Alzheimer's

ALZHEIMER'S

What is Alzheimer’s disease?

Alzheimer's disease is a degenerative neurological disorder that causes the brain to shrink and brain cells to die. During the development of Alzheimer’s disease, nerve cells in areas of the brain that control language, reasoning, sensory processing, and conscious thought die due to plaque deposition.

Alzheimer is commonly seen at the elder age while the chances of developing the disease increase with age. Alzheimer’s disease causes problems with memory, thinking and behavior. It is the most common form of dementia. People with Alzheimer begin to have problems recognising family and friends, learning new things. They also find it difficult to carry out everyday tasks. They might suffer from insomnia. In the more severe stages of Alzheimer’s disease, the brain completely shrinks and people become increasingly dependent on others.

Alzheimer was first discovered in 1906 by a German psychiatrist and neuropathologist Dr. Alois Alzheimer and thereafter this disease is known as Alzheimer. He examined the brain of a woman who had died with symptoms of memory loss, language problems, and altered behavior. He found unusual clumps in her brain, known as amyloid plaques, as well as tangles in her brain fibers that are some of the main features of Alzheimer's disease.

Causes of Alzheimer’s disease

Scientists still haven’t figured out exactly what causes Alzheimer's disease but plaques and tangles in the brain look different than normal individuals. Alzheimer’s disease is caused by the abnormal build-up of amyloid and tau proteins in the brain which form plaques and tangles respectively around brain cells.

The nerve cells work together to fulfill all the communications needed to perform functions such as thinking, learning and remembering. These plaques and tangles block the communication between the nerve cells, which prevents them from carrying out their processes. The slow and ongoing death of the nerve cells starting in one area of the brain then spreading to other areas.

Symptoms of Alzheimer’s disease

The early warning signs of Alzheimer’s disease vary among persons however some of the common symptoms are as below:

  Memory loss

  Repetition of words

  Confusion with time or place

  Drastic changes in mood and personality

  Wandering

  Misplacing things

  Decreased or poor judgment

  Withdrawal from social activities

  Forget conversations, appointments or events, and not remember them later

  Forget the names of family members and everyday objects

  Difficulty in performing familiar tasks

  Difficulty in reading and vision

  Difficulty in speaking or writing right words to identify objects

  Difficulty in solving simple problems



Risk factors of Alzheimer’s disease

Although it's still unknown what factors trigger Alzheimer's disease, several factors are known to increase risk of developing this condition. Some well established risk factors of Alzheimer's disease are as below:

Age:  Aging is the main risk factor for developing Alzheimer’s disease. About 5% of people above 65 years old have Alzheimer’s disease and this percentage increases by about 5% with each increment of 5 years. Although early or young onset Alzheimer's disease can affect people from around the age of 40.

Family history:  Family history or genes affect risk of developing Alzheimer’s disease. However people who develop Alzheimer’s due to a genetic reasons are diagnosed at a age before 60 and they represent a very small portion of all cases of Alzheimer’s disease.

Down’s syndrome:  Down's syndrome has a much higher risk of developing Alzheimer's disease. The genetic fault that causes Down's syndrome also causes a build-up of amyloid plaques. This lead to Alzheimer's disease in most people with Down's syndrome.

Education level:  Having a high level of education and cognitively demanding job, the brain developes greater cognitive reserve which allows the brain to better cope with the early impacts of Alzheimer’s disease. So a low level of education in early life affects cognitive reserve and is one of the most significant risk factors for Alzheimer’s disease.

Head injury:  Head injuries are most commonly caused by accidents, some type of sports and falls. People who have had a severe head injury may be at higher risk of developing Alzheimer's disease.

Cardiovascular risk factors:  Cardiovascular risk factors are the most important ones and are linked to the health of our heart and blood vessels. Having high blood pressure (hypertension) or a high cholesterol level or uncontrolled diabetes or obesity increases the risk of Alzheimer’s disease.

Inactive lifestyle and lack of exercises:  Exercising regularly is associated with a lower risk of developing Alzheimer’s disease. Physical activity is good for the heart and muscles and most probably helps the mind and the brain.

Smoking and alcohol:  People who smoke and take alcohol are at a 45% higher risk of developing Alzheimer’s as compared to non-smokers.


Complications of Alzhimer’s disease

Alzheimer’s disease has many side effects and complications that can create problems for the patient and their caregivers. Apart from physiological and behavioural changes, there are a number of medical complications that are part of Alzheimer’s disease. It is important for all caregivers to be aware of these conditions to minimize problems.


Infections:  People with this disease tend to lose bladder control and thus a urinary catheter might become necessary. Since they are at high risk for infections they might develop Urinary Tract Infection (UTI).

Injuries:  People who have Alzheimer’s disease may fall which can cause serious injuries. Many people with the disease have to use a stick or walker but they may not remember that they need to use them. That is how many serious falls can happen.

Insomnia:  This is a common complication that arises due to this disease. With degeneration of thought-processes as well as physical capabilities, there could be major changes in sleeping habits. Sufferers might either over-sleep or suffer from insomnia for a prolonged period of time.

Depression:  Depression due to Alzheimer’s disease has been recognized as a medical complication that accompanies this condition. Most sufferers suffer from severe depression during the initial phase of the disease, as they realize that they are losing the physical and mental capabilities. Recognizing depression in a sufferer of Alzheimer’s disease is rather difficult since the symptoms can be somewhat obscured by the symptoms of the disease itself.



How is Alzheimer’s disease diagnosed?

There is no single diagnostic test to determine whether a person has Alzheimer’s disease or not. However, a series of clinical and physiological examination mentioned below are carried out to diagnose this condition.


  A complete medical and psychiatric history

  A neurological exam

  Laboratory tests

  A mental status exam

  Neuropsychological tests

  Brain imaging tests like MRI (Magnetic Resonance Imaging) or CT (Computerized Tomography) scan

  Disease processes imaging test performed with Positron Emission Tomography (PET) like Fluorodeoxyglucose (FDG) PET, Amyloid PET imaging and Tau PET imaging

  Interviews with friends and family



Treatment options for Alzheimer’s disease

There is no treatment that cures Alzheimer's disease or alters the disease process in the brain. In advanced stages of the disease, complications from severe loss of brain function such as dehydration, malnutrition or infection result in death.


Medications:

Medications may temporarily improve or slow progression of symptoms. These treatments can sometimes help people with Alzheimer's disease maximize function and maintain independence for a time. Different programs and services can help support people with Alzheimer's disease and their caregivers. Some of most commonly medications are:

  Aricept

  Donepezil

  Exelon

  Memantine

  Namenda

  Namzaric

  Razadyne

  Rivastigmine


Therapies:

Other therapy treatments, activities and support are also important in helping people live well with this disease.

Cognitive stimulation therapy (CST):  Taking part in group activities and exercises designed to improve memory and problem solving skills.

Reminiscence therapy:  Discussion of past experiences to jog a patient’s memory. It usually involves photos, favourite possessions or music.

Simulated presence therapy:  Playing a recorded voices of the closest relatives to reduce challenging behaviour.

Validation theory:  This is based on accepting the reality about dementia and moving past it to get better.

Cognitive rehabilitation:  This technique involves working with a trained professional, such as an occupational therapist, and a relative or friend to achieve a personal goal, such as learning to use a mobile phone or other everyday tasks. Cognitive rehabilitation works by getting you to use the parts of your brain that are working to help the parts that are not.


Alzheimer’s disease gets worse over time. On average, patients with Alzheimer’s disease live, four to eight years after diagnosis. Some patients can live as long as 20 years after diagnosis. The effects of the disease varies from person to person.

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