Alzheimer's Disease & Related Dementias

Protecting Brain Health for All Tennesseans

Promoting health and preventing disease throughout all stages of life is essential for maintaining well-being as we age. By focusing on healthy aging, we aim to address the diverse needs of individuals at every age and stage of life. This approach emphasizes the importance of proactive health management, which includes regular physical activity, balanced nutrition, mental well-being, and preventive healthcare measures.

Healthy aging involves a comprehensive strategy that not only helps to prevent chronic conditions but also enhances quality of life by promoting physical, mental, and social health. TDH’s commitment to this state and national priority reflects a broader understanding that investing in health and wellness from early life through older adulthood (aged 65 and older) can significantly improve life outcomes, reduce healthcare costs, and support a more resilient and vibrant population.

By prioritizing healthy aging, we seek to ensure that people can enjoy longer, healthier lives with greater independence and better management of health conditions. Improving health outcomes for older adults aligns with evidence-based practices and initiatives aimed at creating supportive environments and resources that foster wellness across the lifespan.

Please Note: The information on this page should not be used as a diagnostic tool and is not a substitute for informed medical advice. If you are concerned that you or someone you know has dementia, please talk to your healthcare provider.

What To Do Next:  Following an Alzheimer's  or Dementia Diagnosis

The Tennessee Alzheimer's and Related Dementias Advisory Council is making a new information resource available to help caregivers, family members, and patients determine and make decisions about next steps after receiving an Alzheimer's or related dementia diagnosis.

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Dementia is not a single disease. Dementia does describe a group of symptoms that someone can experience if they are living with a diagnosis of Alzheimer’s disease, vascular dementia, Lewy body dementia, frontotemporal dementia, other dementia, including Huntington’s disease, or a mixture from more than one cause. Dementia symptoms cause a decline in thinking skills, also called cognitive abilities, severe enough to interfere with daily life and independent functioning. It also impacts behavior, emotions, and relationships. Some signs of dementia may include getting lost in a familiar neighborhood, using unusual words to refer to familiar objects, forgetting the name of a close family member or friend, forgetting old memories, and not being able to complete tasks independently. Dementia is progressive and worsens over time. How long this progression takes varies for each person. Some individuals may experience a steady decline for years, while others may lose abilities more rapidly. Your chance of developing dementia increases as you get older, but not everyone will get it. If someone develops dementia before the age of 65, it is called young onset dementia or early-onset dementia.

 

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BOLD Public Health Center of Excellence, Dementia 101

Dementia is NOT a normal part of aging.

Aging is a natural process where the body and brain experiences gradual changes over time. These changes affect our physical and mental abilities. Genes, lifestyles, and environments in which we grow impact how we age. As we get older about 40% of people have some degree of memory loss, called age-associated memory impairment. While these factors may cause memory problems, they:

  • Do not disrupt your daily life.
  • Do not affect your ability to complete normal tasks.
  • Do not affect your ability to learn or remember new things.
  • Are not caused by an underlying medical condition.

Unlike people with normal aging, people with dementia will have memory loss that gets worse over time until they are no longer able to take care of themselves.

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Alzheimer’s (AHLZ-high-merz) is a brain disease that causes changes in memory, thinking, language, and behavior. These changes, or symptoms, get worse over time and will disrupt your daily life.

Alzheimer’s disease is the most common cause of dementia and accounts for 60-80% of dementia diagnosis. Brain changes traditionally associated with Alzheimer’s disease involves amyloid (am-uh-loid) plaques (plak) and neurofibrillary (noor-oh-fib-ril-lary) tangles.

  • Amyloid plaques are unusual clumps of protein called beta-amyloid, found outside nerve cells (neurons). This plaque interferes with neuron-to-neuron communication at synapses.
  • Neurofibrillary tangles are twisted bundles of protein called tau, found inside nerve cells (neurons). This plaque blocks the transportation of nutrients and other molecules critical for normal function and survival of neurons.

Plaques and tangles, known as Alzheimer’s biomarkers, increase as the disease progresses and ultimately cause cell death (neurodegeneration). Neurodegeneration, along with the biomarkers are key features of Alzheimer’s disease.

Late-Onset Alzheimer's: The most common form, generally develops in people aged 65 and older. It has a more gradual progression and is primarily influenced by age-related factors, genetics, and lifestyle, though its exact cause is still not fully understood.

Early-Onset Alzheimer's: Typically occurs in individuals under the age of 65, often affecting those in their 40s or 50s. It is less common and can sometimes be linked to genetic factors, making it more likely to run in families.

Alzheimer's disease can progress quickly in some people and slowly in others. On average, a person with Alzheimer's lives four to eight (4-8) years after diagnosis, but can live as long as 20 years, depending on other factors. Changes in the brain related to Alzheimer's begin years before any signs of the disease.

There are 10 signs to help identify symptoms that could be related to Alzheimer’s disease and related dementias:

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If you notice changes in memory, thinking, or behavior in friends, family, or others close to you, it can be challenging to know how to respond. It is normal to feel unsure or anxious about how to offer support, but these changes are serious health concerns. Knowing the 10 Steps to Approach Memory Concerns can help you feel more confident in assessing the situation and taking appropriate action.

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Alzheimer’s disease follows a progressive pattern or moves through three (3) general stages over time including early, middle, and late, sometimes referred to as mild, moderate, and severe. However, the stages do not always fit neatly into these categories, and each person may move through the disease stages in their own way.

Preclinical: Changes in the brain begin years before a person shows any signs of the disease. This period is called preclinical Alzheimer’s disease, and it can last for years.

Early, Mild Stage: At this stage, a person may function independently and experience mild forgetfulness and/or shorter levels of concentration. Signs of this stage may not be obvious to others including family, friends, and doctors.  

Middle, Moderate Stage: This is typically the longest stage, lasting for many years. People in this stage exhibit increased memory loss and confusion, difficulty recognizing people, forgetting names of family and friends, trouble completing tasks with multiple steps, changes in behavior and mood, wandering, and trouble naming common items. As this stage progresses, the person will lose the ability to function independently and will require a higher level of care.

Late, Severe Stage: In the final stage of the disease, the symptoms of dementia become very serious. People lose the ability to respond to their surroundings, communicate, and eventually control their movements including swallowing and incontinence. They may say some words or phrases, but it is hard for them to tell others when they are in pain. As their memory and thinking skills get worse, their personality may change, and individuals need extensive care.

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A person’s risk profile for developing Alzheimer’s disease is driven by fixed and modifiable risk factors.

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Fixed risk factors, or those that cannot be changed include:

Increased Age - Older age does not cause Alzheimer’s, but it is the most important known risk factor for the disease.

Family History - Having a family history of a parent or sibling with the disease does not mean for sure that you will have it too, but it may mean you are more likely to develop it.

Genetics - Risk genes, including APOE-e4, APOE-e2, and APOE-e3, can increase the chance of diagnosis but it is not guaranteed. Down syndrome, 21 trisomy, increases the risk of a person developing Alzheimer’s starting around age 40. Deterministic genes account for 1% or less of Alzheimer’s diagnosis. It causes familial early-onset forms in which symptoms usually develop in a person’s early 40s and mid-50s.

While some risk factors including age, family history, and heredity cannot be changed, modifiable risk factors are parts of your lifestyle or environment that can be changed to lower your risk of developing Alzheimer’s disease.

https://www.tn.gov/content/dam/tn/health/program-areas/alzheimer/dementia-friendly-materials/Video%205%20-%20Dr.%20Vick%20v3.mp4

For example, some modifiable risk factors include:

  • Chronic disease management. Managing long-term conditions like diabetes, high blood pressure, and high cholesterol can reduce the risk of dementia. This is especially important in mid-life (45+).
  • Preventing other medical conditions. Addressing and managing conditions like hearing loss, depression, mild cognitive impairment (MCI), and traumatic brain injuries (TBI) can reduce the risk of developing dementia. Each of these factors can contribute to cognitive decline, so it's important to seek treatment and support for these issues to help maintain overall brain health.
  • Lifestyle factors. Regular exercise, eating a balanced diet, avoiding smoking, limiting alcohol intake, staying socially active and engaged, and participating in activities that challenge your mind can support cognitive function and reduce the risk of dementia.

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Understanding how common, or prevalent, Alzheimer’s is and who it affects helps Tennessee provide better care and support to everyone, especially those who are most at risk.

In Tennessee

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In the United States

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A formal diagnosis allows people living with dementia to have access to:

  • Treatment: Early diagnosis enables timely interventions with medications, non-pharmacological treatments, and complementary care, helping to manage symptoms, improve quality of life, and slow the progression of the disease.
  • Planning for the Future: It enables individuals and caregivers to plan, including legal, financial, and care decisions while the person with Alzheimer’s can participate.
  • Lifestyle Adjustments: Early diagnosis provides an opportunity to make lifestyle changes that may help preserve cognitive function, such as improving diet, increasing physical activity, and engaging in mental exercises.
  • Access to Support: It allows for early access to support services, resources, and education for both the individual and their caregivers, helping them to better cope with the challenges ahead.
  • Participation in Clinical Trials: Individuals diagnosed early may be eligible to participate in clinical trials, contributing to research that could lead to new treatments or a cure.

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