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 What
is it?
It
is a devastating and progressive organic brain disorder, of insidious
onset, which occurs as the brain ages, causing cognitive impairment
to varying degrees. Chemical and structural changes occur in various
areas of the brain. The resulting damage permanently affects a variety
of brain functions including: memory, emotion, thinking, perception,
speech and behavior.
This
disease may run in families and some genes responsible for this
have been identified. In a few individuals, it was noticed that
Alzheimer's was precipitated by a head injury, some of the serious
systemic illnesses and general anesthesia. Additionally, patients
with Downs syndrome, if they survive until middle age will invariably
develop this disease. Though the progress of thedisorder may be
delayed by medication, there is no cure. Patients may suffer the
effects of Alzheimers disease for up to 20 years.
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presenile
dementia:
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| dementia
beginning in middle age and progressing rapidly (also known
as Alzeihmer's Disease) |
This
ailment is also commonly called Presenile Dementia because
the main symptom of forgetfulness sets in at a younger age than
might otherwise be expected. About 4 million Americans are suffering
from this disorder presently, and half of them are in a severe phase
of illness. More females are afflicted than males (Female to Male
incidence ratio is between 2:1 and 3:1). Onset may occur as early
as age 40. In USA, 40% of people above the age of 85, 20% in the
age group of 75-85, and 10% in the ages between 65 and 75 have been
found to be afflicted by this ailment to various degrees.
How
do we detect it?
There
are 3 phases in the course of this disease. Observations
made by close relatives and friends often provide the first clues
of the disease. Early impairment in the recollection of recent memory
is observed in the 1st phase. Though loss of recent and long time
memories is common in old age, it often occurs earlier with the
development of this disease. Alzheimers disease can sometimes be
detected by close and detailed observation and by comparison with
other people of same age. For patients with this malady, the names
of familiar persons and places become difficult to remember, and
disturbances in mood can be seen.
Also,
a decrease in efficiency may sometimes be noticed by colleagues
at work as well as by family members at home. Patients have difficulty
concentrating, for any length of time, even on previously well known
material. There is usually a gradual loss of interest and motivation
to do any significant amount of work.
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What
are the symptoms?
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| The
symptoms of Alzheimer's vary from person to person and change
as the disease progresses. The first symptom is forgetfulness.
Everyone begins to have some memory problems as they get older.
To learn more on symptoms...More |
The
second phase of illness shows forgetfulness of even major
events in the recent past and main events in the person's past personal
life. He/she will be unable to recollect the location of important
objects, documents, personal belongings and valuable articles. The
person may become unable to handle his or her financial matters.
They may feel that all the normal pleasures and joys of life are
lost. Depression, anxiety and impulsive behavior set in gradually.
Exhibitionism and changes in sexual activity may be seen.
In
the most serious third phase of Alzheimers disease, the
person develops disorientation of time and space. Patients develop
labile emotional patterns with increased irritability, aggressiveness
and restlessness.
The patients Wake-Sleep cycle may become disturbed. Identification
of even familiar persons and objects will be difficult.
Hallucinations
and delusions may also occur. Incontinence of bladder and bowels
is seen in many. Occasionally seizures, similar to epilepsy can
be observed in Alzheimers patients. The ability to talk, to move,
and to care for oneself are lost in the end stages of the disease.
Death often stems from the cumulative effects of infections, the
chronic bedridden condition, suicidal tendency, accidental injuries,
and drug toxicity.
Are
there any Obvious Causes?
No.
In about 10% of the cases, a family history of Alzheimers is present.
In few individuals, a history of a serious head injury exists, in
some, a serious systemic infection has occurred, and in some others,
general anesthesia precipitated the onset of this disease. Patients
of Downs syndrome who survived beyond 30 years of age were invariably
seen to develop Alzheimers disease.
Are
there any Laboratory Tests to diagnose it?
No.
There is no specific test for Alzheimers disease while the patient
is alive. Histopathologic examination of the brain tissue during
a postmortem examination will sometimes reveal brain damage attributable
to Alzheimers disease. EEG and EMG may show nonspecific neuronal
and neuromuscular dysfunction.
Are
There Any Preventive Measures?
No,
as the exact etiology is not known. Hopefully, the progression of
the disease can be slowed through a variety of modalities which
may include; good nutrition, supplementary vitamins and minerals,
physical and mental exercises, yogic exercises, treatment of coexisting
illnesses and socio-psychotherapies. Research is continuing to find
the ways and means to limit the progress of the disease once diagnosed
and determine the chemical and structural changes occurring in the
brain cells with a view toward preventing them.
What
is the Treatment?
As
of today, there is no definite cure for this disease except measures
to slow the progress of the disease as mentioned above. Several
drugs, TACRIN (Cognex) and DONEPEZIL (Aricept) have
been tried with some minimal effect on the progress of the disease.
It is important to rule out the existence of any other major cause
for depression, which is a treatable condition. Depression worsens
the brain function and should be treated appropriately. Schizophrenia
also has to be ruled out in the initial phase of the disease. The
aim of treatment in these patients is to preserve and prolong the
existing mental and physical functions of the body for as long as
possible.
What
else can be done to help a person with this disease?
The
fear of abandonment and embarrassment due to the loss of independence
and ability to care for oneself are major issues for those suffering
with Alzheimers Disease. These issues need sincere reassurance
by the caregivers, friends and all members of the patients family.
There are many social and support groups aimed at providing hope
and lending emotional support to the person with Alzheimer's disease.
He should join such support groups as soon as possible after diagnosis
is confirmed.
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How
long does it last?
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| The
brain function of a person who has Alzheimer's disease continues
to get worse until the person dies. Death may occur after as
few as 3 years or as long as 20 years after the disease is diagnosed.
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Some
states have created additional Community Resources for Alzheimers
patients in their administrative and support services areas, which
may be coordinated through the hospital or doctor's office or through
the local county health department or through visiting nurses associations.
Social workers identify and coordinate many facets of care for Alzheimers
patients, while home health care agencies provide the services of
skilled professionals, such as nurses, medical social workers and
special therapists which in turn provide physical, occupational,
speech, behavioral and respiratory therapies. Home health aides
may be asked to provide personal care of the patient. Adult day
care centers and mental health care centers can give additional
support to the patients and their families. Due to the overwhelming
nature of this disease, most if not all, of the medical and community
resources available are often utilized by patients with Alzheimers
disease.
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