Alzheimer’s Disease

  • September 21, 2020

Alzheimer’s disease is a gradually progressing disorder that causes brain cells to slowly die. It leads to a continuous decline in thinking, behavioral and social skills of a person and hampers his/her ability to function independently. The early signs of this disease can be forgetting recent events or conversations. With the progress of the disease, the affected person will develop severe memory impairment and lose the ability to carry out even the normal daily tasks. There is no cure for Alzheimer’s disease, however, it can be controlled to some extent with medication and mind activity programmes under the guidance of experts.

Symptoms

One of the main symptoms of Alzheimer’s disease is memory loss. The afflicted person is usually unable to recall conversations or incidents that have taken place in the recent past. As the diseases progresses behavioural changes become more apparent and gradually the person is likely to lose the ability to perform simple activities like putting on shoes, buttoning up etc. He/she will find it more and more difficult organizing thoughts. A family member or friend is more likely to notice when the symptoms worsen.

Alzheimer’s affects a person’s:

Memory
We all have occasional memory lapses, but the memory loss associated with Alzheimer’s disease continues and worsens, affecting the ability to function at work or at home.

People with Alzheimer’s often repeat statements, forget things, appointments or event, misplace things, get lost in familiar places, forget names of family members and everyday objects, have trouble naming objects, expressing thoughts or taking part in conversations.

Thinking and reasoning
Alzheimer’s makes it difficult to concentrate, think, reason and rationalize. Making judgements and taking decisions slowly becomes difficult.

Planning and performing familiar tasks
People with advanced Alzheimer’s often find it difficult to do basic tasks such as dressing and bathing.

Changes in personality and behavior
Behavioral changes are common at progressive stages of the disease. A person suffering from Alzheimer’s is likely to go through:

  • Depression
  • Apathy
  • Social withdrawal
  • Mood swings
  • Distrust in others
  • Irritability and aggressiveness
  • Changes in sleeping habits
  • Wandering
  • Loss of inhibitions
  • Delusions, such as believing something has been stolen

With loss of reasoning, the ability to calculate or count gets affected first

While a person with Alzheimer’s struggles with basic calculations, losing the ability to handle finances, certain skills like reading or listening to books, telling stories and reminiscing, singing, listening to music, dancing, drawing, or doing crafts are preserved longer. This is probably because these abilities are controlled by parts of the brain that are affected later in the course of the disease.

Causes of Alzheimer’s disease

Can be hereditary, or caused by lifestyle and environmental factors that affect the brain over time. When the brain proteins fail to function normally, it disrupts the work of brain cells (neurons) and unleashes a series of toxic events. Neurons are damaged, lose connections to each other and eventually die. The loss of neurons spreads to other regions of the brains. In later stages of the disease, the brain shrinks significantly.

Plaques – they are the leftover fragment of a larger protein. They cluster together, and have a toxic effect on neurons and to disrupt cell-to-cell communication.

Tangles – These proteins play a part in a neuron’s internal support and transport system to carry nutrients and other essential materials. In Alzheimer’s disease, they change shape and organize themselves into structures called neurofibrillary tangles and disrupt the transport system and are toxic to cells.

Risk factors

  • Increasing age
  • Family history and genetics
  • People with Down syndrome are likely to develop the disease 10-15 years earlier than others
  • The relation with gender is not known, but women appear to have the greater risk
  • Some people are prone to faster memory decline in comparison of their similar aged counterparts. This condition is called Mild cognitive impairment, and is likely to progress to Alzheimer’s leading to dementia.
  • People with a history of severe head trauma are more at risk
  • Sleep disorders like difficulty in falling asleep or staying asleep is known to be a risk factor.
  • Risk factors associated with heart disease like obesity, smoking (active and passive), high cholesterol, poorly controlled diabetes and lack of exercise also are known to increase chances of Alzheimer’s

Prevention

A number of lifestyle risk factors like changes in diet, exercise and habits for reducing the risk of cardiovascular disease may also lower the risk of developing Alzheimer’s disease and other disorders that cause dementia.

  • Exercise regularly
  • Eat fresh, healthy oils and low in saturated fat
  • Control blood pressure, diabetes and high cholesterol
  • Quit smoking

Studies have found an association between lifelong involvement in mentally and socially stimulating activities and a reduced risk of Alzheimer’s disease for eg. participating in social events, reading, dancing, playing board games, creating art, playing an instrument, and other activities that require mental and social engagement.

Tests

A diagnostic work-up for Alzheimer’s disease would include the following tests:

Physical and neurological exam

The doctor performs a physical exam and assesses the overall neurological health by testing the following:

  • Reflexes
  • Muscle tone and strength
  • Ability to get up from a chair and walk across the room
  • Sense of sight and hearing
  • Coordination
  • Balance

Lab tests
Blood tests may help to rule out other potential causes of memory loss and confusion, such as a thyroid disorder or vitamin deficiencies.

Mental status and neuropsychological testing
A doctor may conduct a brief mental status test or a more extensive set of tests to assess memory and other thinking skills.

Brain imaging
Images of the brain are now used chiefly to pinpoint visible abnormalities related to conditions other than Alzheimer’s disease such as strokes, trauma or tumours that may cause cognitive change. New imaging applications may enable doctors to detect specific brain changes caused by Alzheimer’s.

Imaging of brain structures include the following:

  • Magnetic resonance imaging (MRI) – MRI uses radio waves and a strong magnetic field to produce detailed images of the brain showing shrinkage and other issues
  • Computerized tomography (CT) – A CT scan, a specialized X-ray technology, produces cross-sectional images or slices of your brain. It is used to rule out tumours, strokes and head injuries.

Imaging of disease processes can also be done with positron emission tomography (PET). During a PET scan, a low-level radioactive tracer is injected into the blood stream to reveal a particular feature in the brain. It shows areas of the brain in which nutrients are poorly metabolized, show amyloid deposits in the brain, it measures the burden of neurofibrillary tangles in the brain, is only used in research.

Treatment

Drugs
Medications suggested by the doctor can help for a time with memory symptoms and other cognitive changes.

Creating a safe and supportive environment

Someone with Alzheimer’s, needs to establish and strength routine habits and minimize memory-demanding tasks can make life much easier.

You can take these steps to support a person’s sense of well-being and continued ability to function:

  • Always keep keys, wallets, mobile phones and other valuables in the same place at home, so they don’t become lost.
  • Keep medications in a secure location. Use a daily checklist to keep track of dosages.
  • Arrange for finances to be on automatic payment and automatic deposit.
  • Give a phone to the caregiver to track its location. Program important phone numbers into the phone.
  • Make sure regular appointments are on the same day at the same time as much as possible.
  • Use a calendar or whiteboard in the home to track daily schedules. Build the habit of checking off completed items.
  • Remove excess furniture, clutter and throw rugs.
  • Install sturdy handrails on stairways and in bathrooms.
  • Ensure that shoes and slippers are comfortable and provide good traction.
  • Avoid keeping mirrors as it may be confusing or frightening.
  • A person with Alzheimer’s carries identification or wears a medical alert bracelet.
  • Keep photographs and other meaningful objects around the house.

Certain herbal remedies, vitamins and other supplements are widely promoted as preparations that may support cognitive health or prevent or delay Alzheimer’s.

Lifestyle and home remedies
Healthy lifestyle choices help to promote good overall health and may play a role in maintaining cognitive health.

Exercise
Regular exercise is an important part of a treatment plan for Alzheimer’s. A daily walk can help to improve mood and maintain the health of joints, muscles and the heart. It can also promote restful sleep and prevent constipation.

People with Alzheimer’s who walking problem may use a stationary bike or participate in chair exercises.

Nutrition
People with Alzheimer’s often forget to eat, lose interest in cooking or eat a healthy combination of foods. They may also forget to drink enough water, leading to dehydration and constipation.

Offer the following:

  • Healthy options– Focus on healthy food options that the person with Alzheimer’s disease likes to eat.
  • Water and other healthy beverages –An Alzheimer’s patient must drink several glasses of liquids every day. Avoid beverages with caffeine, that enhance restlessness, interfere with sleep and lead to frequent urination
  • High-calorie, healthy shakes and smoothies –You can supplement milkshakes with protein powders or make smoothies featuring favourite ingredients for people with.
  • Social engagement and activities
    Social interactions and activities can support the abilities and skills that are preserved. Doing things that are meaningful and enjoyable are important for the overall well-being of a person with Alzheimer’s disease. These might include:
    • Listening to music or dancing
    • Reading or listening to books
    • Gardening or crafts
    • Social events at senior or memory care centres
    • Planned activities with children

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