Content reviewed by Ann Dietrich, MD, FAAP, FACEP
Alzheimer’s Disease Overview
ICD-10 Code
- G30 - Alzheimer's disease
Alzheimer’s Disease Etiology and Epidemiology
Alzheimer’s disease is a progressive neurological disorder and the most common cause of dementia. It is characterized by a continuous decline in cognitive, behavioral, and social skills, which affects a person's ability to function independently (Honig et al., 2018). The disease causes brain shrinkage and neuronal cell death.
Alzheimer’s Disease Prevalence:
- Approximately 7 million people in the U.S. have Alzheimer’s disease, with 73% being 75 years or older.
- Of the 55 million people living with dementia globally, over 60% are estimated to have Alzheimer’s disease.
Alzheimer’s Disease Symptoms:
- The primary sign is memory impairment, particularly the inability to recall conversations or recent events.
- As the disease progresses, individuals experience debilitating memory loss and a reduced ability to perform daily tasks (Aisen et al., 2017).
Diagnosis
Diagnosis involves gathering information from family members and performing various tests (Canter, 2016):
History:
- Medical history
- Use of over-the-counter medications (including vitamins, herbs, etc.)
- Diet
- Ability to perform activities of daily living (ADLs)
- Changes in personality or behaviors
Memory Tests:
- Assess attention, counting, language, and problem-solving skills
Diagnostic Tests:
- Blood and urine tests to rule out other medical problems
- CT scan
- MRI and PET scans to rule out other medical issues
Definitive Diagnosis:
- Alzheimer's can only be definitively diagnosed post-mortem through brain tissue examination during an autopsy.
Management
There is no cure for Alzheimer’s disease. Therefore, management focuses on:
Goals:
- Improving or maintaining quality of life
- Enhancing cognition, mood, and behavior
- Promoting a safe environment
- Encouraging social engagement
- Maintaining daily functioning
Treatment:
- Medications can temporarily slow disease progression and alleviate symptoms, helping to improve or maintain independence for a time.
- Support programs are available for patients and their families.
Alzheimer’s Disease Nursing Care Plan
Assessment
- Altered mental status
- Irritability
- Social withdrawal
- Decreased ability to perform ADLs
- Difficulty with numbers
- Misplacing items
- Behavioral changes and impaired decision-making
- Repetitive questioning
- Forgetting conversations
- Inability to multitask
- Difficulty identifying people, places, or things
- Criteria outlined by the National Institute on Aging and the Alzheimer’s Association
Nursing Diagnoses/Risk For
- Dehydration
- Falls
- Infections
- Wandering
- Social Isolation
- Self-care Deficit
- Impaired Communication
- Disturbed Thought Process
Interventions
- Collect baseline cognitive level.
- Assess the ability to read, write, and comprehend.
- Develop a daily routine.
- Allow rest time.
- Avoid reality checks.
- Provide time to respond to stimuli.
- Allow time for activities.
- Monitor weight.
- Assist with ADLs.
Expected Outcomes
- Remain safe and free from injury
- Comfortably express needs
- Maintain weight
- Remain free from irritability
- Maintain or improve function
Individual/Caregiver Education
- Regular checkups
- Healthy diet
- Sufficient rest
- Report behavioral changes
- Keep a daily schedule
- Avoid activities causing behavioral changes
- Speak slowly and allow time to respond
- Assist with ADLs
- Find local support groups
- Consider respite care when needed
FAQs
Additional Information
Content Release Date
3/31/2022
Content Expiration
12/31/2028
Course Contributor
Ann M. Dietrich, MD, FAAP, FACEP, Professor of Pediatrics and Emergency Medicine for the University of South Carolina School of Medicine Greenville, has over 30 years of experience in pediatric emergency medicine. Throughout her career, Dietrich has helped educate medical students, residents, fellows, and junior attendings, including as an educator at Ohio State University and the American College of Emergency Physicians. She also collaborated on several research projects, including one on concussions and one on improving mental healthcare for children. Dietrich helped develop guidelines on the impact of concussions on children and worked with trauma surgeons to enhance care for pediatric trauma patients.
References
- Alzheimer's Association. (2021). Facts and figures. https://www.alz.org/alzheimers-dementia/facts-figures
- Aisen, P., Touchon, J., Amariglio, R., Andrieu, S., Bateman, R., Breitner, J., ... & Members, T. F. (2017). EU/US/CTAD Task Force: lessons learned from recent and current Alzheimer’s prevention trials. The journal of prevention of Alzheimer's disease, 4(2), 116. https://www.jpreventionalzheimer.com/all-issues.html?article=308
- Canter, R. G., Penney, J., & Tsai, L. H. (2016). The road to restoring neural circuits for the treatment of Alzheimer's disease. Nature, 539(7628), 187-196. https://www.nature.com/articles/nature20412
- Clifford, JR., Andrews S., Beach, TG., … & Carillo, MC. (2024). Revised criteria for diagnosis and staging of Alzheimer's disease. Alzheimer’s Association. https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.13859
- Crous-Bou, M., Minguillón, C., Gramunt, N., & Molinuevo, J. L. (2017). Alzheimer’s disease prevention: from risk factors to early intervention. Alzheimer's research & therapy, 9(1), 1-9. https://alzres.biomedcentral.com/articles/10.1186/s13195-017-0297-z
- Honig, L. S., Vellas, B., Woodward, M., Boada, M., Bullock, R., Borrie, M., ... & Siemers, E. (2018). Trial of solanezumab for mild dementia due to Alzheimer’s disease. New England Journal of Medicine, 378(4), 321-330. https://www.nejm.org/doi/10.1056/NEJMoa1705971
- Madnani, RS. (2023). Alzheimer’s disease: a mini-review for the clinician. Frontiers in Neurology. https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1178588/full#ref41
- Weller, J., & Budson, A. (2018). Current understanding of Alzheimer’s disease diagnosis and treatment. F1000Research, 7. https://f1000research.com/articles/7-1161/v1