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Alzheimer's disease
Also known as AD, or Alzheimer’s disease dementiaOverview
Alzheimer's disease (AD) is a slowly progressive disorder of the brain that fades away memory. It is characterized by disturbances in thinking skills, reasoning, language, and perception and, eventually, the ability to carry out simple daily tasks.
The exact cause of Alzheimer's disease is unclear. However, a buildup of harmful proteins in the brain, called amyloid plaques and tau tangles, is believed to contribute to the disease.
Alzheimer’s disease is not a normal part of aging and is not something that inevitably happens in later life. However, the likelihood of having Alzheimer's disease increases substantially with advancing age. A combination of age-related brain changes, and genetic, environmental, and lifestyle factors are thought to increase the risk of this condition.
Current Alzheimer's medications can help temporarily with memory symptoms and other cognitive changes. Caregivers play an extremely pivotal role in helping people with Alzheimer’s disease with their daily needs and activities as well as protecting them from any danger.
Key Facts
- Adults above 65 years of age
- Both men and women but more common in women
- Brain
- Worldwide: 55 million (2020)
- India: 4.1 million (2019)
- Depression
- Delirium
- Mild cognitive impairments
- Stress
- Senility
- Nutritional deficiency
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Lab tests: Thyroid profile total, Vitamin B12, Vitamin D (25-OH), Complete blood count (CBC), and Erythrocyte sedimentation rate
- Imaging tests: CT scan (Head), MRI brain, and CT angiography brain
- Cholinesterase(AChE) inhibitors: Donepezil, Rivastigmine, and Galantamine.
- N–Methyl–D–aspartate (NMDA) receptor blockers: Memantine
- Antidepressants: Fluoxetine and Sertraline.
- Antipsychotics: Risperidone and Olanzapine
- Disease-modifying treatments: Aducanumab.
- Psychosocial interventions: Cognitive stimulation therapies, Cognitive rehabilitation, and Recollections and past stories.
- Psychiatrist
- Elderly care physician (Geriatrician)
- Neurologists
- Alzheimer's and Related Disorders Society of India (ARDSI)
Symptoms Of Alzheimer’s disease
The first symptoms of Alzheimer’s vary from person to person. Memory problems are typically one of the first signs related to this disease. Alzheimer’s disease progresses through several stages, explained as follows:
1. Early symptoms
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Trouble thinking of the right word
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Misplaced items
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Poor judgment or harder-to-make decisions
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Forgetting about recent conversations or events
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Hesitant to try new things
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Asking about the same things repeatedly
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Mood changes, such as increased anxiety or agitation.
2. Middle-age symptoms
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Obsessive, repetitive, or impulsive behavior
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Disturbed sleep
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Increased confusion, and disorientation
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Problems with speech or language (aphasia)
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Seeing or hearing things that are not seen by other people (hallucinations)
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Changes in mood, such as frequent mood swings
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Difficulty performing spatial tasks, such as judging distances
3. Later symptoms
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Gradual loss of speech
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Weight loss
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Difficulty changing position or moving around
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Unintentional passing of urine (urinary incontinence)
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Significant problems with short- and long-term memory.
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Types Of Alzheimer’s Disease
There are two types of Alzheimer's, namely early-onset and late-onset:
1. Late-onset Alzheimer's disease
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Most people with Alzheimer's have late-onset Alzheimer's disease, in which the symptoms appear in the late 60s.
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The specific gene that increases its risk is the Apolipoprotein E (APOE) gene.
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However, inheriting this gene does not always lead to the development of Alzheimer's.
2. Early-onset Alzheimer's disease
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This occurs between the 30s to mid-60s and represents less than 10 per cent of all people with Alzheimer's.
Causes Of Alzheimer’s Disease
Alzheimer’s is a progressive brain disease characterized by changes in the brain that result in the loss of nerve cells and their connections. However, the complete understanding of the causes of this disease is not yet known. Various hypotheses have been proposed for the development of Alzheimer’s disease. These are:
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Cholinergic hypothesis: A decline in the chemical that helps brain cells communicate (acetylcholine), may lead to memory loss and cognitive decline.
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Amyloid hypothesis: The buildup of amyloid-beta proteins in the brain may form plaques, which can disrupt normal brain function.
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Tau hypothesis: A protein called tau, which supports the structure of brain cells, becomes tangled in Alzheimer’s, leading to cell damage and memory problems.
Alzheimer’s disease is named after Dr. Alois Alzheimer, who first identified abnormal brain changes in a patient with memory loss and behavioral issues in 1906. He discovered plaques and tangles in her brain, which are now recognized as key features of the disease.
Risk Factors Of Alzheimer’s Disease
Alzheimer’s disease is thought to be a combination of age-related brain changes, genetic, environmental, and lifestyle factors. These factors are discussed below:
1. Non-modifiable factors
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Advanced age: (people over 65 years of age are at an increased risk)
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Family history
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Genetic predisposition
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Gender (Women are at a higher risk of developing this disease)
2. Modifiable factors
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Obesity: People with higher BMI or obesity (in particular abdominal obesity) are at an increased risk of Alzheimer’s disease after the age of 25 years.
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Alcohol consumption
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Chronic stress
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Sleep issues
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Sedentary lifestyle
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Social network and social engagement
3. Medical conditions
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Cardiovascular and cerebrovascular diseases
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Hypercholesterolemia (high total serum cholesterol levels)
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Hormone imbalances
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Head injury
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Hearing loss
The risk of dementia and AD is 2-fold higher in elderly persons with increased social isolation and less frequent, unsatisfactory contact with relatives and friends.
Diagnosis Of Alzheimer’s Disease
An early and accurate diagnosis is crucial for several reasons. It can tell people whether their symptoms are due to Alzheimer’s disease or other conditions that may be treatable and possibly reversible. Doctors can usually diagnose the disease with the help of the following:
1. Past medical history
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The doctor asks the patient and a family member or friend about their overall health. T
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This includes a family history of Alzheimer’s, diet, past medical issues, and daily activities.
2. Changes in behavior and personality
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A psychiatric evaluation is crucial to distinguish Alzheimer’s from other conditions that can mimic it, such as depression, delirium, and mild cognitive impairment.
3. Cognitive tests involving memory
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Diagnosis of Alzheimer's disease is based on tests to assess memory and thinking skills.
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Most cognitive assessments involve a series of pen-and-paper tests and questions, each of which carries a score.
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The tests assess some different mental abilities, including attention span and concentration, abilities related to vision, communication skills, and short-term memory.
3. Laboratory tests
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Thyroid profile total: This test checks thyroid hormone levels, as thyroid dysfunction can cause memory problems that mimic Alzheimer's symptoms.
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Vitamin B12: Low levels of Vitamin B12 can lead to cognitive decline and memory issues, which may be mistaken for Alzheimer’s disease.
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Vitamin D (25-OH): A vitamin D deficiency has been linked to an increased risk of cognitive decline and AD.
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Complete blood count (CBC): It helps rule out infections, anemia, or other conditions that can cause confusion or cognitive impairment.
4. Imaging studies
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Computed tomography (CT) scan: A CT scan of the brain can give more detailed information about its tissue and structures than standard X-rays of the head.
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MRI (Brain): In a magnetic resonance imagining (MRI) scan, a strong magnetic field and radio waves are used to produce detailed images of your brain to identify the brain parts.
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Positron emission tomography (PET) scan: A PET scan can detect changes in metabolism, blood flow, cellular communication processes, and any other brain activities.
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Celebs affected
Prevention Of Alzheimer’s Disease
The exact cause of Alzheimer's disease is still unknown. Although there's no certain way to prevent the condition, a healthy lifestyle can help reduce its risk. They include:
1. Reduce the risk of cardiovascular disease
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Quit smoking to lower your risk of heart disease.
Buy smoking cessation products to get rid of this habit. -
Maintain a healthy, balanced diet with plenty of fruits and vegetables.
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Stay active with regular moderate exercise.
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Manage hypertension, obesity, high blood sugar, and diabetes with proper treatment.
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2. Stay mentally and socially active
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Evidence suggests that the rate of AD is lower in people who remain mentally and socially active throughout their lives.
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Maintain an active and socially integrated lifestyle by ensuring an extensive social network.
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Also, engaging in learning new languages, playing musical instruments, joining book clubs, or exploring hobbies like gardening and crafts can help maintain cognitive health.
Learn about key lifestyle changes that may help lower your risk.
Specialist To Visit
A general practitioner can carry out some simple checks to find out the cause of AD and can then refer you to a specialist for assessment, such as:
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Psychiatrist (usually an old age psychiatrist)
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Elderly care physician (sometimes called a geriatrician)
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Neurologists
A psychiatrist helps manage behavioral and psychological symptoms of Alzheimer's.
An elderly care physician provides comprehensive medical care for aging-related health issues.
A neurologist diagnoses and treats neurological aspects of Alzheimer's, including cognitive decline.
If you or a loved one are experiencing symptoms of Alzheimer's, it's important to seek professional help for proper diagnosis and management.
Treatment Of Alzheimer’s Disease
A. Medications
1. Cholinesterase(AChE) inhibitors: These aim to increase the availability of acetylcholine in neurotransmission to treat memory disturbances. Examples include:
2. N–Methyl–D–aspartate (NMDA) receptor blocker: These work by regulating the activity of glutamate, a brain chemical, to help prevent nerve cell damage in Alzheimer's disease. Memantine is the most commonly used drug.
3. Antidepressants: These medications help manage depression and anxiety often seen in people with Alzheimer's, improving mood and quality of life. Commonly used drugs include:
4. Antipsychotics: These are used to manage agitation, aggression, and severe behavioral symptoms associated with Alzheimer's disease. Commonly used drugs are:
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B. Disease-modifying treatments
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While treatments can help manage symptoms, finding a cure for Alzheimer's is the most important goal.
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Researchers are focusing on therapies that target amyloid plaques, which are linked to Alzheimer's disease.
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Drugs like Aducanumab show promise in reducing these plaques.
C. Psychosocial interventions
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Cognitive stimulation therapies: These involve taking part in group activities and exercises designed to improve memory and problem-solving skills.
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Cognitive rehabilitation: It works by helping one to use the working parts of the brain to help the parts that are not.
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Recollections and past stories: Life story work involves a compilation of photos, notes, and keepsakes from childhood to the present day. These approaches sometimes help in improving mood and well-being.
Home Care For Alzheimer’s Disease
It is important to ensure safety and quality of life for people with Alzheimer's disease. Caring for a relative or loved one who is suffering from this disease can be challenging. Here are a few points that can help:
Ensure safe environment
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Get rid of tripping hazards like loose rugs and clutter.
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Install grab bars in bathrooms and stair railings for support
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Keep harmful substances like cleaning products and medications away from the person with Alzheimer’s
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Remove unnecessary furniture to help them move freely
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Install carpet on stairs or mark the edges of each step with bright-coloured tape
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Ensure good lighting in hallways and rooms to prevent falls and injuries.
Take care of their needs
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Stick to a simple and consistent daily routine
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Use labels or signs to help them navigate around the house
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Encourage independence with easy-to-use clothing, utensils, and reminders
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Keep emergency contact numbers easily accessible
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Provide a calm and reassuring environment to reduce anxiety and confusion.
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Living With Alzheimer’s Disease
An Alzheimer's diagnosis can be overwhelming for both patients and caregivers, bringing emotions like anxiety, anger, and guilt. However, with the right support and care, a fulfilling life is still possible. Tips that can help include:
Take care of oneself
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Care for physical health by exercising and eating a healthy diet
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Care for mental health by taking part in mentally stimulating activities such as playing games, reading books,s and engaging in calming activities like yoga
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Care for emotional health by experiencing a range of emotions without labeling any of them as good or bad
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Join a support group so that you can connect with people in the same situation and maintain close relationships with them.
Stay active and engaged
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People with AD should try to keep up with the activities that they enjoy and spend time with family and friends.
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If someone is not able to do some things safely anymore, try taking on new activities and do them at times of the day when they feel best
Make a routine
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Always keep keys, cellphones, and other essentials in the same place at home
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Arrange for automatic payment of bills
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Schedule regular appointments on the same day at the same time
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Use a calendar or whiteboard at home for your daily schedule, and make a list of tasks as you complete them.
Living with Alzheimer's can be challenging, but a proactive approach to mental well-being can make a difference. Explore our natural mind care products to help manage stress and anxiety that comes with AD.
Tips for caregivers
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Keep the mood positive
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Convey feelings of affection with facial expressions, and touch
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If the person becomes agitated, acknowledge those feelings, change the topic, or suggest a distraction like going for a walk.
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Keep a sense of humor, and find activities for the person you care about, on which you both can laugh.
Complications Of Alzheimer’s Disease
Alzheimer's is a progressive condition that can worsen with time. The treatments currently available are known to slow the progression of the disease but cannot entirely stop it. Alzheimer's can cause the following complications as it worsens gradually:
- Safety issues: Patients with Alzheimer's disease are at an increased risk of injuries even while performing activities like walking, cooking, cleaning, etc.
- Personal hygiene: In the later stages, Alzheimer's patients struggle with basic human hygiene, such as brushing, bathing, grooming, and using the bathroom.
- Nutritional challenges: With advanced Alzheimer's, a person may forget to eat and may lose interest in eating. This can lead to a variety of malnutrition-related problems.
Prevent malnutrition in Alzheimer’s patients with specialized nutrition drinks designed to support overall health. - Aspiration or choking: Trouble swallowing food can lead to aspiration or choking and cause pneumonia in the lungs.
Alternative Therapies For Alzheimer’s Disease
Alternative therapies for Alzheimer’s disease may help manage symptoms but should never replace conventional treatment. Always consult your doctor before trying anything new. Some of them include:
1. Exercise and yoga
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Performing light exercises can help enhance mood, manage anxiety, and maintain physical activity status in people with Alzheimer's.
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These light exercises can include home-based aerobic routines, dancing, lifting light weights, and yoga, such as Pranayama.
2. Massage therapy and aromatherapy
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Massage therapy induces relaxation and may be helpful for people with Alzheimer’s disease
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Aromatherapy may help ease anxiety and improve mood in individuals with AD, with essential oils like lavender, rosemary, lemon, and peppermint being commonly used.
3. Ayurveda
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Alzheimer's is known as “Smruthi Nasha” in Ayurveda.
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Panchkarma and medicinal herbs, like Shankhpushpi, Guduchi (Giloy), Brahmi, Ashwagandha, Shatavari, etc., may be useful in managing symptoms of Alzheimer's disease.
Frequently Asked Questions
References
- Janicki SC, Schupf N. Hormonal influences on cognition and risk for Alzheimer's disease. Curr Neurol Neurosci Rep. 2010 Sep;10
- Mielke MM. Sex and Gender Differences in Alzheimer's Disease Dementia. Psychiatr Times. 2018 Nov;35(11):14-17. Epub 2018 Dec 30.
- Gottlieb S. Head injury doubles the risk of Alzheimer's disease. BMJ. 2000 Nov 4
- National Institute on Aging. 2023 [cited 2025 Feb 18]. Available from:
- Dong H, Csernansky JG. Effects of stress and stress hormones on amyloid-beta protein and plaque deposition. J Alzheimers Dis. 2009;18(2):459-69.
- Shokri-Kojori E, Wang GJ, Wiers CE, Demiral SB, Guo M, Kim SW, Lindgren E, Ramirez V, Zehra A, Freeman C, Miller G, Manza P, Srivastava T, De Santi S, Tomasi D, Benveniste H, Volkow ND. β-Amyloid accumulation in the human brain after one night of sleep deprivation. Proc Natl Acad Sci U S A. 2018 Apr 24;115(17):4483-4488.
- Rahman A, Hossen MA, Chowdhury MFI, et al. Aducanumab for the treatment of Alzheimer's disease: a systematic review. Psychogeriatrics. 2023;23(3):512-522. Available from
- Overview. Alzheimer’s Disease. National Health Service. July 2021
- Introduction. Alzheimer’s disease. National Health Portal, India. September 2015
- What is Alzheimer’s disease. Alzheimer's.gov. National Institute on Aging (NIA). 2021
- What is Alzheimer’s disease. Basics of Alzheimer’s Disease and Dementia. National Institute of Aging. July 2021
- Key Facts. Dementia. World Health Organization. September 2021
- Brown A, Bayley PJ. The Therapeutic Potential of Yoga for Alzheimer's Disease: A Critical Review. J Alzheimers Dis. Available from :
- Alzheimer's Society. Alternative therapies for dementia | Alzheimer’s Society [Internet]. www.alzheimers.org.uk. 2024. Available from:
- Rao RV, Descamps O, John V, Bredesen DE. Ayurvedic medicinal plants for Alzheimer's disease: a review. Alzheimers Res Ther. 2012 Jun 29;4(3):22. Available from:
- Alzheimer's Disease International. Dementia Statistics [Internet]. Alzheimer’s Disease International. 2020. Available from:
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