Objective: This discussion post aims to explore the role and impact of community partnerships or coalitions in promoting health and well-being within your home community.
Review the Presentation: Watch the session which explores Brain Health and Preventative Measures within the Latino and African American Communities. This presentation offers valuable insights into tailored strategies that address health disparities and enhance community wellness.
Complete a Short Evaluation: Reflect on and assess the material presented. Your evaluation will help you integrate these lessons into your clinical practice, ultimately empowering you to educate your community
Alzheimer’s:
What Is It?
Can I Reduce My Risk?
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This presentation is supported by the Centers for Disease Control and Prevention of the US Department of Health and Human Services (HHS) as part of a financial assistance award (1NU58DP006781) totaling $1.5 million with 100% funded by CDC/HHS. The contents are those of UsAgainstAlzheimer’s and do not necessarily represent the official views of, nor an endorsement by, CDC, HHS or the US Government.
Acknowledgement
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Thank You to Our Partners & Sponsors
The mark “CDC” is owned by the US Dept. of Health and Human Services and is used with permission. Use of this logo is not an endorsement by HHS or CDC of any particular product, service, or enterprise.
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Priority Learning Objectives
2 Recognize risk factors for Alzheimer's
3 Learn how you can make changes in your life to reduce your risk of Alzheimer’s
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1 Learn about dementia and Alzheimer’s disease
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The brain changes as it ages
Wisdom and expertise can increase with age
But the speed of making decisions and managing multiple tasks may slow down.
While SOME forgetfulness may be a normal part of aging, total or severe memory loss is not normal.
The Aging Brain1-3
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Like other organs in the human body, the brain changes as it ages. Physical structures in the brain change, and its ability to carry out various functions tends to decline.
Wisdom and expertise can increase with age, while the speed of processing information, making decisions, and recall of information can slow down. [this is basically slowing down of executive functioning]
This process is known as cognitive aging, which refers to a decline in memory, decision-making, processing speed, and learning. For example, a person might need longer to learn a new skill, have more difficulty recalling certain words or finding common items such as glasses or keys. These changes are considered a normal part of aging and varies from person to person from day to day.
When changes in a person’s cognitive ability affects their daily life, it may be an indication that it is due to something other than normal aging changes. Subjective Cognitive Decline is self-reported confusion or memory loss that is happening more often or is getting worse. A growing body of evidence suggests that Subjective Cognitive Decline is one of the earliest warning signs for Alzheimer’s and other dementias. In the 2016 Behavioral Risk Factor Surveillance System (BRFSS) surveys conducted by state health departments, one in 9 adults age 45 or older reported experiencing subjective cognitive decline. Over half of those respondents reporting Subjective Cognitive Decline had not talked about their memory issues with a health care provider.
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Umbrella term for loss of memory and other thinking
Abilities severe enough to interfere with daily life.
DEMENTIA
Dementia4, 5
Alzheimer’s
60-80%
Lewy Body Dementia
5-10%
Vascular Dementia
5-10%
Hippocampal
Sclerosis
3-13%
Fronto-
temporal
Dementia
3-10%
Others:
Parkinson’s
Huntington’s
Mixed Dementia
Dementia from more than one cause
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Dementia is a general term for a decline in cognitive function severe enough to interfere with daily life.
Dementia is not a specific disease. Rather, it’s an overall term that describes a wide range of symptoms associated with a decline in memory or other thinking skills.
Dementia is NOT normal aging.
It is caused by damage to brain cells from disease or trauma (such as a brain injury or stroke). This damage interferes with the ability of brain cells to communicate with each other. When brain cells cannot communicate normally, thinking, behavior, and feelings can be affected.
Many dementias are progressive, meaning symptoms start out slowly and gradually get worse.
There are several types of dementia. Alzheimer's disease accounts for 60-80% of cases and is the most common cause of dementia.
Other types of dementia include vascular dementia, Lewy Body dementia, frontotemporal, Huntington’s disease and others. Researchers increasingly believe a large number of dementia cases are mixed dementia when a person has multiple types of dementia.
Sometimes dementia-like symptoms can be caused by other conditions, such as depression, vitamin deficiencies, thyroid problems, and some infections, that when treated will result in improvement of dementia-like symptoms. A key difference between these conditions and dementia is that the symptoms usually appear suddenly, whereas dementia develops slowly over time. This is one reason why it is important for someone with memory changes to be seen by a health professional to determine a possible cause of confusion or memory loss.
Dementia is a general term for a decline in cognitive functioning- that is, thinking, remembering, and reasoning severe enough to interfere with daily life.
Dementia is not a specific disease. It is an overall term that describes a wide range of symptoms associated with a decline in memory or other thinking skills. Dementia is characterized by damage to the brain cells due to age, brain injury, other conditions or diseases, heredity, or a combination of factors.
Many dementias are progressive, meaning that symptoms start out slowly and gradually get worse. In the most severe stages of dementia, a person must depend on others for basic activities of daily life.
The causes of dementia can vary, depending on the types of brain changes that may be taking place. Alzheimer's disease is the most common cause of dementia in older adults. Other dementias 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.
Certain brain diseases and conditions cause dementia. Alzheimer’s disease is an irreversible, progressive brain disease that slowly destroys memory and thinking skills, and eventually the ability to carry out the simplest tasks. The brain changes associated with Alzheimer’s disease occur on a continuum and can begin up to 20 years before a person has any noticeable symptoms or impairment. Alzheimer’s progressively damages and eventually destroys brain cells over the course of many years, even decades.
Alzheimer’s disease is the most common cause of dementia. It accounts for an estimated 60% to 80% of cases.
The term Alzheimer’s dementia is used to describe the stage of Alzheimer’s disease when an individual has observable symptoms such as memory loss, mood/behavior changes, and difficulty with activities of daily living.
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1 in 9 people (10.9%) age 65 and older has Alzheimer’s
Almost 2/3 of Americans with Alzheimer’s are women
Key Alzheimer’s Disease in the U.S. – 20245
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In 2019 – AD was 6th leading cause of death for ALL adults (not just older adults)
When COVID-19 became 3rd leading cause of death, AD was 7th leading cause of death. (2021)
6.9 million older adults have Alzheimer’s
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Alzheimer’s disease must be considered a public health crisis. There are many reasons for this.
First, the burden is large and it is growing. Today, around 6.5 million people in the U.S. aged 65 and older are living with Alzheimer's dementia.
One in 9 adults aged 65 and older (10.7%) currently has Alzheimer’s dementia meaning they are in the stage of Alzheimer’s disease when their symptoms are noticeable and impacting daily living. Approximately one in three (33.2%) people aged 85 and older has the disease.
Women make up almost 2/3 of seniors living with Alzheimer’s dementia in the U.S. According to the Framingham Heart Study data, the estimated lifetime risk for Alzheimer’s dementia at age 45 was approximately one in five (20%) for women and one in ten (10%) for men.
Alzheimer’s Disease – A Public Health Crisis
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What is Alzheimer’s Disease?5
Alzheimer’s disease is the most common type of dementia.
It is a progressive disease beginning with mild memory loss and possibly leading to loss of the ability to carry on a conversation and respond to the environment.
Alzheimer’s disease involves parts of the brain that control thought, memory, and language.
It can seriously affect a person’s ability to carry out daily activities.
The risk of developing Alzheimer’s increases with age but is not a normal part of aging.
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https://www.cdc.gov/aging/aginginfo/alzheimers.htm
Memory loss that disrupts daily life
Challenges in planning or solving problems
Difficulty completing familiar tasks
Confusion with time or place
Trouble understanding visual images and spatial relationships, such as judging distances
10 EARLY Signs of Alzheimer’s6
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Alzheimer’s affects people in different ways. The most common symptom begins with gradually worsening ability to remember new information. As damage spreads, individuals experience other difficulties.
The following are ten early signs and symptoms of Alzheimer’s:
Memory loss that disrupts daily life
One of the most common signs of Alzheimer’s dementia, especially in the early stages, is forgetting recently learned information.
Others include: forgetting important dates or events; asking for the same information over and over; relying on family members for things they used to handle on their own.
Challenges in planning or solving problems
Some people may experience changes in their ability to develop and follow a plan or work with numbers.
They may have trouble following a familiar recipe or keeping track of monthly bills.
They may have difficulty concentrating and take much longer to do things than they did before.
Difficulty completing familiar tasks at home, at work or at leisure
People with Alzheimer’s may have a hard time completing daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work, or using a cell phone.
Confusion with time or place
People with Alzheimer’s can lose track of dates, seasons, and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.
Trouble understanding visual images and spatial relationships
For some people, having vision problems is a sign of Alzheimer’s. They may have difficulty with balance or judging distance, and trip over things at home, or spill or drop things more often. In terms of perception, they may pass a mirror and think someone else is in the room. They may not recognize their own reflection.
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New problems with words in speaking or writing
Increasingly misplacing things and losing the ability to retrace steps
Decreased or poor judgment
Withdrawal from work or social activities
Changes in mood and personality
10 EARLY Signs of Alzheimer’s (continued)6
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New problems with words in speaking or writing
People with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue, or they may repeat themselves. They may struggle with vocabulary or call things by the wrong name (e.g., calling a watch a “hand clock”).
Misplacing things and losing the ability to retrace steps
A person with Alzheimer’s may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing.
Decreased or poor judgment
People with Alzheimer’s may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, such as giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean.
Withdrawal from work or social activities
A person with Alzheimer’s may start to remove themselves from hobbies, social activities, work, or volunteer projects. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby.
Changes in mood and personality
The mood and personalities of people with Alzheimer’s can change. They can become confused, suspicious, depressed, fearful, or anxious. They may be easily upset at home, at work, with friends, or in places where they are out of their comfort zone.
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Preclinical Alzheimer’s Disease
Mild AD Cognitive Impairment
Mild AD Dementia
Moderate AD Dementia
Severe AD Dementia
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No symptoms but possible biological changes in the brain
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Very mild symptoms that may not interfere with everyday activities (forgetting important information or recent events; unable to understand task with multiple steps)
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Symptoms interfere with some everyday activities (can’t remember recent events; asks same question over and over; personality changes; trouble expressing thoughts)
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Symptoms interfere with many everyday activities (worsening confusion – can’t remember day of week or family member; need help with activities like going to the bathroom and getting dressed; may start to wander)
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Symptoms interfere with most everyday activities (lose ability to communicate; require daily assistance; unable to control bowel functions)
*Although arrows are of equal size, the phases of Alzheimer’s may not be equal in duration*
This is when most people are diagnosed – but it differs significantly!
Different Stages of Alzheimer’s7, 8
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There is no one test to determine if someone has dementia, diagnosis is made from a combination of many factors.
Doctors diagnose dementia based on several factors, including:
Comprehensive medical exam that involves reviewing current medications, asking about your medical history, or running memory tests, etc.
Brain imaging like an MRI or PET Scan
Doing a spinal tap to determine specific proteins associated with Alzheimer’s
Blood biomarkers are up and coming but still not widely available; they may not be appropriate for all groups
Many doctors may diagnose “dementia” but not specify a type and follow ups may be need with a neurologist, psychiatrist, psychologist or geriatrician.
How Is Dementia Diagnosed?
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Medical evaluations, done by doctors, are required to look for treatable causes of dementia (such as infection, medication side effects, etc.)
Consulting with other professionals early in the process is important! Work with other trained professionals to ensure patient wishes are considered:
Social worker
Elder care attorney
How Are Behaviors Addressed?
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There is no known cure for Alzheimer’s disease!
There are treatments that can help with symptoms and treatments that could potentially delay progression, but no treatments that reverse the effects of Alzheimer’s
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Medications that can help with symptoms
| Medications that help with behaviors | ||
| Medication Name (Generic/Brand) | Indicated For | |
| Brexpiprazole (Rexulti®) | Agitation associated with dementia due to Alzheimer's disease. | |
| Suvorexant (Belsomra®) | Insomnia, has been shown to be effective in people living with mild to moderate Alzheimer’s disease. | |
| Lots of other medications can be used for dementia-related depression, agitation, anxiety, aggression, etc. | ||
| There are several medications that can help with memory and thinking, depending on Alzheimer’s stage | ||
| Benzgalantamine (Zunveyl®) Donepezil (Aricept®) Galantamine (Razadyne®) | Rivastigmine (Exelon®) Memantine (Namenda®) Memantine + Donepezil (Namzaric®) |
*This list is not comprehensive and all medications have potential side effects, talk to a doctor for more information.
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Medications that can help slow down disease progression
These treatments are brand new (within last 4 years), can be expensive, are done in a clinic with an IV, and can have side effects.
Some people may have a genetic risk factor that increases their risk of brain swelling or brain bleeds.
None of these treatments REVERSE decline, but they may DELAY disease progression and allow a person to live independently for longer (some clinical trials show 8-10 months more, compared to no treatment)
These treatments are only approved for patients who have mild cognitive impairment or mild Alzheimer’s.
Treatments:
Aducanumab (Aduhelm®), approved by the FDA in 2021, but was discontinued in 2024
Lecanemab (Lequembi®), approved by FDA in 2023
Donanemab (Kisunla®), approved by FDA in 2024
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By 2030, nearly 40% of Americans living with Alzheimer’s will be Latino or African American11
Dolores Huerta, civil rights leader, and Dr. David Satcher, former U.S. Surgeon General, speak at a 2019 UsAgainstAlzheimer’s event
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African American people are
2X AS LIKELY
to have Alzheimer’s
Latino people are
1.5X AS LIKELY
to have Alzheimer’s
Brain Health in Black & Latino Communities
9, 11-13
Less likely than White patients to receive a timely diagnosis
More likely to report experiencing racial discrimination along their patient & caregiver journeys
Less likely to be enrolled in cutting-edge Alzheimer’s and brain health research
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Health Conditions That Affect Alzheimer’s That Are More Common in Black & Latino Communities9, 14-20
AFRICAN AMERICAN PEOPLE
LATINO/HISPANIC PEOPLE
2X AS LIKELY
TO HAVE ALZHEIMER’S
1.5X AS LIKELY
TO HAVE ALZHEIMER’S
STROKE
50% more likely to have a stroke
SOCIAL ISOLATION
Loneliness more likely to impact immigrants
HEART DISEASE
30% more likely to die from heart disease
OBESITY
50% have obesity (vs 41% of non-Hispanic White adults)
DIABETES
100% as likely to die from diabetes
OBESITY
46% have obesity
DIABETES
30% more likely to die from diabetes
BLOOD PRESSURE
Similar prevalence (vs White adults) but lower rates treatment & control
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While there is no cure for Alzheimer’s disease and many in our communities are at higer risk, there’s good news!
Many cases of dementia CAN BE PREVENTED!
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Protect Your Brain & Lower Your Risk!21
{
}
45%
of dementia cases
can be delayed or reduced
by addressing these
factors
INCREASE
Education
Physical Activity
Social Contact
DECREASE
Hearing Loss
High blood pressure
Obesity
Smoking
Depression
Diabetes
High LDL cholesterol
Alcohol Intake
Head Injury
Vision Loss
Exposure to air pollution
TO REDUCE YOUR RISK:
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45% of dementia cases could be prevented by addressing certain lifestyle factors. The vast majority of these can be addressed in mid/late life – it’s not too late!
You Can Take Control of Your Brain Health TODAY!
Find practical resources, tips, and ideas for all of these at
https://mybrainguide.org/brain-health-for-all-communities/
Get Exercise and Stay Fit – Staying fit helps keep the brain healthy. Learn how to make an exercise plan that is right for you.
Keep in Touch – Staying social helps keep your brain healthy. Research shows that talking to people and spending time with friends and family can improve brain health and slow rates of memory problems.
Eat Healthy Food – Healthy eating habits make a big difference for brain health.
Get Enough Sleep – Sleep helps reduce the buildup of proteins associated with Alzheimer’s disease. It also helps you feel better and keeps your immune system healthy.
Take Care of Common Health Problems – It’s important to take care of other conditions like high blood pressure, diabetes and depression. This can help to prevent memory loss.
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What you can do, with the help of your nurses and other healthcare providers:
Manage you hypertension or Type II diabetes with appropriate medications.
What’s good for your heart, is good for your brain! Good heart health through improved physical activity, diet, and sleep can help reduce the risk of cognitive decline.
High Blood Pressure
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Growing evidence suggests that the health of the brain is closely linked to the overall health of the heart and blood vessels.
The brain is nourished by one of the body’s richest networks of blood vessels. With every beat, the heart pumps blood to the head, where brain cells use the
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