Dementia is a collective name for progressive brain syndromes which affect memory, thinking, behaviour and emotion. Dementia is the leading cause of disability and dependency among the elderly. Alzheimer's disease is the most common cause of dementia and accounts for 50%-75% of all cases.
How
does this degenerative disease of the elderly affect the brain cells to cause memory loss?
In
this condition brain cells and nerves is disrupted transmitting or carrying
messages in the brain, particularly those responsible for storing memories. The
nerve cells die in particular regions of the brain. The brain shrinks as gaps
develop in areas which are responsible for storing and retrieving new
information. These changes affect an individual to remember, speak, think and
make decisions. The production of certain chemicals in the brain, such as
acetylcholine is also affected.
What
are the Symptoms of the disease?
Typically,
Alzheimer's disease begins with lapses of memory, difficulty in finding the
right words for everyday objects or mood swings.
As Alzheimer's progresses, the person may:
Ø Routinely forget
recent events, names and faces and have difficulty in understanding what is
being said
Ø Become confused when
handling money or driving a car
Ø Undergo personality
changes, appearing to no longer care about those around them
Ø Experience mood swings
and burst into tears for no apparent reason, or become convinced that someone
is trying to harm them
Ø As the disease
progresses, people may also
Ø Adopt unsettling
behaviour like getting up in the middle of the night or wander off and become
lost
Ø Lose their inhibitions
and sense of suitable behaviour, undress in public or make inappropriate sexual
advances.
What
are the Causes of Alzheimer’s diseases?
Alzheimer's
is caused by brain cell death and total brain size shrinks with Alzheimer's -
the tissue has progressively fewer nerve cells and connections.
Nerve
cells (neurons) in the brain in Alzheimer are under a microscopic look like
‘plaques’ and 'tangles' between and within brain cells. These are abnormal
protein clumps,
Researchers
do not fully understand why the changes that lead to Alzheimer's disease occur.
Several different factors are believed to be involved. Risk factors for
developing the condition include aging, a family history of Alzheimer's, and
carrying certain genes.
How
is Diagnosis of Alzheimer’s disease done?
Symptoms
can be diagnosed at any stage of Alzheimer's dementia and the progression
through the stages of the disease is monitored after an initial diagnosis, too,
when the developing symptoms dictate how care is managed.
For
doctors to make an initial diagnosis of Alzheimer's disease, they must first be
satisfied that there is dementia. It involves cognitive or behavioural symptoms
that show a decline from previous levels of "functioning and
performing" and interfere with ability "to function at work or at
usual activities."
TWO
of the five symptom areas listed below as per from guidelines jointly produced
by the National Institute on Aging and the Alzheimer's Association diagnose a
patient:
1.
Worsened ability to take in and remember new information, for example: asking
repeated questions
2.
Impairments to reasoning, complex tasking, exercising judgment:
3. Impaired visuospatial abilities (but not,
for example, due to eye sight problems): Inability to recognize faces or common
objects or to find objects in direct view
4.
Impaired speaking, reading and writing: Difficulty thinking of common words
while speaking, hesitations
5.
Changes in personality and behaviour:
·
Out-of-character
mood changes, including agitation; less interest, motivation or initiative;
apathy; social withdrawal
·
Loss
of empathy
·
Obsessive
or socially unacceptable behaviour.
What
are the Stages of Alzheimer's disease?
·
Preclinical
(no signs or symptoms yet)
·
Mild
cognitive impairment
·
Dementia.
The
Alzheimer's Association has broken this down further, describing seven stages along
a continuum of cognitive decline based on symptom severity - from a state of no
impairment, through mild and moderate decline, and eventually reaching
"very severe decline."
Some
tests carried out are:
o
Tests
of blood and urine samples
·
Arranging
brain scans (possibly including CT, MRI and EEG).
·
Sometimes
dementia symptoms are related to an inherited disorder such as Huntington's
disease, so genetic testing may be done.
·
There
must be memory loss and impairment in one other area of cognition for a diagnosis
of dementia such as Alzheimer's to be made. Cognitive testing is a vital
diagnostic tool
·
Normal
cognitive health - score above 26
·
Mild-to-moderate
Alzheimer's - below 26
·
Moderate
- below 20 but above 10
·
Severe
- score under 10.
What
is Treatment and prevention of Alzheimer's disease?
There
is no known cure for Alzheimer's disease - the death of brain cells in the
dementia cannot be halted or reversed.
Effective management of these conditions includes:
·
Activities
and/or programs of adult day care
·
Support
groups and services.
·
Drug
therapy There are four drugs in a class called cholinesterase inhibitor
approved for symptomatic relief
What is Prevention of disease?
There
is a lot of research into risk factors associated with Alzheimer's disease, so there
may be lifestyle measures we can take to potentially reduce our risk and enjoy
a healthier life more generally.
To
understand more about Alzheimer's disease please visit Wockhardt Hospital.
About
Wockhardt Hospitals
Wockhardt
Hospitals follow process driven quality systems that adhere to international
standards of clinical care, safe environment, infection control and respect for
patient rights & privacy. Many of the Wockhardt group of hospitals has
accreditation of the NABH (National Accreditation Board of Hospitals
&Healthcare), the highest and the most stringent quality standards
institution in India and the National authority in healthcare accreditation. To
achieve high degree of clinical excellence, we have entered into strategic alliances
with Partners Medical International, USA, whereby Wockhardt Hospitals has
access to Harvard’s expertise and experience in the fields of surgery and other
Medicare services. Wockhardt group of hospitals in India is a preferred
destination for patients from Europe, USA, Africa, Middle East and South Asia.
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