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Alzheimer’s Disease

ALZHEIMER’S DISEASE

In the elderly population, Alzheimer’s Disease is the most common cause of dementia. Dementia is the loss of behavioral abilities and cognitive functions like thinking, remembering and reasoning.

Cause

Alzheimer’s disease is caused by the death of brain cells. The total brain size shrinks as the nerve cells and connections become fewer and fewer. Plaques also develop between the dying cells in the brain due to the buildup of a protein known as beta-amyloid.

Risk factors

The risk factors of developing Alzheimer’s disease include age since it is most likely to develop in older people. Persons with a family history of the disease are also more likely to develop it. Having the APOE gene also increases a person’s risk for developing this condition. Being female is also another risk factor for this condition.

Evaluation

The evaluation of dementia includes a thorogh physical exam by your primary care doctor followed by consultaino with a neurologist.  Your neurologist will order various studies to exclude reversible causes of memory loss and disease states that can be confused with AD.  These tests may include labs, such as a B12 level, TSH, Vitamin D level, blood count and blood chemistry; an EEG, brain MRI, an in office memory test called an MMSE, a thoughouh neurological exam. At times, neuropsychological testing is ordered as well as spinal fluid anaylis and occasionall PET scans.

Stages

The very early signs and symptoms of Alzheimer’s disease include memory problems. Other symptoms of this stage include thinking problems which can manifest as poor judgment and trouble finding the right words.

The next stage is the mild disease stage at which Alzheimer’s is usually diagnosed. Symptoms of this stage include worsening memory lapses and changes in cognitive functions which can lead to problems like getting lost, misplacing things, poor judgment, trouble handling money and paying bills. Persons at this stage may also repeat questions and take longer to complete normal daily tasks. There may also have mood and personality changes.

The next stage is the moderate Alzheimer’s disease stage. In this stage damage occurs in the areas of the brain that control language, reasoning, sensory processing and conscious thought. Symptoms of this stage therefore include increased memory loss and confusion, problems recognizing family members and friends, inability to learn new things, difficulty carrying out tasks that involve multiple steps like getting dressed. Other symptoms of this stage include impulsive behavior, hallucinations and problems coping with new situations.

The next stage is the severe Alzheimer’s stage in which patients cannot talk and are completely dependent on caregivers. Symptoms of this stage include inability to communicate, weight loss, convulsions, problems swallowing, lack of control of the bladder, groaning, moaning and grunting. Increased sleep in another symptom and towards the end the person may spend most of their time in bed as their body shuts down.

Treatment

There is no cure for Alzheimer’s disease since the death of the brain cells cannot be stopped or reversed. Medications prescribed to reduce the symptoms include Donepezil, Alantamine, Rivastigmine and other cholinesterase inhibitors. Persons with Alzheimer have low levels of acetylcholine in the brain and these drugs maintain existing levels of acetylcholine in the mild to moderate stages of the disease.

Therapeutic interventions that help people with Alzheimer’s live more ably include the effective management of any other conditions they may have in addition to Alzheimer’s.  These treatments include medications like Aricept, Exelon and Namenda.  Physical and mental exercise have been shown to slow decline. This should be combined with dementia quality of life care for those with declining independence.

The treatment of Alzheimer’s disease is important since if not treated it progresses and adversely affects a person’s daily life and activities. It can even progress to such an extent that a person must depend entirely on others for the basic activities of daily living.

Research

The latest research on Alzheimer’s disease reveals that levels of amyloid beta 42 in the cerebral spinal fluid (CSF) may be associated with Alzheimer’s disease and may help predict the diagnosis.

Support groups for patients with Alzheimer’s disease in Tennessee can be found at Alzheimer’s Tennessee whose website is http://www.alztennessee.org/support-groups/  They offer a toll-free monthly telephone support group which meets in the first Monday of the month at 2 p.m. and can be accessed through the phone number 866 212 0875 with the pass code 522552. The contact person for the Knoxville group can be reached via email at linda.johnson@tnalz.org or by phone at 865 544 6288.

 

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Posted on

September 7, 2014