Nearly 7 million Americans over the age of 65 are living with Alzheimer’s disease, by far the most common form of dementia. New York state ranks second in the nation for the highest percentage of senior citizens with the disease, at 12.7% (behind Maryland’s 12.9%). That’s due in part to its larger at-risk population, including individuals over the age of 65, Black, and Hispanic people.
The nationwide cost of long-term assistance and health care for Alzheimer’s sufferers is expected to reach $360 billion this year, a 4% increase over last year. Spending for the 426,500 individuals in New York totaled $18.9 billion in 2024 — not including the hours of unpaid care provided by family and friends, worth an additional $22.6 billion.
A healthy brain has trillions of interconnected nerve cells, or neurons, that transmit signals throughout the body’s nervous system, enabling us to walk, talk, breathe, and think. In Alzheimer’s disease, two normally-occurring proteins — beta-amyloid and tau — are overproduced, for reasons that are unclear. Excess amyloid forms plaques outside the neurons; tau snarls into knots, or neurofibrillary tangles, inside the neurons. The result is nerve cell dysfunction and destruction, causing brain inflammation and atrophy.
It takes at least 20 years for Alzheimer’s to appear once this process begins. The first sign is usually mild memory impairment, such as frequently forgetting names, recent conversations, or events. Symptoms are progressive, and can impact judgment, language, behavior, or personality. Memory loss becomes severe: The victim may forget personal history details, or how to perform daily activities, like grooming and going to the bathroom. End-stage Alzheimer’s victims are often bedridden; death usually occurs between three to 11 years after the initial diagnosis, most commonly from pneumonia.
Risk factors for Alzheimer’s disease include age (65 or older), race, family history, smoking, traumatic brain injury, and environmental factors like chronic exposure to pollution, pesticides, and heavy metals. Less than 10% of the victims are under the age of 65.
Alzheimer’s has no cure, but early diagnosis allows prompt treatment with medications that can slow the dementia’s progression or ease symptoms, and gives the patient (and family) time to access resources, plan advanced medical directives, and address legal or financial issues.
Consult your health professional if you experience any of the 10 warning signs of dementia, which include memory loss that disrupts daily life, difficulty completing familiar tasks, or new trouble with depth perception. Your clinician will do a physical examination, and a variety of cognitive tests. You may be referred to a neurologist for further studies, such as a brain PET scan to check for amyloid plaques and fibrillary tangles.
Until recently, bloodwork was used to rule out other causes of dementia, like vitamin deficiencies or hypothyroidism. But on May 16, the U.S. Food and Drug Administration approved the first blood test to diagnose Alzheimer’s disease. The Lumipulse G pTau217/ß-Amyloid 1-42 Plasma Ratio detects the presence of plaques in symptomatic patients over the age of 55 by measuring blood levels of tau and amyloid proteins. The FDA found that 91.7% of individuals with elevated protein counts had amyloid plaques on brain scan; 97.4% with normal levels had a negative brain scan; nearly 20% had indeterminate results.
The Lumipulse G Plasma Ratio is not a standalone test: if positive, brain imaging and cognitive testing must be done to confirm an Alzheimer’s diagnosis. But it is a step closer to researchers’ long-term goal of a simple screening blood test for the disease.
Treatment for Alzheimer’s includes prescription medications like donanemab and lecanemab, which can slow its progression by clearing existing amyloid plaques. Donepezil and memantine may improve cognitive symptoms by altering the brain’s neurotransmitter levels.
Safe and supportive environments help make life easier for Alzheimer’s sufferers and caregivers. Keys, wallets, or mobile phones should be kept in the same place at home; light switches labeled, and medications secured. Placing family photos around the home can stimulate memory and promote emotional well-being. Alzheimer’s victims should carry an ID or wear a medical alert bracelet.
Reduce your risk of Alzheimer’s disease by maintaining overall good health. Stay at a normal weight; eat nutritiously (less meat, more legumes, and plenty of fruits and vegetables); keep physically and mentally active, and socially connected. Schedule routine checkups with your primary care provider to make sure your blood pressure and blood sugar are normal — both are associated with increased risk. Treat hearing problems, and cut down on alcohol consumption.
Information about Alzheimer’s disease and resources for caregivers in the Hudson Valley can be found here.
Dr. Mary Jenkins, a contributor to the Herald and member of its board of directors, retired after nearly 40 years as a family practice physician in New York state.