Scientists believe that for most people, Alzheimer's disease results from a combination of genetic, lifestyle and environmental factors that affect the brain over time.
Less than 5 percent of the time, Alzheimer's is caused by specific genetic changes that virtually guarantee a person will develop the disease.
Although the causes of Alzheimer's are not yet fully understood, its effect on the brain is clear. Alzheimer's disease damages and kills brain cells. A brain affected by Alzheimer's disease has many fewer cells and many fewer connections among surviving cells than does a healthy brain.
As more and more brain cells die, Alzheimer's leads to significant brain shrinkage. When doctors examine Alzheimer's brain tissue under the microscope, they see two types of abnormalities that are considered hallmarks of the disease:
June 17, 2014
- Plaques. These clumps of a protein called beta-amyloid may damage and destroy brain cells in several ways, including interfering with cell-to-cell communication. Although the ultimate cause of brain-cell death in Alzheimer's isn't known, the collection of beta-amyloid on the outside of brain cells is a prime suspect.
Tangles. Brain cells depend on an internal support and transport system to carry nutrients and other essential materials throughout their long extensions. This system requires the normal structure and functioning of a protein called tau.
In Alzheimer's, threads of tau protein twist into abnormal tangles inside brain cells, leading to failure of the transport system. This failure is also strongly implicated in the decline and death of brain cells.
- Goldman L, et al. Goldman's Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.clinicalkey.com. Accessed April 8, 2014.
- Alzheimer's disease fact sheet. National Institute on Aging. http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-fact-sheet. Accessed April 8, 2014.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed April 8, 2014.
- Halter JB, et al. Hazzard's Geriatric Medicine and Gerontology. 6th ed. New York, N.Y.: The McGraw-Hill Companies; 2009. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=540. Accessed April 8, 2014.
- Leal SL, et al. Perturbations of neural circuitry in aging, mild cognitive impairment, and Alzheimer's disease. Ageing Research Reviews. 2013;12:823.
- Wright CB. Etiology, clinical manifestations, and diagnosis of vascular dementia. http://www.uptodate.com/home. Accessed April 8, 2014.
- Papadakis MA, ed., et al. Current Medical Diagnosis & Treatment 2014. 53rd ed. New York, N.Y.: The McGraw-Hill Companies; 2014. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=1. Accessed April 8, 2014.
- Grabowski TJ. Clinical manifestations and diagnosis of Alzheimer’s disease. http://www.uptodate.com/home. Accessed April 8, 2014.
- Caring for a person with Alzheimer's disease. National Institute on Aging. http://www.nia.nih.gov/alzheimers/publication/caring-person-alzheimers-disease/about-guide. Accessed April 8, 2014.
- Alternative treatments. Alzheimer's Association. http://www.alz.org/alzheimers_disease_alternative_treatments.asp. Accessed April 8, 2014.
- Alzheimer's disease at a glance. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/alzheimer/ataglance. Accessed April 8, 2014.
- Smith GE (expert opinion). Mayo Clinic, Rochester, Minn. April 19, 2014.