What is Alzheimer's Disease?
According to the National Institute of Neurological Disorders and Stroke,
Alzheimer's disease is a progressive, neurodegenerative disease that occurs
when nerve cells in the brain die. The disease often results in the following
behaviors:
·
Impaired memory,
thinking, and behavior
·
Confusion
·
Restlessness
·
Personality and
behavior changes
·
Impaired judgment
·
Impaired
communication
·
Inability to follow
directions
·
Language
deterioration
·
Impaired thought
processes that involve visual and spatial awareness
·
Emotional apathy
With Alzheimer's disease, motor function is often preserved.
When Alzheimer's was first identified by German doctor Alois Alzheimer in
1906, it was considered a rare disorder. Today Alzheimer's disease is
recognized as the most common cause of dementia (a disorder in which mental
functions deteriorate and break down). An estimated 5.3 million Americans have
Alzheimer's disease. According to the Alzheimer's Association, this number
includes 5.1 million people over the age of 65, as well as 200,000 to 500,000
people younger than 65 who have early-onset Alzheimer's and other types of
dementias.
How is Alzheimer's Different from Other Forms of Dementia?
Alzheimer's disease is distinguished from other forms of dementia by
characteristic changes in the brain that are visible only upon microscopic
examination during autopsy. Brains affected by Alzheimer's disease often show
presence of the following:
- Fiber tangles
within nerve cells (neurofibrillary tangles)
- Clusters of
degenerating nerve endings (neuritic plaques)
Another characteristic of Alzheimer's disease is the reduced production of
certain brain chemicals necessary for communication between nerve cells,
especially acetylcholine, as well as norepinephrine, serotonin, and
somatostatin.
What Causes Alzheimer's Disease?
Although intense investigation has been underway for many years, the causes
of Alzheimer's disease are not entirely known. The National Institute on Aging
says that suspected causes often include the following:
·
Age and family
history
·
Certain genes
·
Abnormal protein
deposits in the brain
·
Other risk and
environmental factors
·
Immune system
problems
What are the Warning Signs or Symptoms of Alzheimer's Disease?
According to the Alzheimer's Association, the following are the most common
symptoms of Alzheimer's disease. However, each individual may experience
symptoms differently. Symptoms may include:
·
Memory loss that
affects job skills, especially short-term memory loss
·
Difficulty
performing familiar tasks
·
Problems with
language
·
Disorientation to
time and place
·
Poor or decreased
judgment
·
Problems with
abstract thinking
·
Misplacing things
·
Changes in mood or
behavior
·
Changes in
personality
·
Loss of initiative
Loss of ability to recognize who people are, even people well known to the
individual, such as his or her child or spouse, when the disease progresses to
a severe stage
The symptoms of Alzheimer's disease may resemble other medical conditions
or problems. Always consult your doctor for a diagnosis.
How is Alzheimer's Diagnosed?
There is not a single, comprehensive test for diagnosing Alzheimer's
disease. By ruling out other conditions through a process of elimination,
doctors, or other specialists, can obtain a diagnosis of probable Alzheimer's
disease with approximately 90 percent accuracy. However, the only way to
confirm a diagnosis of Alzheimer's disease is through autopsy.
Examination and evaluation are essential in determining whether the
dementia is the result of a treatable illness. In addition to a complete
medical history and extensive neurological motor and sensory exam, diagnostic
procedures for Alzheimer's disease may include the following:
- Mental Status Test - This is a brief
and simple test of memory and some other common cognitive or thinking skills;
it is usually part of a complete neurological exam.
- Neuropsychological Testing
- Blood Tests
- Lumbar Puncture (Spinal Tap) - A procedure
performed by inserting a hollow needle into the lower back (lumbar spine).
- Urinalysis - Laboratory
examination of urine for various cells and chemicals, such as red blood cells,
white blood cells, infection, or excessive protein.
- Chest X-Ray - A diagnostic
test which uses invisible electromagnetic energy beams to produce images of
internal tissues, bones, and organs onto film.
- Electroencephalogram (EEG) - A procedure that
records the brain's continuous electrical activity by means of electrodes
attached to the scalp.
- Computed Tomography Scan (also called a
CT or CAT Scan) - A
diagnostic imaging procedure that uses a combination of X-rays and computer
technology to produce horizontal, or axial, images (often called slices) of the
body. A CT Scan shows detailed images of
any part of the body, including the bones, muscles, fat, and organs. CT Scans
are more detailed than general X-Rays.
- Magnetic Resonance Iimaging (MRI) - A diagnostic
procedure that uses a combination of large magnets, radiofrequencies, and a
computer to produce detailed images of organs and structures within the body.
- Genetic Testing - Some genetic
testing is available, especially in some research settings. Because there is no
cure or effective treatment for Alzheimer's, the decision to undergo genetic
testing is one that requires careful consideration and counseling with a
specialist in genetics.
Can Alzheimer's Disease Be Prevented?
Because the cause of the disease is unknown, there are no prevention protocols
to follow at this time. And, because the controllable risk factors for
Alzheimer's disease are unknown, it is not yet possible to reduce the chances
of developing the disease.
What is the Treatment for Alzheimer's?
Specific treatment for Alzheimer's disease will be determined by your
doctor based on:
·
Your age, overall
health, and medical history
·
Extent of the
disease
·
Your tolerance for
specific medications, procedures, or therapies
·
Expectations for
the course of the disease
·
Your opinion or
preference
At this time, there is No Cure for Alzheimer's, No Way of slowing down the
progression of this disease, and no treatment available to reverse the
deterioration of Alzheimer's disease. New research findings give reason for
hope, and several drugs are being studied in clinical trials to determine if
they can slow the progress of the disease or improve memory for a period of
time.
There are some medications available to assist in managing some of the most
troubling symptoms of Alzheimer's disease, including the following:
·
Depression
·
Behavioral
disturbance
·
Sleeplessness
In managing the disease, physical exercise and social
activity are important, as are proper nutrition, health maintenance, and a calm
and well-structured environment.
What are Alzheimer's Rehabilitation Programs?
The Rehabilitation Program for people with Alzheimer's
differs depending on the symptoms, expression, and progression of the disease,
and the fact that making a diagnosis of Alzheimer's is so difficult. These
variables determine the amount and type of assistance needed for the
Alzheimer's individual and family.
With
Alzheimer's rehabilitation, it is important to remember that, although any
skills lost will not be regained, the caregiving team must keep in mind the
following considerations:
·
To manage the
disease, plan a balanced program of physical exercise, social activity, proper
nutrition, and health maintenance activities.
·
Plan daily
activities that help to provide structure, meaning, and accomplishment for the
individual.
·
As functions are
lost, adapt activities and routines to allow the individual to participate as
much as possible.
·
Keep activities
familiar and satisfying.
·
Allow the
individual to complete as many things by himself or herself as possible. The
caregiver may need to initiate an activity, but allow the individual to
complete it as much as he or she can.
·
Provide
"cues" for desired behavior (for example, label drawers, cabinets,
and closets according to their contents).
·
Keep the individual
out of harm's way by removing all safety risks (for example, car keys and
matches).
·
As a caregiver
(full-time or part-time), understand your own physical and emotional limitations.
(Source: John Hopkins Medicine Health Library)