Alzheimer’s disease

 

Other Names: Alzheimer’s disease (AD), also known as Alzheimer disease, or just Alzheimer’s

Definition:
Alzheimer’s is a chronic neurodegenerative disease that usually starts slowly and gets worse over time. It destroys memory and other important mental functions.
It’s the most common cause of dementia — a group of brain disorders that results in the loss of intellectual and social skills. These changes are severe enough to interfere with day-to-day life.
In this disease, the brain cells themselves degenerate and die, causing a steady decline in memory and mental function….CLICK  & SEE

Alzheimer’s is a type of dementia that is more common with increasing age. People with a family history of the condition are also at increased risk of developing it.

At present Alzheimer’s disease medications and management strategies may temporarily improve symptoms. This can sometimes help people with Alzheimer’s disease maximize function and maintain independence.But because there’s no cure for this disease, it’s important to seek supportive services and tap into one’s support network as early as possible.

Symptoms:
At first, increasing forgetfulness or mild confusion may be the only symptoms of Alzheimer’s disease that one notices. But over time, the disease robs one of more of one’s memory, especially recent memories. The rate at which symptoms worsen varies from one person to other person.

If some one has Alzheimer’s, he or she may be the first to notice that the person are having unusual difficulty remembering things and organizing different thoughts. Or may not be recognizing that anything is wrong, even when changes are noticeable by the family members, close friends or co-workers.

Brain changes associated with Alzheimer’s disease lead to growing trouble with:
Alzimer’s is a slowly progressive chronic disease. It progresses in different stages:
Stages of Alzheimer’s disease:

*Effects of ageing on memory but not AD
*Forgetting things occasionally
*Misplacing items sometimes
*Minor short-term memory loss
*Not remembering exact details

Early stage Alzheimer’s:

*Not remembering episodes of forgetfulness
*Forgets names of family or friends
*Changes may only be noticed by close friends or relatives
*Some confusion in situations outside the familiar

Middle stage Alzheimer’s:

*Greater difficulty remembering recently learned information
*Deepening confusion in many circumstances
*Problems with sleep
*Trouble knowing where they are

Late stage Alzheimer’s:

*Poor ability to think
*Problems speaking
*Repeats same conversations
*More abusive, anxious, or paranoid

Causes:
Scientists believe that for most people, Alzheimer’s disease results from a combination of genetic, lifestyle and environmental factors that affect the brain over time.

Less than 5 percent of the time, Alzheimer’s is caused by specific genetic changes that virtually guarantee a person will develop the disease.

Although the causes of Alzheimer’s are not yet fully understood, its effect on the brain is clear. Alzheimer’s disease damages and kills brain cells. A brain affected by Alzheimer’s disease has many fewer cells and many fewer connections among surviving cells than does a healthy brain.

As more and more brain cells die, Alzheimer’s leads to significant brain shrinkage. When doctors examine Alzheimer’s brain tissue under the microscope, they see two types of abnormalities that are considered hallmarks of the disease:

*Plaques. These clumps of a protein called beta-amyloid may damage and destroy brain cells in several ways, including interfering with cell-to-cell communication. Although the ultimate cause of brain-cell death in Alzheimer’s isn’t known, the collection of beta-amyloid on the outside of brain cells is a prime suspect.

*Tangles. Brain cells depend on an internal support and transport system to carry nutrients and other essential materials throughout their long extensions. This system requires the normal structure and functioning of a protein called tau.

In Alzheimer’s, threads of tau protein twist into abnormal tangles inside brain cells, leading to failure of the transport system. This failure is also strongly implicated in the decline and death of brain cells.

Click & see: Transmittable Alzheimer’s’ concept raised :

Risk Factors:
Age:
Increasing age is the greatest known risk factor for Alzheimer’s. Alzheimer’s is not a part of normal aging, but your risk increases greatly after 65 years of age. Nearly half of those older than age 85 have Alzheimer’s.

People with rare genetic changes that virtually guarantee they’ll develop Alzheimer’s begin experiencing symptoms as early as their 30s.

Family history and genetics:

The risk of developing Alzheimer’s appears to be somewhat higher if a first-degree relative — parent or sibling — has the disease. Scientists have identified rare changes (mutations) in three genes that virtually guarantee a person who inherits them will develop Alzheimer’s. But these mutations account for less than 5 percent of Alzheimer’s disease.

Most genetic mechanisms of Alzheimer’s among families remain largely unexplained. The strongest risk gene researchers have found so far is apolipoprotein e4 (APOE e4). Other risk genes have been identified but not conclusively confirmed.

Sex: Women may be more likely than are men to develop Alzheimer’s disease, in part because they live longer.

Mild cognitive impairment:

People with mild cognitive impairment (MCI) have memory problems or other symptoms of cognitive decline that are worse than might be expected for their age, but not severe enough to be diagnosed as dementia.

Those with MCI have an increased risk — but not a certainty — of later developing dementia. Taking action to develop a healthy lifestyle and strategies to compensate for memory loss at this stage may help delay or prevent the progression to dementia.

Past head trauma: People who’ve had a severe head trauma or repeated head trauma appear to have a greater risk of Alzheimer’s disease.

Lifestyle and heart health:

There’s no lifestyle factor that’s been conclusively shown to reduce your risk of Alzheimer’s disease.

However, some evidence suggests that the same factors that put you at risk of heart disease also may increase the chance that you’ll develop Alzheimer’s. Examples include:

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*Lack of exercise (a sedentry life style)
*Smoking
*High blood pressure
*High blood cholesterol
*Elevated homocysteine levels
*Poorly controlled diabetes
*A diet lacking in fruits and vegetables

These risk factors are also linked to vascular dementia, a type of dementia caused by damaged blood vessels in the brain. Working with your health care team on a plan to control these factors will help protect your heart — and may also help reduce your risk of Alzheimer’s disease and vascular dementia

Diagnosis:
There is no specific test today that can confirms the Alzheimer’s disease. The doctor will make a judgment about whether Alzheimer’s is the most likely cause of the symptoms based on the information that the patient provides and results of various tests that can help clarify the diagnosis.

The doctor will Physical and neurological exam:

The doctor will perform a physical exam, and is likely to check the overall neurological health by testing the patient 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

The doctor may ask the patient to under take the following tests:

1. Blood test: The tests may help the doctor to rule out other potential causes of memory loss and confusion, such as thyroid disorders or vitamin deficiencies

2. Mental status testing: The doctor may conduct a brief mental status test to assess the patient’s memory and other thinking skills. Short forms of mental status testing can be done in about 10 minutes.

3. Neuropsychological testing : The doctor may recommend a more extensive assessment of the patient’s thinking and memory. Longer forms of neuropsychological testing, which can take several hours to complete, may provide additional details about the mental function compared with others’ of a similar age and education level.

4. 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 tumors — that may cause cognitive change. New imaging applications — currently used primarily in major medical centers or in clinical trials — may enable doctors to detect specific brain changes caused by Alzheimer’s.

Brain-imaging technologies include:

i) Magnetic resonance imaging (MRI). An MRI uses radio waves and a strong magnetic field to produce detailed images of your brain. You lie on a narrow table that slides into a tube-shaped MRI machine, which makes loud banging noises while it produces images. MRIs are painless, but some people feel claustrophobic inside the machine and are disturbed by the noise.

MRIs are used to rule out other conditions that may account for or be adding to cognitive symptoms. In addition, they may be used to assess whether shrinkage in brain regions implicated in Alzheimer’s disease has occurred.

ii) Computerized tomography (CT). For a CT scan, you’ll lie on a narrow table that slides into a small chamber. X-rays pass through your body from various angles, and a computer uses this information to create cross-sectional images (slices) of your brain. It’s currently used chiefly to rule out tumors, strokes and head injuries.

Positron emission tomography (PET). During a PET scan, you’ll be injected in a vein with a low-level radioactive tracer. You’ll lie on a table while an overhead scanner tracks the tracer’s flow through your brain.

The tracer may be a special form of glucose (sugar) that shows overall activity in various brain regions. This can show which parts of your brain aren’t functioning well. New PET techniques may be able to detect your brain level of plaques and tangles, the two hallmark abnormalities linked to Alzheimer’s.

Future diagnostic tests:

Researchers are working with doctors to develop new diagnostic tools to help definitively diagnose Alzheimer’s. Another important goal is to detect the disease before it causes the symptoms targeted by current diagnostic techniques — at the stage when Alzheimer’s may be most treatable as new drugs are discovered. This stage is called preclinical Alzheimer’s disease.

New tools under investigation include:

* Additional approaches to brain imaging
* More-sensitive tests of mental abilities
* Measurement of key proteins or protein patterns in blood or spinal fluid (biomarkers)

Treatment:
Current Alzheimer’s medications can help for a time with memory symptoms and other cognitive changes. Two types of drugs are currently used to treat cognitive symptoms:

Cholinesterase inhibitors. These drugs work by boosting levels of a cell-to-cell communication chemical depleted in the brain by Alzheimer’s disease. Most people can expect to keep their current symptoms at bay for a time.

Less than half of those taking these drugs can expect to have any improvement. Commonly prescribed cholinesterase inhibitors include donepezil (Aricept), galantamine (Razadyne) and rivastigmine (Exelon). The main side effects of these drugs include diarrhea, nausea and sleep disturbances.

Memantine (Namenda). This drug works in another brain cell communication network and slows the progression of symptoms with moderate to severe Alzheimer’s disease. It’s sometimes used in combination with a cholinesterase inhibitor.

Creating a safe and supportive environment:

Adapting the living situation to the needs of a person with Alzheimer’s is an important part of any treatment plan. For someone with Alzheimer’s, establishing and strengthening routine habits and minimizing memory-demanding tasks can make life much easier.

One 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.
*See if the doctor can simplify the medication regimen to once-daily dosing, and arrange for the finances to be on automatic payment and automatic deposit.
*Develop the habit of carrying a mobile phone with location capability so that one can call in case the person is lost or confused and people can track the location via the phone. Also, program important phone numbers into the person’s phone, so that he or she does not have to try to recall them.
*Make sure regular appointments are on the same day at the same time as much as possible.
*Use a calendar or white board in the home to track daily schedules. Build the habit of checking off completed items so that you can be sure they were completed.
*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.
*Reduce the number of mirrors. People with Alzheimer’s may find images in mirrors confusing or frightening.

Exercise:

Regular exercise is an important part of everybody’s wellness plan — and those with Alzheimer’s are no exception. Activities such as a daily 30-minute walk can help improve mood and maintain the health of your joints, muscles and heart.

Exercise can also promote restful sleep and prevent constipation. Make sure that the person with Alzheimer’s carries identification if she or he walks unaccompanied.

People with Alzheimer’s who develop trouble walking may still be able to use a stationary bike or participate in chair exercises. You may be able to find exercise programs geared to older adults on TV or on DVDs.

Yoga & Meditation : It is proved that even an acute Alzheimer’s patient can improve a lot if he or she does Yoga & meditation regularly under the guidance of an expart teacher.

Alzheimer’s patients should be careful of taking daily nutritional food in time.

Study results have been mixed about whether diet, exercise or other healthy lifestyle choices can prevent or reverse cognitive decline. But these healthy choices promote good overall health and may play a role in maintaining cognitive health, so there’s no harm in including the above good and healthy lifestyle.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
Resources:
https://en.wikipedia.org/wiki/Alzheimer%27s_disease
http://www.mayoclinic.org/diseases-conditions/alzheimers-disease/basics/definition/con-20023871

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