This memorable quote from one of the most popular movies of the century is how the narrator chooses to describe the ailment his wife suffers from. Their physician, Dr. Barnwell, explains further: "It's a degenerative brain disorder affecting memory and personality with no cure or therapy, and there's no way of telling how fast it will progress. It differs from person to person. Some days will be better than others. It will grow worse with the passage of time."
How has our understanding of this condition changed over the last 25 years since Mr. Sparks first penned these words in 1996?
Alzheimer's Disease, the most common cause of dementia, is now understood to progress through five different stages: (1) Preclinical Alzheimer's Disease (where there may be no symptoms, but test results are positive for having the disease) (2) Mild cognitive impairment due to Alzheimer's (mild symptoms may appear) (3) Mild dementia (4) Moderate dementia (5) Severe dementia.
Here are four facts about this disease that every patient, caregiver, or loved one should be aware of:
You are not alone in Alzheimer's Disease:Someone is diagnosed with Alzheimer's Disease in the United States every 65 seconds. The prevalence of the disease doubles every five years after the age of 65, with one in three deaths due to Alzheimer's or another form of dementia.The mortality of the disease has been on the rise in the United States with an estimated 145% increase in deaths from Alzheimer's between 2000 and 2017.
You may be at risk: Besides non-preventable risk factors such as aging and genetics, there are other risk factors associated with developing Alzheimer's earlier in life. These include head trauma (anywhere from mild concussion to moderate to severe traumatic brain injury) and cardiovascular risk factors (such as diabetes, hypertension, or cigarette smoking). Newer research, such as Mander et al 2105 and Holth et al 2019 has shown that chronic sleep deprivation is also a risk factor that may lead to problems with memory consolidation.
You can reduce your risk: Reducing cardiovascular risk factors—especially hypertension—with antihypertensive medications has shown added benefits in preventing dementia and lowering the risk of mild cognitive impairment (MCI). Mediterranean diets high in fruits, vegetables, grains, and seeds have also been shown to reduce both cardiovascular and dementia risks, as shown in Scarmeas et al 2006, among other studies. Read more about what you can do to lower your risk of Alzheimer's Disease here!
You can detect it: You may detect Alzheimer's even before symptoms have set in. Abnormal developments and processes in the brain can be identified through various tests and imaging techniques, which can be used for the early detection of Alzheimer's. Read about some of the current research on better diagnosing Alzheimer's Disease here!
You can further reduce your risk through exercise (which has many cognitive benefits), eating lots of vitamin E (which helps slow down the progression of dementia as shown by Dysken et al 201410), and practicing good sleep habits (which may be helpful in preventing early onset of the disease).
Though the understanding of Alzheimer's hasn't changed significantly from Dr. Barnwell's explanation in The Notebook, there has been a wealth of new information gained regarding the progression, risk factors, risk reduction, and the early detection of Alzheimer's Disease.