Alzheimer's Disease - Causes, Symptoms, Diagnosis, Prevention & Treatment
Health Education

Alzheimer's Disease

Authored by DesiMD Doctor on 17 Nov 2015 - 16:04.

Alzheimer's disease is a progressive, irreversible disease of the brain that destroys memory and other mental functions. It was named after Alois Alzheimer, a German psychiatrist and neuropathologist, whose contribution in research played a major role in the understanding of the disease. The disease is divided into four stages based on the pattern of cognitive and functional impairments:

  • Pre-dementia
  • Early
  • Moderate
  • Advanced

Alzheimer’s disease and dementia are used as interchangeable terms many a time but a distinct difference lies between these two. Dementia refers to a set of symptoms, but not the disease itself whereas Alzheimer’s is a disease which makes up 60-70% of dementia cases. An Alzheimer patient may have dementia but a patient with dementia may not necessarily suffer from Alzheimer’s disease.

The exact cause of the disease is still unknown with an exception of few cases that are known to be caused due to genetic defects. Two common hypotheses related to the cause are:

  • A combination of genetic, environmental and lifestyle factors lead to the development of plaques and tangles in the brain that eventually cause death of brain cells.
  • Alzheimer’s patients are short of a chemical “acetylcholine” in the brain that involves in the transmission of messages throughout the brain.

Mild confusion and increasing forgetfulness are the initial symptoms of the disease which are followed by loss of recent memory. As the disease progresses, patient may feel difficulty in reading, listening and writing. Further, the patient may not be able to recognize his/her family members and forgets procedures related to daily activities such as brushing teeth or combing hair. At a later stage, the patient may feel frustrated due to increasing loss of memory and may wander away from home.

Alzheimer’s disease is diagnosed by patient’s behavior and history that is reported to the psychiatrist by patient himself or a relative of him.

The National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) and the Alzheimer's disease and Related Disorders Association established NINCDS-ADRDA Alzheimer's Criteria for diagnosis, which require the presence of cognitive impairment and a suspected dementia syndrome to be confirmed by neuropsychological testing for a clinical diagnosis of possible or probable AD. Confirmation of definitive diagnosis is based on a microscopic examination of brain tissue.

Your psychiatrist may recommend any of the following tests to rule out the possibility of other diseases:

  • Laboratory tests
  • Neuropsychological tests
  • Mental status tests
  • Imaging tests (of brain)
  • Beyond the age of 65 years, risk of the disease doubles every 5 years
  • Genetics play a role in few cases
  • Women are at higher risk than men
  • Exposure to environmental toxins contribute to the disease development
  • Down syndrome patients are at high risk
  • Low-educated people are more likely to get the disease
  • Head injury may also increase the risk
  • Heart disease, stroke, high levels of cholesterol and blood pressure are the other factors known to elevate the risk
  • Diet high in saturated fats and simple carbohydrates can increase the risk

MANAGEMENT:

The present management can just alleviate the symptoms but cannot completely cure as Alzheimer’s is an irreversible disease. Improvement in the patient’s health depends on the drug treatment and personal care.

Drug therapy: Acetyl cholinesterase inhibitors and NMDA receptor antagonists are two major classes of drugs used in the treatment.

Tacrine, rivastigmine, galantamine and donepezil are cholinesterase inhibitors which supplies the brain with a chemical messenger ‘acetylcholine’ as there is a shortage of this chemical in the disease. Memantine is the only drug under NMDA antagonists to help relieve the symptoms. These drugs can sometimes be used in combination depending on the severity of the disease.

Caregiving:

We must help the patient to establish and strengthen routine habits while eliminating tasks that demand memory or technique to make his/her life much easier.

Modification which can improve patients conditions:

  • Remove unnecessary furniture and excess mirrors from the surroundings to avoid confusion for the patient
  • Assign a fixed spot for important valuables at home, so they do not become lost
  • Regular exercise can help improve mood
  • A calendar or a board can be used to track daily schedules
  • Patients may forget to eat or drink leading to weakness and dehydration; therefore they should be notified periodically to avoid the consequences
  • A heart healthy diet with low fat and high fruits/vegetables can improve cognitive symptoms
  • Patients should be socially engaged to preserve their mental function
  • Food rich in Omega-3 fatty acid including fish can prevent cognitive decline

At present, there is no proven way to prevent Alzheimer’s disease. However, the risk of developing the disease can be minimized by reducing your risk to heart diseases. Keeping yourself active – physically, mentally and socially, can also help in lowering your risk of developing the disease.

Getting involved in intellectual activities like playing board games, reading, playing musical instruments and solving puzzles reduces the risk. Higher level of education and learning a new language can delay the onset of the disease. Mediterranean diet and food high in flavonoids such as cocoa, tea and red wine are associated with lower risk of the disease.

*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.