ALZHEIMER’S DISEASE
Alzheimer’s is a progressive, degenerative disease and another form of dementia which affects the memory, thinking and behavior and eventually loses control in reasoning, planning, language and perception. Dementia is serious disorder that affects a person’s ability to carry out daily activities. Alzheimer’s disease is a neurogenerative disease. Well-known case of this disease is the US president Ronald Reagan. This disease is named after the German physician Aloi Alzheimer who first explained this disease. In US Alzheimer’s is the seventh leading cause of death and there is no cure for the disease at present. This disease begins slowly and in course of time the symptoms get worse. The patients even forget how to brush their teeth and comb their hair.
In any type of dementia, memory loss is an important feature for the diagnosis. The rate of development or advancement in each person differs from each other. If the diseases advance quickly, it will continue to progress rapidly and if it is slow advancement of the disease, it will continue on a slow pace. The old people have greater risks of developing Alzheimer’s disease and it is not a part of normal ageing. Family history is also a risk factor. In addition to old age and family history, there are other factors also such as:
(a) Very old blood pressure, diabetes, coronary heart diseases.
(b) History of head injury or damage.
(c) High levels of homocyteine.
(d) Being a female or as a women live longer than men, they are more prone to develop Alzheimer’s disease.
Two types of Alzheimer’s disease are early onset and late onset. Symptoms appear before 60 years in early onset.
The exact cause of Alzheimer’s disease is not known but it is thought to be depending on genetic and environmental factors. Alzheimer’s disease is diagnosed by its distinguishing symptoms and by excluding other causes of dementia. The time span of the disease may vary from five and 20 years according to the age in which it got affected.
Symptoms
Symptoms include:
(a) Repeating statements and sentences.
(b) Mislaying items.
(c) Forgetting names of familiar objects and people.
(d) Change in personality such as less spontaneity apathy and also have the inclination to retreat from social interaction.
(e) Lose of interest in things enjoyed before.
(f) Difficulty in performing tasks which takes time such as balancing checkbook and playing complex games.
(g) Mood change.
More obvious symptoms can be seen in the advanced stage of the disease. They are:
(a) Lose of memory in current events.
(b) Forget their self and events in their life.
(c) Cannot choose proper clothing.
(d) Dejected, nervous and fantasy.
(e) Difficulty in performing task such as preparing meals and driving.
During the last stage the patient cannot survive with out the assistance until death. The symptoms are:
(a) Does not understand language or cannot communicate.
(b) Cannot recognize the members of the family.
(c) Cannot do the daily basic things like eating, dressing and bathing.
Age is a factor
Alzheimer’s disease occurs around 50% of persons over the age of 85 but it is not normal as people lived over 100 years of age never developed Alzheimer’s disease. It normally occurs in people above the age 70. One of the risk factors of this disease is the advancing age. The frequency of the disease increases as the population ages. There are very rare cases of Alzheimer’s disease at 40s and 50s i.e. 2%-5% of patients. Half of these patients with early onset disease are because of gene mutation and the offspring of the patient with early onset disease is also at high risk of developing Alzheimer’s disease. Late onset of Alzheimer’s disease is due to a common form of gene located on chromosome 19. But in majority of patients no specific genetic risks are identified.
Patient with Down syndrome will develop the brain changes of Alzheimer’s disease by 40 years of age. Those who have Alzheimer’s disease will mostly from other diseases such as heart disease or some other health problem rather than Alzheimer’s disease.
The increased frequency of this disease is in women led to the research about the role of estrogen hormone. More recent studies show that estrogen should not be prescribed to post menopausal women to decrease the risk of Alzheimer’s disease.
Diagnosis
Alzheimer’s disease can be diagnosed when a person has a cognitive decline which is like dementia. There are many other conditions such as:
(a) Neurological disorders such as Parkinson’s disease, brain tumors, strokes, cerebrovascular disease, blood clots and multiple sclerosis.
(b) Brain infections such as chronic syphilis, chronic HIV or chronic meningitis.
(c) Cognitive impairment can be caused as a side effect of some medicines which is used to control bladder urgency and incontinence. Psychiatric medications such as antidepressants and anti-anxiety medicines and also neurological medications such as ant-seizure medicines.
(d) Psychiatric disorders
(e) Abuse of legal and illegal drugs and abuse of alcohol.
(f) Metabolic disorders such as Vitamin B1 deficiency or thiamine deficiency.
(g) Head injuries with brain contusion and blood clots in brain.
(h) Dementia can be caused by brain tumors.
(i) Acute carbon monoxide poisoning can also lead to dementia.
Many other disorders can be confused with Alzheimer’s disease. The diagnosis also includes:
(1) A thorough general medical checkup.
(2) Neurological examination which include testing memory and other function of thinking.
(3) Psychiatric evaluation to assess mood, anxiety and clarity of thought.
It is understood that during the course of the disease ‘plaques’ and ‘tangles’ develop in structure of the brain, leading to the brain, leading to the death of brain cells. The examination of brain cells is possible only during autopsy.
Reducing cardiovascular risk factors such as hyper cholestrolemia, hypertension, diabetes, smoking, lack of physical activity and high dietary saturated fats can reduce the onset and course of Alzheimer’s disease. Intellectual stimulation such as playing chess or completing crossword puzzles and regular physical exercise also can reduce the progression of the disease.
Role of the family
The role of the family is most important in both reducing cost of care and improving the quality of life of the patient. Home care may delay the symptoms and delay or eliminate the need for more professional and costly care. Home based care also may have economic, emotional and ever psychological costs to the patient’s family.
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