Alzheimer’s is a progressive and degenerative disease. It is another form of dementia that affects the memory, thinking and behavior of a person. This condition leads to the loss of control in reasoning, planning, language, and perception of the person. Dementia is a serious disorder that affects the person’s ability to carry out daily activities because of the memory loss. Alzheimer’s disease is a neurodegenerative disease.This disease is named after the German physician Aloi Alzheimer, who first explained this disease. In the US, Alzheimer’s is the 7th leading cause of death and there is no cure for the disease at present. This disease begins slowly and the symptoms become worse gradually. The patients even forget how to brush their teeth and comb their hairs, and other daily activities.
In any type of dementia, memory loss is an important feature used for the diagnosis. The rate of development or advancement of the disease in each person differs. If the disease advances quickly, it will continue to progress rapidly. If it is a slow advancement of the disease, it will continue in a slow pace. Old people have a greater risk of developing Alzheimer’s disease than young adults and it is not a part of normal aging. Family history is also considered as a major risk factor. In addition to old age and family history, there are other risk factors that triggers Alzheimer's disease such as:
(a) Very old blood pressure, diabetes, and coronary heart disease.
(b) History of head injury or damage.
(c) High levels of homocysteine.
(d) Being a female. Women live longer than men, so they are more prone to develop Alzheimer’s disease.
There are two types of Alzheimer’s disease such as early onset and late onset. Symptoms appear before 60 years in early onset disease. In late onset, the symptoms of the disease occur after 60's.
Even though the exact cause of Alzheimer’s disease is not known, it is believed that genetic and environmental factors play a major role. Alzheimer’s disease is diagnosed by its distinguishing symptoms and by excluding other causes of dementia. The time span of the disease may vary from five and 20 years, according to the age in which it got affected.
Symptoms of Alzheimer's disease include:
(a) Repeating statements and sentences.
(b) Mislaying items.
(c) Forgetting names of familiar objects and people.
(d) Change in personality such as less spontaneity in apathy and also have an inclination to retreat from social interaction.
(e) Loss of interest in things enjoyed before.
(f) Difficulty or takes time in performing tasks such as balancing checkbook and playing complex games.
(g) Mood change.
More obvious symptoms can be seen in the advanced stage of the disease such as:
(a) Loss of memory on recent events.
(b) Forget their self and events occurred in their life.
(c) Cannot choose proper clothing.
(d) Dejected, nervous and lives in fantasy.
(e) Difficulty in performing tasks such as preparing meals and driving.
During the later stage, the patient cannot survive without the assistance of others until death. The symptoms are:
(a) Does not understand the language or cannot communicate.
(b) Cannot recognize the members of the family.
(c) Cannot do the daily activities like eating, dressing and bathing.
Age is a factor
Alzheimer’s disease occurs around 50% of persons over the age of 85, but it is not a normal case as there are people lived over 100 years of age never developed Alzheimer’s disease. It normally occurs in people above the age of 70. One of the major risk factors of this disease is the advancing age. The frequency of the disease increases as the population ages. There are very rare cases of Alzheimer’s disease between the age of 40s and 50s i.e., in 2%-5% of patients. Gene mutation is one of the major causes of early onset of this disease. The offspring of the patients with early onset of the disease is at a high risk of developing Alzheimer’s disease. Late onset of Alzheimer’s disease is due to a common form of a gene located on chromosome 19. However, the majority of patients do not have any specific genetic risks.
Patient with Down syndrome will develop brain changes of Alzheimer’s disease by 40 years of age. Those who have Alzheimer’s disease before 40's may be suffering from other diseases such as heart disease or some other health problems.
The increased frequency of this disease is in women led to the research about the role of estrogen hormone. More recent studies show that estrogen should not be prescribed to post- menopausal women to decrease the risk of Alzheimer’s disease.
Alzheimer’s disease can be diagnosed, when a person has a cognitive decline just like dementia. Other symptoms to diagnose this condition are:
(a) Neurological disorders such as Parkinson’s disease, brain tumors, strokes, cerebrovascular disease, blood clots, and multiple sclerosis.
(b) Brain infections such as chronic syphilis, chronic HIV or chronic meningitis.
(c) Cognitive impairment can be caused as a side effect of some medicines which is used to control bladder urgency and incontinence. Psychiatric medications such as antidepressants and anti-anxiety medicines, and also neurological medications such as anti-seizure medicines can cause this condition.
(d) Psychiatric disorders
(e) Abuse of legal and illegal drugs, and abuse of alcohol.
(f) Metabolic disorders such as Vitamin B1 deficiency or thiamine deficiency.
(g) Head injuries with a brain contusion and blood clots in the brain.
(h) Dementia caused by brain tumors.
(i) Acute carbon monoxide poisoning can also lead to dementia.
Many other disorders can be confused with Alzheimer’s disease. The diagnosis also includes:
(1) A thorough general medical checkup.
(2) Neurological examination, which include testing of memory and other cognitive abilities.
(3) Psychiatric evaluation to assess mood, anxiety and clarity of thought.
It is understood that during the course of this disease, ‘plaques’ and ‘tangles’ usually develop in the structure of the brain leading to the death of brain cells. The examination of brain cells is possible only during an autopsy.
Reducing cardiovascular risk factors such as hypercholesterolemia, hypertension, diabetes, smoking, lack of physical activity, and high dietary saturated fats can reduce the onset and course of Alzheimer’s disease. Intellectual stimulation such as playing chess or completing the crossword puzzle, and regular physical exercise also can reduce the progression of this disease.
Role of the family
The role of the family is most important in the management of Alzheimer's disease. Proper care provided by family helps to reduce the cost of care and improve the quality of life of the patient. Home care may delay the symptoms and delay or eliminate the need of more professional and costly care. Home based care also reduces the economic, emotional and even psychological costs to the patient’s family.