What Everybody Needs to Know

Alzheimer’s Disease (AD) Defined
Diagnosis Makes a Difference!
How are Dementia and Alzheimer’s Different from “Normal Aging” and Forgetfulness?
Warning Signs
Care Partners: Roles, Risks and Remembering You’re Not Alone

Alzheimer’s Disease (AD) Defined

Alzheimer’s disease (AD) is the most common cause of dementia. It is a progressive and terminal disease that starts in the brain, destroying memory and thinking skills and eventually, the ability to carry out the simplest tasks of daily living.

In most people with AD, symptoms first appear after age 60. The changes typically occur slowly, over months and years not hours and days.

If the person has a sudden change in health status, living situation or caregiver system (for example, death of a spouse) he or she may APPEAR to change quickly. The brain has actually been changing slowly but since the person was in a routine, the person’s abilities weren’t being challenged and he or she was relying on OLD patterns and memories to function.

The pattern and progression of the disease is predictable BUT the experience is individual and ultimately, the person’s entire life is affected by AD.

AD usually starts in a region of the brain that affects recent memory, then gradually spreads to other parts of the brain. Although treatment can slow the progression of AD and help manage its symptoms in some people, currently there is no cure for this devastating disease.

AD is named after Dr. Alois Alzheimer, a German doctor. In 1906, Dr. Alzheimer described changes in the brain tissue of a woman who had died of an unusual mental illness. He found abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary tangles).

Today, these plaques and tangles in the brain are considered hallmarks of AD. The third main feature of AD is the gradual loss of connections between nerve cells (neurons) in the brain. This loss leads to diminished cell function and cell death.


Dementia is an “umbrella” medical term used to describe a set of symptoms causing a person to have changes in brain function that interfere with the ability to function and do everyday activities. Symptoms are typically caused by a disease, or condition, such as Alzheimer’s.

A person with dementia has problems in multiple areas of brain function. These problems can include; memory, language, impulse control, ability to do things for self, personality, understanding of time, etc.

Unlike normal age-related memory changes, dementia gets worse over time. Many diseases and disorders can cause dementia. Some can be reversed or cured and others cannot.  Reversible dementia symptoms include those caused by brain tumors, chronic alcohol abuse, poor nutrition, medication mismanagement and depression.

The most common irreversible cause of dementia is Alzheimer’s disease. Other common causes or types of dementia are:

    • Lewy body dementia
    • Frontotemporal dementia (FTD)
    • Vascular dementia (also called multi-infarct dementia)
    • Mixed dementia (more than one type of dementia occurring in the same brain)

Different types of dementia impact the brain in different ways, have different symptoms, cause changes in different abilities…in different orders…and at different rates.

Diagnosis Makes a Difference

Early diagnosis is important and accurate diagnosis is critical.

Early treatment is more effective than waiting. Plus early and accurate diagnosis allows for better planning and opportunity to include the person with dementia in the process. Planning makes a difference in options the person may have as the disease leads to changes in abilities and needs.

How is Alzheimer’s disease diagnosed?

Clinicians can now diagnose Alzheimer’s disease with up to 90 percent accuracy. But it can only be confirmed by an autopsy, during which pathologists look for the disease’s characteristic plaques and tangles in brain tissue.

Diagnosis is complicated and includes gathering lots of information, including the following:

    1. History of the changes
    2. Health history
    3. Medication review
    4. Physical exam (especially focusing on neurological and cardiovascular systems)
    5. Laboratory studies
    6. Imaging study of the brain (MRI, CT, PET)
    7. Cognitive assessment
    8. Emotional assessment
    9. Others (ECG, EEG etc. as indicated)

 These tests may be repeated to give doctors information about how the person’s health and memory are changing over time. Sometimes these tests help doctors find other possible causes of the person’s symptoms. For example, thyroid problems, drug reactions, depression, brain tumors, and blood-vessel disease in the brain can cause Alzheimer’s-like symptoms. Some of these other conditions can be treated successfully.

Such tests also can help diagnose other causes of memory problems. These problems include mild cognitive impairment and vascular dementia. Mild cognitive impairment is a medical condition that causes people to have more memory problems than other people their age. Vascular dementia is a medical condition caused by small strokes or changes in the brain’s blood supply.

How are Dementia and Alzheimer’s Different from “Normal Aging” and Forgetfulness?

Normal aging includes being more forgetful, taking longer to learn new information, requiring more practice to learn new skills or technologies (you can do it, just have to try harder than before), having more trouble recalling people’s names, and knowing the word you want but hesitating.

It is not uncommon to lose or forget things every now and then. But, if memory problems get in the way of everyday living, it may be time to call for more information or to see a doctor.

Note the differences between the Warning Signs and signs of “normal aging” below.

Warning Signs

Every case of Alzheimer’s disease is different, but experts have identified common warning signs of the brain disease. Because treatments are more effective with early diagnosis, it is especially important to look for signs that might indicate Alzheimer’s disease versus basic forgetfulness.

Please review the following warning signs, and if you or someone you know is exhibiting these symptoms, please consult a healthcare professional. The locally-staffed Alzheimer’s Tennessee, Inc. HelpLine is prepared to offer you support, referrals and care consultations.  Contact our Knoxville Helpline at 865.544.6288 and our Cookeville Helpline at 931.526.8010.

Typical warning signs include the following:

    • Memory loss especially when it comes to recent or important events, names, placement of objects, and other new information.
      Versus sign of “normal aging”:
      Periodically and temporarily forget names, appointments, or where you left your keys.
    • Disorientation to time and place. Become lost on your own street or forget where you are, how you got there and how to return home.
      Versus sign of “normal aging”:
      Forget the day of the week or why you entered a room.
    • Struggle to complete familiar actions, such as brushing teeth, getting dressed, preparing a meal, or placing a telephone call.
      Versus sign of “normal aging”:
       Sometimes need assistance with an electronic device.
    • Trouble finding the appropriate words, completing sentences, and following directions and conversations. May repeat and call things by the wrong name.
      Versus sign of “normal aging”:
       Occasionally struggle to find the right word.
    • Poor judgment when making decisions, for example, wear several shirts on a warm day or give away large sums of money to solicitors. Versus sign of “normal aging”: Make questionable or debatable decisions at times.
    • Changes in mood and personality, such as increased suspicion, rapid and persistent mood swings, withdrawal, and disinterest in usual activities.
      Versus sign of “normal aging”:
      Feel fatigued by work and social obligations now and then or become irritable when a routine is disrupted.
    • Difficulty with complex mental assignments, such as balancing a checkbook or other tasks involving numbers or following directions.
      Versus sign of “normal aging”:
       Make a mistake when balancing a checkbook or leave an ingredient out of a recipe every now and then.

Care Partners: Roles, Risks and Remembering You’re Not Alone

Caring for a person with Alzheimer’s disease at home is a difficult task and can become overwhelming at times. Each day brings new challenges as the caregiver copes with changing levels of ability and new patterns of behavior.

Research has shown that caregivers themselves often are at increased risk for depression and illness, especially if they do not receive adequate support from family, friends, and the community.

One of the biggest struggles caregivers face is dealing with the difficult behaviors of the person they are caring for. Dressing, bathing, eating-basic activities of daily living-often become difficult to manage for both the person with Alzheimer’s and the caregiver.

Having a plan for getting through the day can help caregivers cope. Many caregivers have found it helpful to use strategies for dealing with difficult behaviors and stressful situations. Through trial and error you will find that some tips work, while others do not. Each person with Alzheimer’s is unique and will respond differently, and each person changes over the course of the disease.

Do the best you can, and remind yourself to take breaks. Ask for help and be very specific with your request. Do not ask “What would you be willing to do?” or “Can you help out?”  Instead ask, “Can you stay with mom on Thursday evening from 7 to 9 so I can go grocery shopping and stop by the pharmacy?” When people know the boundaries of a request they are much more likely to feel comfortable with helping.

Alzheimer’s Tennessee, Inc. offers “Caring & Coping” caregiver workshops throughout the year that focus on caregiving strategies.

Contact us for more information.


Ongoing research is helping us learn more about ways to maintain a healthy brain and about the risk factors for Alzheimer’s disease and other kinds of dementia.  AD develops over many years and appears to be affected by a number of factors that may increase or decrease a person’s chances of developing the disease. While age and family history are risk factors, other things such as diet, exercise, and lifestyle are believed to have an influence as well. We can’t control some of these risk factors, but we can control others.

Ways to maintain brain health

    • Manage health risks
    • Eat healthy
    • Get regular exercise
    • Engage your brain
    • Stay socially connected

Find more about these methods of Active Alzheimer’s Prevention here


There is no known cure for Alzheimer’s disease, but there are treatments that can prevent some symptoms from getting worse for a limited time. Ongoing research offers hope that someday it may be possible to delay the onset of Alzheimer’s, slow its progress, or prevent it altogether.

The course of Alzheimer’s disease-which symptoms appear and how quickly changes occur-varies from person to person. The time from diagnosis to the end of life varies, too. It can be as little as 3 years if the person is over 80 years old when diagnosed, or as long as 10 years or more if the person is younger.

A person with Alzheimer’s should be under a doctor’s care and may see a neurologist, psychiatrist, family doctor, internist, or geriatrician (a specialist who treats older adults). The doctor can treat the person’s physical and behavioral problems and answer the many questions that the person and his or her family may have.

Several prescription drugs are currently approved by the U.S. Food and Drug Administration (FDA) to treat people who have been diagnosed with Alzheimer’s disease. Treating the symptoms of Alzheimer’s can provide patients with comfort, dignity, and independence for a longer period of time and can encourage and assist their caregivers as well.

More details about treatments and medications here

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East Tennessee Office:
5801 Kingston Pike
Knoxville, TN 37919
Alzheimer's of Tennessee - East TN Office
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1459 Interstate Dr. Ste 211
Cookeville, TN 38501 Alzheimer's of Tennessee - Cumberlands Office
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Johnson City, TN 37604 Alzheimer's of Tennessee - Northeast Tennessee Office