Alzheimer's Disease

What is it?

Alzheimer’s disease is a degenerative disorder, which destroys brain cells. It leads to a decline in mental function affecting memory, thinking, language and behavior. The disease affects people more than 65 years old. Dementia is a general decline in mental ability and Alzheimer's disease is the most common cause.

What are the causes?

In Alzheimer’s disease, changes in the chemistry and structures of the brain hinder the ability to process, store, and retrieve information. The exact cause of these changes is not known. Some people with Alzheimer’s disease have a family history of the disease and show signs of the disease earlier in life, i.e. before the age of 65.

What are the symptoms?

The symptoms of Alzheimer’s disease vary and change as the disease gets worse. The first symptom is increasing forgetfulness. Most people begin to have some memory problems, as they get older. For a person in the early stages of Alzheimer’s disease, however, these problems are more obvious than in others of the same age. Their attention span becomes shorter. They have a harder time concentrating. Over time, memory loss becomes more severe. Friends notice the memory loss and that the person has problems dealing with written matter. They may misplace or lose important objects. More importantly, recent memory is affected more than long-term memory. Memory is usually the first to be affected. Then thinking is impaired and the patient becomes increasingly disoriented. He is unable to locate his whereabouts i.e., he cannot tell where he is, whether it is morning or evening, or what he had for breakfast. Furthermore, the patient loses the ability to read, write and care for his personal hygiene, so he dirties himself while eating, does not dress properly, and later may pass urine or stools in clothes. Because memory is impaired, confusion and restlessness are common and these conditions worsen with fever.

How is the diagnosis made?

Alzheimer's disease can be diagnosed with a careful study of the patient’s medical history and physical examination. While there is no single diagnostic test, memory testing can be helpful. Blood tests and brain scans are done to see whether there is a recognizable cause of the decline in brain function. It is especially important to rule out depression, a treatable condition that can cause symptoms similar to Alzheimer’s disease. Generally in Alzheimer’s disease there is atrophy of the brain seen on CT Scan or MRI and there is no other abnormality. Thus, if there is clear dementia, the brain shows cerebral atrophy and there is no obvious explanation for this, such as alcoholism, drug abuse or stroke, Alzheimer’s disease is clinically diagnosed. However, a definite diagnosis can only be made by examining brain tissue after death. Nowadays, Cerobrospinal fluid can be tested for certain markers especially if someone has a positive family history.

What is the treatment?

There is no cure. The goal of treatment is to preserve mental and physical function as much, and as long as possible. The best approach seems to be to control other illnesses, consuming a healthy diet and regular exercise. Medicines may be sometimes helpful if used early in Alzheimer’s disease to slow memory loss. Recent research suggests that the disease may be due to the deficiency of a chemical, acetylcholine, the replacement for which is being worked upon. Associated depression should be treated.

What are the prevention?

It is difficult to prevent Alzheimer’s disease until its causes are better understood. People with a family history of this disease should see their doctor regularly. Early diagnosis will allow them to take advantage of new treatments as they become available. It must be noted that Alzheimer’s is a degenerative disease, i.e., it gets worse with time, so the diagnosis, if possible, should be made even before significant symptoms are visible, through genetic tests and brain scans. Obviously no treatment can help once the brain cells die, so the emphasis is on early diagnosis.

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