Alzheimers - Symptoms & Problems
Problems of Alzheimer's Disease
Approximately 70% of the people with dementia have Alzheimer's disease which affects memory, thinking and behavior. This is one form of dementia the gets worse and worse over time. Alzheimer's disease is classified under cortical dementia, which means there is brain damage primarily affecting the brain cortex or outer layer. It causes memory impairment, thinking problems, problems with language, decision-making ability, judgment, and personality are necessary features for this diagnosis.
Alzheimer's Memory March
November is Alzheimer's Awareness Month
There are 16 million people with Alzheimer's disease in the world and 4.5 million of them are Americans. Each person with Alzheimer's has at least one caregiver and many other people are involved in their disease, such as social workers, doctors,volunteers and support workers and host of other people may be directly or indirectly involved in their care.
November is Alzheimer's awareness month and their color is purple. This is when they do the memory-walk to try to raise money to find a cure.
Causes and Risk factors
Age and family history are the primary risk factors for Alzheimer's disease, and the older you get the greater your chance of developing the disease. Having a close blood relative that has or had the disease puts you at higher risk. Also, having a certain combination of genes for proteins that appear to be abnormal in Alzheimer's disease increases your risk. There is a blood test you can get to find out if you have this combination.
The risk of Alzheimer's appears to increase as a result of several different conditions that the damage heart or blood vessels. The things to be concerned with our high blood pressure, heart disease, stroke, diabetes and high cholesterol.
There are two types of Alzheimer's disease, one called early-onset and the other is late onset. In the early onset, symptoms appear before age 60 and they are less acute; the late onset tends to progress more rapidly. In late onset the development of the disease happens after age 60 or older and the genetic role is less clear.
What is Alzheimer's disease?
Brain Abnormalities of Alzheimer's
Alzheimer's disease has two abnormalities in the brain: amyloyd plaques and neurofribrillary tangles. Yet, the only way to know for certain if someone has Alzheimer's disease is to examine a sample of their brain tissue after death.
The plaques are found in the tissue between the nerve cells and are usually clumps of a protein called beta amyloid along with the generating bits of neurons and other cells. The tangles are bundles of twisted filaments found within the neurons made up primarily of a protein called tau. How all this works is very complex and researchers don't know if the amyloid plaques and neuralfibrillary tangles are harmful or are they merely a side effect.
How Alzheimer's Affects Brain
Progression of Alzheimer's Symptoms
Dementia symptoms usually first appear as forgetfulness. As the disease progresses it causes difficulty with many areas of mental functioning including language, memory, perception, emotional behavior or personality, and cognitive skills (such as calculation, abstract thinking or judgment).
According to the US National Library of Medicine National Institutes of Health these are the symptoms to watch for in Alzheimer's disease. "The early symptoms of Alzheimer's is language problems such as trouble finding the name of familiar objects, misplacing items, getting lost unfamiliar routes, personality changes in loss of social skills, losing interest in things previously enjoyed, flat mood, difficulty performing task that takes some thought but used to come easily such as balancing the checkbook, playing complex games such as bridge or learning new information or routines."
As the symptoms become worse they interfere more and more with the patient's ability to take care of themselves.
Caregivers and patients should ask their doctor the following questions about using these drugs:
- What are the potential side effects of the medicine and are they worth the risk, since there will likely be only a small change in behavior or function?
- When is the best time, if any, to use these drugs in the course of the disease?
Sometimes other medicines are needed to control aggression, agitation or dangerous behaviors but they are usually given in very low doses.
Many people take folate (vitamin B 9), vitamin B12, and vitamin E. There is no evidence that these vitamins will slow down the disease. Some people also believe that the herb ginkgo biloba slows the development of dementia, however, high-quality studies have failed to prove this. Do not use ginkgo biloba if you are taking any type of blood thinner.
Diagnosis and Treatment
When doctors try to diagnose a patient that they suspect has Alzheimer's they will do a thorough history and physical and make sure the patient doesn't have thyroid disease, vitamin deficiency, brain tumor, stroke, intoxication for medication, chronic infection, anemia or severe depression. They will do a CAT scan to look for other causes of dementia such as a brain tumor or stroke.
Unfortunately there's no cure for Alzheimer's disease. The earlier the disease is diagnosed the better it can be treated. Doctors will attempt to slow the disease, which is difficult to do and manage behavior problems, such as, confusion, sleep problems and agitation. Families should modify their home environment as necessary and caregivers need a lot of support from other family members.
Your local Alzheimer's Association Chapter can connect you with many resources that will help you cope with the challenges of this disease. They also have an eight week educational course called EASE. There is also the Wanderers ID program which gives your patient a GPS tracking deviceto be worn in case they wander off. This is worn as a watch and it also has a separate clip on pager.
Drug treatment for these patients has been mostly unsuccessful, as sometimes symptoms even become worse, but they are given in hopes they can slow the progress of the disease. There are 2 types of medications that available:
- Donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne) which affects the level of a chemical in the brain called see the acetylcholine. Side effects include indigestion, diarrhea, loss of appetite, nausea, vomiting, muscle cramps and fatigue.
- Memantine (Namenda) is the other drug approved for treating patients with Alzheimer's disease. Possible side affects include agitation or anxiety.
If you need more information about Alzheimer's diseases call the Alzheimer Association helpline 1-800-272-3900, available 24/7. There website also has a wealth of information.
Research and Prevention Guide
The first study for Alzheimer's was started in 1982, but it's really over the last 15 years that scientists have made enormous strides in understanding the disease. At this time medication just treats the symptoms and not the disease itself which means the damage to the brain cells continues.
Currently there is a lot of research happening to find a cure for Alzheimer's disease. One research project, the Gap Study, is using Intravenous Immune Globulin (IVIg) which may act on some of the underlying causes of Alzheimer's, instead of just on the symptoms. In this study patients are continuing to take their current medications in addition to the Immune Globulin. There are several sites around the country where they're conducting this study and the participant must have a study partner working with them which I presume would be their caretaker.
The first international collaboration on Alzheimer's disease genetics was launched this month on February 1. This collaborative effort spans universities in both England and the United States and plans to combine the knowledge, staff and resources of for consortia that conduct research on Alzheimer's disease genetics. The European Alzheimer's Disease Initiative and of France is a part of this effort.This is very exciting research as they will work to identify the genes that contribute to risk and progression of the disease, as well as, attempting to identify the proteins and other targets for drug development.
Even though there's no way to prevent Alzheimer's disease there are some daily practices that might be worth incorporating into your routine, particularly if you have a family history with dementia. The suggestions are ones we have already heard of for the most part for healthy living. They include consuming a low-fat diet, eat cold water fish at least 2 to 3 times a week, reduce your intake of not linoleic acid which is found in margarine, butter and dairy products, maintain a normal blood pressure and stay mentally and socially active throughout your life.
My personal advice would be to live each day like it might be your last, enjoy life, smile and laugh and don't take yourself too seriously.
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