One day, when you visit your grandparents, you may realize some changes with your grandmother. A couple of days ago, maybe you sit together, drunk tea together, had a conversation together or maybe she asked lots of questions about your life and your family. However, on that day, she couldn’t remember your last visit, your last chat, or even you. It means that she has Alzheimer’s disease. Her short term memory was impaired. Also, her long term memory was sometimes clear sometimes very dark to remember anything.
In this article, I will try to explain what Alzheimer’s disease is and who affected that. After that, whether there is a relationship between Autism Spectrum Disorder (ASD) and Alzheimer’s Disease or not, and what kind of interventions and treatments are needed.
There are many similarities between the elderly and children. Neither of them can do their daily care without the help of others, they cannot take care of themselves. Both need adults to guide them in everyday life issues. Both have trouble learning new things. So, when things go wrong in the brain of very old and very young people, the reason is more often the same as those with brain disorders. The result is Autism Spectrum Disorder in children and Alzheimer’s Disease in the elderly.
The biggest difference between Autism Spectrum Disorder and Alzheimer’s disease may be age. Both involve the accumulation of proteins in the brain. Autism is a neurodevelopmental disease usually seen in children. This situation manifests itself as a neurodegenerative disease in an adult, namely Alzheimer’s. They both feed on infectious waste, including neurotoxins.
According to DSM – 5, these disorders are classified into two different criteria. Autistic Spectrum Disorder is a neurodevelopmental disorder and it begins early years of life. In other respects, Alzheimer’s Disease is a neurocognitive disorder and it begins late periods of life.
Autistic Spectrum Disorder (ASD)
Autism is a neurodevelopmental disorder that can be defined as starting from the first 3 years of life and continuing lifelong. The person cannot form an appropriate relationship with others verbally and non-verbally. Today, with the help of simple tests, the disorder can be diagnosed early. Early diagnosis and appropriate rehabilitation programs play an important role in people with ASD’s lives in order to improve their life qualities.
The cause of ASD is unknown. It is thought to be genetic. It is more common in males than in females. 70% of individuals with ASD suffer from mental retardation. On the other hand, 10% of them could have superior intelligence.
Alzheimer’s Disease (AD)
It is one of the neurocognitive disorder and also one of the chronic disorders. Although the physiology of each chronic disease vary, they all;
• Require emotional and physical adjustments
• Disrupt family dynamics
• Need constant medical care
• Require self-management
Alzheimer’s Disease usually begins after 65, but there is an early onset type that tends to progress more quickly than late-onset type. Early-onset occurs before age 60. It represents fewer than 5% of all AD patients and can be traced to a genetic defect. Late-onset occurs after age 60 and it is %100 genetics related.
In this disease, there is clear evidence of the decline in learning and memory. It typically begins with memory loss. However, as the disease progresses the memory loss and disorientation quickly become profound.
Memory loss characterizes Alzheimer’s Disease. Firstly, it may appear in the form of small ordinary failures of memory. Then, it progresses to the point that individuals fail to recognize family members and forget how to perform even routine self-care. Sometimes, in the early phases of AD, individuals are aware of their memory impairments. And this awareness makes the symptoms more stressful.
Family history mostly reveals the predisposition of disease. Several genes have been linked to AD. Genetics is not the only contributing factor of AD. Environmental and behavioral factors that play a role in the development of it. There are some risk factors.
• having a stroke
• type 2 diabetes
• the process of inflammation
• presence of the amino acid homocysteine
• head injury (environmental factor)
• low education level (environmental factor)
• lack of mentally challenging activities during adulthood (environmental factor)
People with more education have a higher socioeconomic status and it provides them with better nutrition and health care. This opportunity protects them against the conditions contributing to Alzheimer’s Disease. Education means cognitive activity in that sense. Cognitive activity throughout a person’s life may increase brain resources and it inhibits the development of AD in people prone to the disorder.
Most of the people with AD show psychiatric symptoms. As the disease worsens people may become violent and may experience hallucinations and delusions.
AD is difficult to diagnose because it includes many behavioral problems which are also symptoms of psychiatric disorders. In addition to memory loss, they show many psychiatric symptoms. The most common psychiatric problem among AD patients is DEPRESSION. 20% of them exhibit symptoms of clinical depression. The experience of negative mood is especially common among the early phases of the disease and in the early-onset AD.
Also, there are some other psychiatric problems that hey can exhibit. For example;
• agitation and irritability
• verbal aggression (37%)
• physical aggression (17%)
• sleep difficulties; they tend to wonder at all times of the day and night.
• suspiciousness and paranoia; they forget where they put their belongings and accuse others of taking them.
• inappropriate sexual behaviors
• apathy (emotionlessness) and dysphoria
Elderly women have more predisposition than elderly men do in terms of having Alzheimer’s. The reason behind this could be something surprising. Because women tend to live longer than men and thus live long enough to develop an age-related neurocognitive disorder. Among people with AD, women tend to Show greater cognitive impairment in the brain than men. There is no significant evidence for this gender difference.
Treatment and Prevention of Alzheimer’s Disease
Helping the Patient
AD remains without a cure but physical symptoms and other accompanying disorders can be treated. The primary focus of treatment is the use of drugs to slow AD’s progress. Patients use drugs for delaying the progression of cognitive deficits. And also they use neuroleptic drugs, which act on the nervous system and modify psychotic behavior, for reducing agitation and aggression.
Antidepressants and anti-anxiety drugs may be used to help control emotional symptoms. Antipsychotic drugs may help control hallucinations, delusions, and agitation.
Behavioral approaches such as sensory stimulation and reality orientation help for retaining cognitive abilities. That kind of programs provides pleasant stimulation in order to slow cognitive loss
Behavior therapies also can be helpful in controlling patients with AD ’s outbursts and emotional instability.
As the patient with AD worsens and loses awareness, the stress of the disease becomes more severe for the family. The responsibility of caregiving is a factor in the decision for having a family member institutionalize.
Helping the Family
It is a very difficult task that caring for a family member who may be abusive or no longer recognizes you. Cognitive impairments lead to changes in behavior in terms of no longer seem like the same person.
This responsibility of taking care of someone is emotional and practical. Problems of caregiving disrupt the family routine, require time, and demand new skills.
Most women play a role in caregiver (70%). Women tend to feel that they should have more responsibility by providing care.
There is a direct relationship between the level of impairment of Alzheimer’s disease patients and the level of caregiver distress. The caregiver’s stress does not decrease even when caregiving is done. In fact, the caregiving burden extends after the death of the person with AD.
If the caregiver feels overwhelmed, there are some support groups. They can provide information about caring and about community resources that provide respite care, which is temporary care for AD patients in order to provide to refresh main caregivers. Also, online and telephone-based services do the same thing for main caregivers.
The hardest time for caregivers starts with the diagnose because of the loss of relationship with them starts at that moment.
Similarities Between Autism Spectrum Disorder and Alzheimer’s Disease
At a psychological level, Alzheimer’s disease and Autism Spectrum Disorder both have a number of features in common. These features include catatonic state, disrupted sleep, attention transition issues, and difficulty with balance and language comprehension.
The biggest similarity that comes to mind is wandering. The child with ASD wanders everything around them and it ends with mostly escaping from home on purpose. On the other hand, the person with AD wander the place around them and go for a walk or thinks that he/ she is in the wrong place and wants to go own place.
Both conditions can also cause rages and mood swings seemingly out of the blue. There is not a certain explanation of what triggers hostility in AD patients, but people with ASD tend to burst when they are overwhelmed. Since they take in everything that’s going on all at once, it’s hard for them to filter out distractions and focus. If you don’t know what you are looking at, this looks like a killer mood swings out of nowhere, but it’s not. Again, there are similarities in mood swings of Alzheimer’s and autism, but there is not a significant result in terms of the cause is similar or different.
Another similarity is communication and language. Individuals with AD and individuals with autism both tend to repeat information and questions over and over again. For instance, at least 5 times a day every day, you can hear from your child with ASD “The cable is canceled. “ and “Daddy and mommy are getting a divorce because they can’t get along.” They never forget like an Alzheimer’s patient, but I think they want to assure themselves that this information is correct.
When it comes to forgetting, in fact, these conditions are polar opposites. Alzheimer’s patients tend to be very forgetful, but children with ASD have a memory like an elephant. They can tell not only details of events, but the day of the week, date, and time. However, if you change the smallest thing in the room, they will zero in on it because it’s not the way they remember it.
Smart Buttons for Alzheimer’s Disease Patients and People with Autism
Smart button is a life-saving button for AD patients and people with ASD. With a simple button attached to the individual’s clothes, it is life-saving for them when they leave the safe zone. The proximity button is easily controlled by the proximity distance created by the caregiver of the individual. The patient can walk around safely with a small battery powered by Bluetooth. The smart button is in constant contact with the radio frequencies between the individual and the caregiver. When the person disappears, it sends an urgent warning to caregiver’s phone.
The smart button, which was originally targeted at Alzheimer’s patients, is also used extensively by people with ASD and their caregivers, after some point. Almost half of the individuals with autism tend to walk outside on their own and they are mostly under 14 ages. That’s why it provides security zones for them.
Autism Spectrum Disorder May Be a Buffer Against Alzheimer’s Disease
Why does a person with ASD usually not develop Alzheimer’s disease? They often have plaques and tangles just like an AD patient but rarely have severe memory problems. The answer is that they cannot break down polyphenols and polyphenols partially take the place of glutathione in limiting oxidative damage to the brain. The downside is that too heavy concentration of polyphenols can negatively affect behavior through overstimulation. Indeed, a person with autism may be less likely to develop Alzheimer’s disease for this reason.
Having autism may protect people from Alzheimer’s Disease. This idea needs many more experiments before scientists approve its correctness 100%. Scientists claim that looking at connections between those disorders is really exciting and they are showing skyrocketing levels.
The researchers focused on brain plasticity which is the ability of the brain to change in response to incoming information. These changes include strengthening connections between nerve cells and neural highways. Studies showed that the brains of AD patients have low brain plasticity, however, people with ASD have high brain plasticity.
It’s a really novel idea in which autism could be protective. More studies will help sort out the relationship between the two disorders. It will ultimately point to ways to ease the symptoms of both diseases. Exercise, medications, and cognitive training may all have the potential to change brain plasticity.