Alzheimer's Disease

1 What is Alzheimer's Disease?

Alzheimer’s disease is a progressive brain disorder characterized by loss of memory and cognitive decline.

Symptoms develop slowly and worsen over a period of time, gradually interfering with their ability to carry out daily routines.

Alzheimer’s disease accounts to 60-80% of dementia cases. As the disease progresses, memory loss and intellectual decline worsens, affecting their ability to respond to their immediate environment.

Alzheimer’s does not have a complete cure, but treatment helps to alleviate the symptoms.

These treatment methodologies help to improve the quality of life and independence of the patient for some amount of time.

Support services are very essential to help out when the disease progresses.

alzheimers

2 Symptoms

Alzheimer’s disease starts with mild symptoms that gradually worsen over time and interfere with daily life.

In the next stage, the patient may notice small changes in their behavior like forgetting words, places, or something as simple as misplacing things.

These symptoms do not interfere with the patient’s ability to do things independently. Most of them consider these as normal signs of aging and ignore them.

In the next stage, more noticeable changes include:

  • Forgetfulness, especially something which is just read or learned
  • Repeatedly asking the same questions
  • Difficulty planning and organizing
  • Difficulty remembering names and people

As the disease progresses, moderate decline in intellectual ability becomes more noticeable.

In this stage, patients may forget their own information, and have trouble remembering what month or year it is. Even cooking or ordering from a menu is hard for the patient.

Moderate, severe and very severe decline

With a moderately severe decline in the cognitive abilities, patients may lose track of location and time.

He/she may not be able to remember their address or phone number.

With a severe decline of mental abilities, it is normal for them to mistake a person for somebody else. Delusions are common at this stage. They may also need help in using the washroom.

Very severe decline is characterized by difficulty in every routine activity like eating, walking, and even sitting.

They become more and more dependent on others for all their activities.

3 Causes

A combination of genetic, environmental and lifestyle factors are the causes of Alzheimer’s disease.

In some cases, specific gene mutations are associated with this disease. It is a neurodegenerative disease in which the brain cells degenerate over a period of time.

Two types of abnormalities are characteristic:

  • Plaques – accumulation of the protein beta-amyloid results in the formation of small clumps in the brain. This buildup is known as plaque and is considered to be one of the causes for the death of brain cells. They also affect the communication of nerve cells.
  • Tangles – twisted fibers of another protein called tau also build up inside the brain cells. The abnormal structure of the proteins affect the support and transport of nutrients through the nerve cells. This structure is also considered to be associated with the death of neurons.

The major risk factors of Alzheimer’s disease are:

  • Age – the risk of this disease is high after the age of 65 years. After 60 years, the chance of dementia doubles. People with genetic mutations may have an early onset of the disease.
  • Family history – higher risk is linked to family history of Alzheimer’s disease, particularly if any immediate family members have Alzheimer’s. Gene mutations are associated with Alzheimer’s disease.
  • Down’s syndrome – patients with Down’s syndrome have an increased chance of developing dementia due to Alzheimer’s. The symptoms develop 10-20 years sooner than normal people.
  • Sex – it is more common among women as they tend to live longer than men.
  • Cognitive impairment – the risk of Alzheimer’s is more common among people with mild cognitive impairment.
  • Lifestyle – lack of exercise, smoking, hypertension, high levels of cholesterol, poorly controlled type 2 diabetes, and obesity are all linked to the increased risk of Alzheimer’s disease

4 Making a Diagnosis

There is no confirmatory diagnostic test for Alzheimer’s disease. Diagnosis is mostly based on symptoms.

Physical and neurological examinations help to assess the neurological abilities of the person like reflexes, muscle tone, vision, hearing, coordination, and balance.

Lab tests are recommended to rule out the chances of other diseases and disorders that have similar symptoms.

Memory and cognitive skills are assessed using neuropsychological tests. They provide details of mental function that are then compared to a healthy person of the same age.

Imaging techniques help to visualize the abnormalities in brain. This includes MRI, CT scan, and PET scan.

5 Treatment

Several treatment methods are used for symptoms of Alzheimer's disease.

Cognitive changes and memory loss are corrected using medications like cholinesterase inhibitors and memantine.

Cholinesterase inhibitors help to improve the levels of neurotransmitters, improving message transmission in the brain and controlling neuropsychiatric symptoms.

Donepezil, galantamine, and rivastigmine are the most commonly used cholinesterase inhibitors. Memantine reduces the progression of the disease.

They may be used alone or in combination with cholinesterase inhibitors.

6 Prevention

As the exact cause of the disease is not known, it is not possible to completely prevent Alzheimer's disease.

However, taking adequate precaution helps to delay the onset of major symptoms.

Improving cardiovascular health by quitting smoking and alcohol use, having a healthy balanced diet, and regular exercise helps to reduce the risk of developing this disease.

Staying mentally active also helps in improving cognition.

7 Alternative and Homeopathic Remedies

There are several alternative and homeopathic remedies for Alzheimer's disease.

Some of the common homeopathic remedies used in the treatment of Alzheimer’s include Nux vom, Mercurius, Ignatia, Calcaria carb, Lycopodium, Staphisagria, Chamomilla, and Terentula hispanica.

Many other herbal remedies are suggested for improving cognitive health of the patient, but lack adequate scientific evidence.

Omega-3 fatty acids, curcumin, ginkgo, and vitamin E are the most common supplements considered to be useful in alleviating symptoms of the disease.

8 Lifestyle and Coping

Adjusting lifestyle to suit the needs of the patient is very important in improving their quality of life and coping with Alzheimer's disease.

Having a well planned routine helps the patient to deal with memory loss.

Regular exercise like daily walking helps to improve heart health and muscle strength. It also helps in having good sleep.

Patients should have a medical alert bracelet always. Nutrition is yet another field in which patients may need assistance as they forget to drink an adequate amount of water and eat nutritious food.

High-calorie foods and healthy beverages help to prevent dehydration and constipation.

9 Risks and Complications

Memory loss and other cognitive changes lead to a number of other complications associated with Alzheimer's disease.

With disease progression, these physical functions are the most affected: 

  • Aspiration of food into lungs
  • Pneumonia
  • Infections
  • Falls and fractures
  • Malnutrition
  • Dehydration
  • Bedsores
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