Alzheimer's Disease 18


Definition


Alzheimer's disease is the most common cause of dementia and is a progressive disease. The disease affects the brain's neurons and causes them to die off, which causes a loss of memory, behavioral changes, and a decline in language and thinking skills. (1)

There are two types of Alzheimer's Disease, early onset and late onset. Late onset is the most common and occurs in individuals sixty and older. It is thought to run in the family but is not genetically proven yet. Early onset appears before the age of sixty and isn't as common, but progresses much quicker than late onset. It is genetically proven to run in the family. (2)



Causes


While the cause of Alzheimer's is still unknown, it is known that plaque and insoluble twisted fibers build up in the brain. There is thought that these buildups are what could cause the broken connections between neuron. Whether these build ups are a cause of the disease or a byproduct it is still unknown. (1) Genetics does play a role in early onset Alzheimer's but is not yet proven in late onset.(2)

Some things that have been thought to cause Alzheimer's are genes and high blood pressure for long periods of time. Females are more likely to develop Alzheimer's, and a history of head trauma has been shown to be a risk in developing Alzheimer's. (2)

Signs & Symptoms


Symptoms of Alzheimer's disease include:
  • Loss of Abstract Thinking — Someone with Alzheimer's disease may lose the ability to draw conclusions and solve problems. It may become difficult to balance a checkbook, for example, because the patient has forgotten what to do with the numbers.
  • Disorientation — People with Alzheimer's disease can become lost on the street where they live, forget where they are and how they got there, and not know how to get back home.
  • Lack of Initiative — A person with the disease may become passive or unmotivated, sitting in front of the television for hours, sleeping more than usual and not pursuing his or her usual activities.
  • Language Problems — People with Alzheimer's disease often forget simple words or substitute words with inappropriate ones. An Alzheimer's patient who can't find his or her toothbrush may ask for "that thing for my mouth."
  • Misplacing Items — We're all prone to misplacing a wallet or key from time to time, but a person with Alzheimer's will put things in unusual places, such as an iron in the freezer or a wristwatch in the sugar bowl.
  • Mood Swings — Rapid mood swings — from calm to tears to anger — for no apparent reason is another common symptom.
  • Personality Changes — Personalities tend to change with age, but a person with Alzheimer's disease may have a severe personality change, becoming extremely confused, suspicious, fearful or dependent on a family member.
  • Poor Judgment — A loss of judgment is a common symptom. A patient may dress without regard to the weather, wearing several shirts or blouses on a warm day or very little clothing in cold weather. Others may give away large amounts of money to telemarketers or pay for home repairs or products they don't need. (4)


For many people, detecting the first signs of memory problems in themselves or a loved one brings an immediate fear of Alzheimer’s disease. However, most people over 65 experience some level of forgetfulness. It is normal for age-related brain shrinkage to produce changes in processing speed, attention, and short term memory, creating so-called “senior moments.” Forgetfulness is merely inconvenient, though, and generally involves unimportant information. Understanding the significance of these age-related changes begins with knowing the difference between what is normal and what is an early symptom of Alzheimer’s. (3)

SIGNS OF NORMAL CHANGE VS. EARLY ALZHEIMER’S SYMPTOMS
Normal
Early Alzheimer’s disease
Can’t find your keys
Routinely place important items in odd places, such as keys in the fridge, wallet in the dishwasher
Search for casual names and words
Forget names of family members and common objects, or substitute words with inappropriate ones
Briefly forget conversation details
Frequently forget entire conversations
Feel the cold more
Dress regardless of the weather, wear several skirts on a warm day, or shorts in a snow storm
Can’t find a recipe
Can’t follow recipe directions
Forget to record a check
Can no longer manage checkbook, balance figures, solve problems, or think abstractly
Cancel a date with friends
Withdraw from usual interests and activities, sit in front of the TV for hours, sleep far more than usual
Make an occasional wrong turn
Get lost in familiar places, don’t remember how you got there or how to get home
Feel occasionally sad
Experience rapid mood swings, from tears to rage, for no discernible reason

The three stage Alzheimer’s disease model

3 Stages of Alzheimer’s disease
Description
Duration
Characteristics
Mild/Early
2-4yrs
Frequent recent memory loss, particularly of recent conversations and events. Repeated questions, some problems expressing and understanding language. Mild coordination problems: writing and using objects becomes difficult. Depression and apathy can occur, accompanied by mood swings. Need reminders for daily activities, and may have difficulty driving.
Moderate/Middle
2-10 yrs
Can no longer cover up problems. Pervasive and persistent memory loss, including forgetfulness about personal history and inability to recognize friends and family. Rambling speech, unusual reasoning, and confusion about current events, time, and place. More likely to become lost in familiar settings, experience sleep disturbances, and changes in mood and behavior, which can be aggravated by stress and change. May experience delusions, aggression, and uninhibited behavior. Mobility and coordination is affected by slowness, rigidity, and tremors. Need structure, reminders, and assistance with the activities of daily living.
Severe/Late
1-3+ yrs
Confused about past and present. Loss of ability to remember, communicate, or process information. Generally incapacitated with severe to total loss of verbal skills. Unable to care for self. Falls possible and immobility likely. Problems with swallowing, incontinence, and illness. Extreme problems with mood, behavior, hallucinations, and delirium. In this stage, the person will need round the clock intensive support and care.
(3)

Medical Treatment


Currently there is no cure for Alzheimer's. However, there are a few medications available that can help treat the symptoms. The two main types of medications are:
  • Cholinesterase inhibitors. (Aricept, Cognex, Exelon, Razadyne) These help prevent the breakdown of acetylcholine, which is a chemical needed for memory and learning. They help slow the progression of the disease for an average of 6-12 months in about half of all patients.
  • Glutamate regulators. (Namenda) These work by regulating the activity of glutamate, which is essential for memory and learning. In patients with Alzheimer's their brains release too much glutamate.

Researchers are looking for new treatments to alter the course of the disease and improve the quality of life for people with dementia.

The following links provide information about medical treatment options from the Alzheimer's Association. (5)

Dietary Treatment

There is not a specific diet too help Alzheimer's patients, but a well-balanced, nutritious diet is beneficial. Maintaining a healthy weight and staying hydrated are very important. Eating a variety of foods from all foods groups, limiting saturated fats and sodium, and cutting down on sugar are all recommended. Studies about the benefits of omega-3 fatty acids in Alzheimer's patients are mixed: some suggest they may slow the progression while others suggest they do not help. There is no harm in taking an omega-3 supplement or consuming lots of omega-3s through diet, therefore it is generally recommended to get at least 1 g/day.

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Sources:
1. http://www.alzfdn.org/AboutAlzheimers/definition.html
2. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001767/
3. http://www.helpguide.org/elder/alzheimers_disease_symptoms_stages.htm#signs
4. http://www.ucsfhealth.org/conditions/alzheimers_disease/signs_and_symptoms.html
5. http://www.alz.org/alzheimers_disease_treatments.asp
6. http://www.webmd.com/alzheimers/guide/alzheimers-nutrition
7. http://yarrownutrition.wetpaint.com/page/Alzheimers+Disease
8. http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-medications-fact-sheet