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Alzheimer's disease is the most common form of dementia, which is a group of brain disorders. It is categorized by a gradual loss of mental function and memory which decreases intellectual and social skills eventually effecting one's everyday life.

There are two types of Alzheimer's Disease (AD):
  • Early Onset AD: With this type of the disease, the symptoms will appear before the age of 60. This is much less common than Late Onset AD and may have a genetic link. There have been several genes that have been identified and may run in families. Although it is more rare, symptoms do tend to get worse quickly.
  • Late Onset AD: This is the most common type of AD and occurs in people who are aged 60 or older. This type may run in families, but a genetic link has not been proven.

3 brains showing shrinkage and spread of disease, from mild to severe (http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-fact-sheet)
3 brains showing shrinkage and spread of disease, from mild to severe (http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-fact-sheet)








Signs and Symptoms


One of the earliest signs of Alzheimer's is difficulty with memory such as an inability to concentrate and forgetfulness. Although these things are common, even in people with no neurological damage, Alzheimer's is characterized by persistent and worsening memory.

Examples of memory loss include:
  • constantly repeating questions and statements
  • being overly forgetful
  • misplacing things on a regular basis in obscure places
  • etc.
Memory loss can progress to the point of forgetting about certain aspects of life such as family member's names and past events.

Other symptoms that follow the progression of Alzheimer's disease are difficulty with speaking and writing due to an inability to express thoughts or find the right words. Numbers become a hard concept to grasp because the person may have trouble being able to think and reason. One may also find difficulty responding correctly to day-to-day issues, performing once familiar tasks, and may experience a change in personality and behavior.

Risk Factors and Causes


The highest risk factor for Alzheimer's disease (AD) is age. Those age 65 and over are at a higher risk and the number of people with Alzheimer's doubles for each additional five years added onto this age. AD is seen more often in women due to the fact that women tend to live longer than men, thus increasing this rate. Genetics are also considered a risk factor that is beyond the control of an individual.

Other risk factors include:
  • head trauma
  • birth order
  • down syndrome
  • low level of education
  • age at birth
  • having high blood pressure for a long period of time.

There is no proven cause of AD, but studies show it develops in the brain over a long period of time as a result of many different series of events. You are more likely to get this disease if you have a close blood relative who has been diagnosed with Alzheimer's Disease. Genes and environmental factors seem to play a role in the development of this disease as well as lifestyle factors. Aluminum, lead, and mercury are no longer believed to be a cause of AD as previously thought.

Medical Management and Therapy


Currently, there is no cure for Alzheimer's Disease. Treatment that is believed to be most effective at this time is a combination of NSAIDs (nonsteroidal anti inflammatory drugs) and nutritional supplements such as vitamin E, acetylcholine, antioxidants, and omega-3 fatty acids. Although this drug treatment seems to work best, drug treatments at this time remain strictly experimental because there is no definite therapy that exists. A first cholinesterase inhibitor named Tacrine is approved by the the FDA and helps to improve cognition and function in those with AD, although improvement are small.

The most effective form of treatment that is non-drug related is primary care management. Behavioral and psychological symptom improvements have been seen as a result of collaborative interdisciplinary care.

Medical Nutrition Therapy


Malnutrition and dehydration can be a common problem in patients with Alzheimer's Disease. The primary objective with a patient is to assess their current nutritional status. The patient should maintain a reasonable body weight and be able to meet the daily intake requirements.

During mealtimes, it is best to minimize distractions and offer only one course at a time. The patient may have trouble with eating enough during mealtimes. To help with this, nutrient dense foods should be served during mealtimes and snacks. Research has shown that the greatest amount of intake is during lunchtime. Food intake should be maximized at this time, because this is usually when patient's have the greatest cognition. Mealtimes will also take longer than average and 30 to 45 minutes should be allowed to give the patient enough time for adequate intake.

The patient should be encouraged to remain independent when they can. You can do this by providing finger foods and guide their hand to initiate eating. Verbal and physical cues can be given to remind the patient to chew and swallow. The caretaker should provide assistance if necessary.

alzheimers_lancastria.jpg
lancastria.net

References
http://www.mayoclinic.com/health/alzheimers-disease/DS00161/DSECTION=symptoms
http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-fact-sheet
Mahan, L., & Escott-Stump, S. (2008). Krause's Food and Nutrition Therapy. Missouri: Saunders Elsevier.
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001767/