the next 60 years Alzheimer’s disease was considered a rare condition that affected people under the age of 65. It was not until the 1970s that Dr Robert Katzman declared (rather boldly at the time) that “senile dementia” and Alzheimer’s disease were the same condition and that neither were a normal part of aging.

Alzheimer’s disease can be either sporadic or familial.

Sporadic Alzheimer’s disease can affect adults at any age, but usually occurs after age 65 and is the most common form of Alzheimer’s disease.Alzheimer’s Disease and Autism Paper

Familial Alzheimer’s disease is a very rare genetic condition, caused by a mutation in one of several genes. The presence of mutated genes means that the person will eventually develop Alzheimer’s disease, usually in their 40’s or 50’s.

The Healthy Human Brain

The whole brain is fed and provided with oxygen by a complex network of arteries, veins and capillaries. This vascular network is strictly controlled and segregates the brain from the rest of the blood stream. The blood brain barrier protects the brain from infection, but consequently if the brain does become infected it is difficult to treat, as many antibiotics are too large in their molecular structure to cross the barrier. This is also a major problem when finding agents to treat Alzheimer’s disease, as they must pass this barrier to target the brain.

Behind the ears and temples are the temporal lobes of the brain. These regions process speech and working memory, and also ‘higher’ emotions such as empathy, morality and regret. Beneath the forebrain are the more primitive brain regions such as the limbic system. The limbic system is a structure that is common to all mammals and processes our desires and many emotions. Also in the limbic system is the hippocampus – a region that is vital for forming new memories.Alzheimer’s Disease and Autism Paper

The cerebellum is at the back of the brain, which stores our muscle memory so we can do things without thinking – such as riding a bike. The midbrain and brain stem are the most primitive regions of the brain. They control bodily functions such as heart rate and digestion and act as an interface between the spinal cord and the rest of the brain.

All these complex tasks are mediated by the connections between the brain cells (neurons) called synapses. In the adult human brain there are around 100 billion brain cells, each connected to its neighbours by 5-10,000 synapses.

Our brains form a million new connections – a million new synapses – every second we are alive. The pattern and strength of the connections is constantly changing and no two brains are alike.

It is in these changing connections that memories are stored, habits learned and personalities shaped, by reinforcing certain patterns of brain activity, and losing others.

Brain cells communicate though synapses in a variety of ways. Signals pass move across the synapse in the form of chemicals that are known as neurotransmitters. Neurotransmitters a passed from one brain cell, across the synapse (connection) and to the receiving brain cell, which collects the neurotransmitter with a receptor. The receiving cell can then send out another burst of neurotransmitters to other brain cells to pass the message on.Alzheimer’s Disease and Autism Paper

The Brain with Alzheimer’s Disease

Going back to the 1900s, Dr Alzheimer examined the brain of his patient, Mrs Deter, upon her death. He found shrinking of the outer layer of the brain or cortex – the region of the brain involved in memory, language and judgment. We know that the so called shrinking of the brain is caused by the death of the brain cells.

Dr Alzheimer also found two types of deposits in Deter’s brain. One kind was found outside the brain cells, which are known plaques and the other type of deposit was found inside brain cells known as “neurofibrillary tangles. These plaques impair synapses so signals cannot pass between brain cells. Tangles kill brain cells by preventing the normal transport of food and energy around the brain cell.

As brain cells die the brain shrinks, which can be detected using imaging such as magnetic resonance imaging (MRI).

The outer part of the brain is usually the area affected first by the disease. Short-term memory loss is therefore one of the first symptoms of Alzheimer’s disease. But as the disease progresses to deeper parts of the brain, long-term memory is also lost. The disease also affects many of the brain’s other functions and consequently, many other aspects of behaviour are disturbed.

Apart from the few individuals with Familial Alzheimer’s disease, it is not known why one individual gets Alzheimer’s disease late in life and another does not. Scientists are investigating what triggers the formation of plaques and tangles and about other chemical changes that damage brain cells in Alzheimer’s disease.

A variety of suspected causes are being investigated including factors in the environment, biochemical disturbances and immune processes. The cause may vary from person to person and may be due to one factor or a number of factors.Alzheimer’s Disease and Autism Paper

Symptoms of Alzheimer’s disease

In the early stages the symptoms of Alzheimer’s disease can be very subtle. However, it often begins with lapses in memory and difficulty in finding the right words for everyday objects.

Other symptoms may include:

Persistent and frequent memory difficulties, especially of recent events
Vagueness in everyday conversation
Apparent loss of enthusiasm for previously enjoyed activities
Taking longer to do routine tasks
Forgetting well-known people or places
Inability to process questions and instructions
Deterioration of social skills
Emotional unpredictability

Symptoms vary and the disease progresses at a different pace according to the individual and the areas of the brain affected. A person’s abilities may fluctuate from day to day, or even within the one day, becoming worse in times of stress, fatigue or ill-health.Alzheimer’s Disease and Autism Paper

How does Alzheimer’s disease progress?

The rate of progression of the disease varies from person to person.

However, the disease does lead eventually to complete dependence and finally death, usually from another illness such as pneumonia. A person may live from three to twenty years with Alzheimer’s disease, with the average being seven to ten years.

How is Alzheimer’s disease diagnosed?

There is currently no single test to identify Alzheimer’s disease. The diagnosis is made only after careful clinical consultation.

The clinical diagnosis might include:

A detailed medical history
A thorough physical and neurological examination
A test of intellectual function
Psychiatric assessment
A neuropsychological tests
Blood and urine tests
Lumbar puncture for cerebral spinal fluid tests
Medical imaging (MRI, PET)

These tests will help to eliminate other conditions with similar symptoms such as nutritional deficiencies or depression. After eliminating other causes, a clinical diagnosis of Alzheimer’s disease can be made with about 80% to 90% accuracy if the symptoms and signs are appropriate. The diagnosis can only be confirmed after death by examination of the brain tissue.

It is important to have an early and accurate diagnosis to determine whether a treatable condition other than Alzheimer’s disease, is causing the symptoms. If Alzheimer’s disease is diagnosed, medical treatment and other assistance can be discussed.

Is there treatment available?

At present there is no cure for Alzheimer’s disease. However, one group of drugs called cholinergeric drugs appears to be providing some temporary improvement in cognitive functioning for some people with mild to moderate Alzheimer’s disease.

Drugs can also be prescribed for secondary symptoms such as restlessness or depression or to help the person with dementia sleep better.Alzheimer’s Disease and Autism Paper

Community support is available for the person with Alzheimer’s disease, their families and carers. This support can make a positive difference to managing dementia. Dementia Australia provides support, information and counselling for people affected by dementia. Dementia Australia also aims to provide up-to-date information about drug treatments.

Dementia can affect how people feel, act and function as well as their health. Symptoms usually include the gradual loss of memory and communication skills, and a decline in the ability to think and reason clearly. People may be less able to carry out ordinary daily activities.

Currently around 850,000 people in the UK are affected by dementia.

What is Alzheimer’s disease?

Alzheimer’s disease is the most common cause of dementia, affecting around six in every 10 people with dementia.  Alzheimer’s may also occur with other types of dementia, such as vascular dementia or dementia with Lewy bodies. You might hear this called ‘mixed dementia’.Alzheimer’s Disease and Autism Paper

Alzheimer’s becomes more common with advancing age, but it’s not a normal part of ageing. The majority of people who develop the disease are over the age of 65.

More rarely, Alzheimer’s can affect younger people. It’s thought that over 42,000, or around 5% of people with Alzheimer’s are under 65. These rare cases of the disease are called early-onset Alzheimer’s.

In Alzheimer’s disease, changes occur in the brain that go beyond those associated with normal ageing. These changes include the build-up of two proteins, called amyloid and tau. Although researchers don’t yet have a complete understanding of what triggers Alzheimer’s, research suggests that both proteins are involved in driving the disease. As Alzheimer’s progresses, more and more nerve cells in the brain become damaged. This damage leads to the symptoms of Alzheimer’s.

With our help, researchers are learning more about why these proteins build up in the brain and how they damage nerve cells. Research is underway to understand more about what happens in the brain during Alzheimer’s and find new ways to treat the disease.Alzheimer’s Disease and Autism Paper