Nervous System
Alzheimer
 

Alzheimer's disease is a cerebral disorder. It was called (Alzheimer's) after the German physician Alois (Alzheimer), who had been the first to describe the disease, in 1906, before scientists of the past century managed to discover a lot of important facts related to the disease.

What is Alzheimer's disease?

  • It is an progressive cerebral disease that destroys brain cells, causing serious disorders with the faculties of memory, thinking and behavior. Furthermore, it severely affects the patient's life and work, as well as his pattern of social life. As time passes, the patient's case deteriorates continuously, and often leads to his demise.
  • Nowadays, Alzheimer's disease is ranked the sixth major reason for death around the world.
  • Alzheimer's disease is one of the most common sorts of dementia, as it is a general term of losing memory (Amnesia) and other mental faculties. Its danger lies in the fact that it almost paralyses the everyday life of the patient. Nearly 50 – 70 % of the known dementia cases are due to Alzheimer's disease.
  •  It is an incurable disease at the present. However, its symptoms can be successfully cured. And by supporting the patients, they become able to adapt to the disease, and make their lives better.


The early stage of Alzheimer's disease:
By this stage we mean the early symptoms of Alzheimer's disease, which appear in the form of problems in thinking, memory, concentration.

Such symptoms can be observed by the doctor during the examination. Patients of this stage usually require only simple support from those around them, to be able to practice the everyday activity. Therefore, it is quiet uncommon that Alzheimer's patients can be recognized and properly examined in such an early stage. They are often diagnosed in more advanced stages of the disease. Hence, by the term early-onset Alzheimer's, we mean the onset of the disease in people under the age of 65 years.


Stages of the disease
A. Stage 1:
This stage does not include any cognitive impairment (normal function).  The person does not experience any memory problems. An interview with a medical professional does not show any evidence of symptoms of dementia.

B. Stage 2:
This stage comprises a very mild cognitive decline (may be normal age-related changes or earliest signs of Alzheimer's disease). The person may feel as if he or she is having memory lapses — forgetting familiar words or the location of everyday objects. But no symptoms of dementia can be detected during a medical examination or by friends, family or co-workers.

C. Stage 3:
It is the stage of Mild cognitive decline (early-stage Alzheimer's can be diagnosed in some, but not all, individuals with these symptoms). Friends, family or co-workers begin to notice difficulties. During a detailed medical interview, doctors may be able to detect problems in memory or concentration.

Common stage 3 difficulties include:

  • Noticeable problems coming up with the right word or name.
  • Trouble remembering names when introduced to new people.
  • Having noticeably greater difficulty performing tasks in social or work settings.
  •  Forgetting material that one has just read.
  •  Increasing trouble with planning or organizing, as well as Losing or misplacing a valuable object.

D. Stage 4:
It is the stage of moderate cognitive decline (mild or early-stage Alzheimer's disease). At this point, a careful medical interview should be able to detect clear-cut problems in several areas:

  •  Forgetfulness of recent events.
  •  Impaired ability to perform challenging mental arithmetic — for example, counting backward.
  •  Greater difficulty performing complex tasks, such as planning dinner for guests, or paying bill.
  •  Forgetfulness about one's own personal history.
  •  Becoming moody or withdrawn.

E. Stage 5:
It is the stage of moderately severe cognitive decline (moderate or mid-stage Alzheimer's disease) Gaps in memory and thinking are noticeable, and individuals begin to need help with day-to-day activities. At this stage, those with Alzheimer's may:

  •  Be unable to recall their own address or telephone number or the high school or college from which they graduated.
  •  Become confused about where they are or what day it is
  • Have trouble with less challenging mental arithmetic, etc.
  • Need help choosing proper clothing for the season or the occasion.
  •  Still require no assistance with eating or using the toilet.
  •  Still require no assistance with eating or using the toilet.

F. Stage 6:
It is the stage of severe cognitive decline (moderately severe or mid-stage Alzheimer's disease). Memory continues to worsen, personality changes may take place and individuals need extensive help with daily activities. At this stage, individuals may:

  •  Lose awareness of recent experiences as well as of their surroundings.
  •  Remember their own name but have difficulty with their personal history
  • Distinguish familiar and unfamiliar faces but have trouble remembering the name of a spouse or caregiver
  •  Need help dressing properly and may, without supervision, make mistakes such as putting pajamas over daytime clothes or shoes on the wrong feet
  •  Have increasingly frequent trouble controlling their bladder or bowels.
  • Experience major personality and behavioral changes, including suspiciousness and delusions (such as believing that their caregiver is an impostor)or compulsive, repetitive behavior like hand-wringing or tissue shredding
  • Tend to wander or become lost

G. Stage 7:
It is the stage of very severe cognitive decline (Severe or late-stage Alzheimer's disease). In the final stage of this disease, individuals lose the ability to respond to their environment, to carry on a conversation and, eventually, to control movement.
Risk Factors:

  •  Age.
  • Family history of the patient.
  •  Genetics and heredity.
  •  Gender (for women are more susceptible to infection than men).
    The risk of developing Alzheimer’s or vascular dementia appears to be increased by many conditions that damage the heart or blood vessels. These include:
  •  High blood pressure.
  •  High cholesterol.
  •  Irregular blood sugar levels.
  •  Obesity.

Diagnosis:

  • The doctor usually collects information relating to the patient's medical\health history (either from him or his family), to see whether there are similar medically relevant cases. Then he behaves as follows:
  •  Preliminary examination and laboratory tests.
  •  Psychological and mental assessment tests, including Mini-Mental State Exam (MMSE), and The Mini-Cog.
  •  Brain imaging; and this includes structural imaging and functional imaging by means of Magnetic Resonance Imaging (MRI), or by using Computerized Tomography (CT), or Positron Emission Tomography (PET).

 Treatment:

Although current medications cannot cure Alzheimer’s or stop it from progressing, they may help lessen symptoms, such as insomnia, anxiety, agitations and depression. There are two types of medication:
1. Cholinesterase inhibitors - including:

  • Donepezil (Aricept) 
  •  Rivastigmine (Exelon) 
  •  Galantamine (Razadyne)

2. Mematine (Namenda)
• It is the first drug certified for treating Alzheimer's, rather than relieving its symptoms. It regulates the activity of glutamate, a different messenger chemical involved in learning and memory, and delays worsening of symptoms for some people temporarily.
Keep in mind that it is necessary for the patient to have his family and friends around him, and to adequately rest and enjoy new or familiar experiences. Also, talking with the patient should be formulated in short and simple sentences, focusing on one idea, and the patient should be given sufficient time for response. In addition, it is important to avoid concurring and distracting voices when talking to the patient (for instance, TV and radio). Finally, the patient's routine has to be maintained, to avoid distraction and enhance communication.

Websites that can be referred to for further information:


 
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