Alzheimer’s risk rises with age, but aging isn’t everything

Metin Dedei, a neurologist at Liv Hospital Vadi Istanbul, said that although the risk of developing Alzheimer’s disease increases with age, it is not a natural consequence of aging. He noted that occasional forgetfulness associated with aging can be normal.

Experts warn that when forgetfulness begins to interfere with daily life, it may be an important warning sign of Alzheimer’s disease. Speaking ahead of World Alzheimer’s Day on Sept. 21, Dedei emphasized that Alzheimer’s is not a natural part of aging and highlighted the importance of recognizing early symptoms and seeking timely medical evaluation.

Dedei noted that forgetting someone’s name, where you have put an item or something you need to do from time to time can happen to anyone. The important point, he said, is how often the forgetfulness occurs and how much it affects a person’s daily life.

“Repeatedly asking the same questions, repeatedly talking about the same subjects, being unable to remember events that happened recently, having difficulty finding one’s way in places that were previously very familiar and struggling with everyday tasks are among the important warning signs,” Dedei said.

He added that difficulty using technological devices such as phones and remote controls, forgetting to take medication or attend appointments and a gradual worsening of these problems should prompt an evaluation for Alzheimer’s disease. He stressed that it is important to consult a neurologist as soon as possible.

Beyond forgetfulness

“Although forgetfulness is the first thing that comes to mind when we think of Alzheimer’s, the disease does not affect memory alone,” Dedei said. “Particularly in the early stages, people may have difficulty finding the right words, planning or solving problems, as well as changes in their judgment and decision-making abilities.”

Difficulty using technological devices such as phones or remote controls that a person previously used with ease, as well as deterioration in visual and spatial skills, can also be signs of the disease.

“A person may begin to have difficulty organizing tasks they previously handled easily, managing money, planning everyday activities or finding their way,” Dedei said.

He also emphasized that changes in personality and behavior should be taken seriously. Withdrawing socially, losing interest in activities they previously enjoyed, a lack of motivation, increased anxiety, or unusual behaviors can all appear during the early stages, he said.

Dedei pointed out that these symptoms can also result from other conditions, including normal aging, depression, sleep disorders, thyroid problems, or vitamin B12 deficiency. For this reason, he stressed that doctors should assess the overall picture rather than focusing on a single symptom.

Lifestyle, Alzheimer’s risk

Dedei said that risk factors for Alzheimer’s disease are generally divided into two groups: those that cannot be changed and those that can.

“Older age, a family history of the disease and genetic predisposition – particularly genetic variants such as APOE e4 – are among the risk factors that cannot be changed. High blood pressure, diabetes, high cholesterol, a sedentary lifestyle, obesity, smoking, hearing loss, depression and low educational attainment are among the modifiable risk factors,” he said.

Dedei noted that age is one of the best-known risk factors for Alzheimer’s, but emphasized that growing older does not mean a person will develop the disease. He also said that people with a family history of Alzheimer’s should not assume that they will inevitably develop it.

Although genetic factors cannot be changed, Dedei explained that the impact of many risk factors can be reduced through lifestyle changes.

‘Lifelong prevention’

Dedei said that there is currently no treatment that can completely prevent or stop Alzheimer’s disease. However, he emphasized the importance of lifestyle changes aimed at reducing the risk of the disease and protecting brain health.

“Regular exercise; maintaining cardiovascular health by keeping blood pressure, blood sugar, and cholesterol levels under control; following a Mediterranean-style diet rich in olive oil and fiber and including plenty of fish; getting enough good-quality sleep; and avoiding smoking and alcohol are among the recommendations,” he said.

Remaining socially active, ensuring that problems such as hearing loss and depression are properly treated and keeping the mind continuously engaged are also important for maintaining brain health, he added.

Early diagnosis

Dedei said that as Alzheimer’s disease progresses, people may find it increasingly difficult to make decisions on their own behalf and maintain their daily lives independently. For this reason, early diagnosis is important for both patients and their families.

“Early evaluation can help distinguish forgetfulness caused by conditions such as depression, medication side effects, vitamin B12 deficiency, hearing loss and thyroid disease from forgetfulness associated with Alzheimer’s disease,” he said.

It can also allow supportive treatments aimed at slowing the progression of symptoms and lifestyle changes to begin earlier.

“Early diagnosis also gives patients and their families time to make legal and financial plans, while potentially increasing access to certain treatments that can be used during the early stages of the disease,” Dedei said.

Different methods

Dedei explained that several methods are now used together to diagnose Alzheimer’s disease.

“The information provided by the patient and their relatives, changes in daily life, and tests assessing memory and other cognitive abilities are evaluated together,” he said.

When necessary, blood tests may be used to investigate other conditions that could be causing forgetfulness. Imaging techniques such as brain MRI, CT scans, and PET scans may also be used.

“In recent years, certain specialized biomarkers measured in blood and cerebrospinal fluid (CSF) have made it possible to detect Alzheimer’s-related changes at an earlier stage,” Dedei said.

However, he stressed that no single test is sufficient on its own. A diagnosis should be based on an overall assessment that takes into account the patient’s general condition, clinical examination, and test results.

New treatments

Dedei said that there have been significant developments in the treatment of Alzheimer’s disease in recent years, particularly with the development of new medications used in the early stages of the disease that target the accumulation of a protein called amyloid in the brain.

He explained that the aim of these medications is not to eliminate the disease completely, but to slow its progression to some extent in appropriate patients. He also stressed that these treatments are not suitable for everyone.

Before treatment begins, doctors need to assess the stage of the disease, the person’s overall health and certain specific risks, Dedei said.

“During treatment, regular follow-up and MRI monitoring may also be required. Looking ahead, important goals include detecting Alzheimer’s disease much earlier, before symptoms appear and developing new treatments that target different mechanisms involved in the disease,” he said.

Dedei reminded people should seek an evaluation for Alzheimer’s if forgetfulness begins to interfere with daily life, or if they experience changes in personality or behavior, difficulty making decisions, worsening symptoms, frequent loss of belongings or trouble finding their way. He also advised consulting a neurologist or geriatrician without delay if a person begins struggling to manage money or medications or if family members notice significant changes in their behavior or abilities.

DAILYSABAH