What is Alzheimer's disease?
Alzheimer's disease is the most common and important cause of senile dementia. Dementia is a progressive and irreversible decline of the function of the brain, causing memory loss and effects on language and social skills.
What causes Alzheimer's disease and who is at risk?
Alzheimer's disease is a condition of middle and old age, being exceptionally uncommon in younger people. Although much is known about which cells in the brain degenerate and die during Alzheimer's disease, relatively little is known about what triggers this process. Rarely, the condition may be inherited, but for the vast majority of people there is no clear hereditary factor.
Sex Distant Disease
Other common causes of dementia
A number of other causes of dementia exist that need to be distinguished from Alzheimer's disease because they may be partly or wholly reversible.
The most common of these is 'cerebrovascular dementia'. This is caused by multiple small strokes (blood clots or bleeds) affecting the brain. This illness often differs from Alzheimer's disease in that its progression is not continual and gradual but occurs in a step-wise manner often with periods of relative stability. The memory loss may, however, be indistinguishable from Alzheimer's disease.
A magnetic resonance imaging (MRI) brain scan should allow easy diagnosis of cerebrovascular dementia. It is important that this diagnosis be made because treatment with aspirin may help prevent the progression of symptoms.
Underactivity of the thyroid gland may mimic Alzheimer's disease and is easily diagnosed from a simple blood test. An effective therapy is available which replaces the hormones normally produced by the thyroid.
What are the symptoms and complications of Alzheimer's disease?
The development of mental changes in Alzheimer's disease is often so slow that the sufferer and his or her family cannot easily date the onset of the first symptoms.
The gradual and progressive development of forgetfulness is usually the first symptom. This is often noticed as difficulty finding little-used words including names; appointments are forgotten and possessions misplaced. If working, difficulty coping with the demands of an intellectually challenging job may be the first clue of the disease. As the condition progresses, the individual often asks the same questions again and again as recent memories are lost before more distant ones.
Speech becomes halting because of a failure to remember the required word. The understanding of spoken and written language then becomes impaired and inability to speak a full sentence develops.
Mathematical skills, such as counting money, suffer the same fate. Other skills deteriorate which are seen as difficulty parking the car, difficulty dressing or problems with navigating a well-known route home. Eventually, the sufferer loses the ability to use common objects such as a razor.
Social graces which remain untouched in the early phases of the illness are lost, and habits such as dressing and bathing are neglected. There may be changes in behaviour such as angry outbursts, selfishness and indifference to the feelings of others.
Finally, eating is neglected and weight loss occurs. Incontinence of urine and faeces (stools) are late features. Ultimately, the ability to stand and walk are lost, with the sufferer being bed-bound, having to be fed and bathed. Pressure sores from lack of movement may develop and become infected. Pneumonia is a common cause of death. The course of the illness usually extends over a period of five or more years.
How do doctors recognise Alzheimer's disease?
There are no specific or reliable tests for Alzheimer's disease. Brain scans are usually performed and show shrinkage of the overall volume of the brain, but this is not specific and occurs in other forms of dementia.
The diagnosis of Alzheimer's disease depends on the pattern and progression of symptoms, with specialised tests being performed to rule out rarer but more easily treated disorders. These include blood tests for underactivity of the thyroid gland, vitamin deficiency and rare infections; electrical recordings of the brain (an electroencephalogram; EEG) should also be performed because a form of epilepsy that is readily treated can also cause a confused state that mimics Alzheimer's disease.
What is the treatment for Alzheimer's disease?
Unfortunately, no treatment yet exists to halt or prevent the loss of brain cells that is the underlying cause of Alzheimer's disease. However, there is much that can be done both at home, in hospital and in specialised care centres to improve the quality of life of a sufferer.
A new drug, known as tacrine, which appears to improve memory in the earlier phases of the condition, has recently become available.
What is the outcome of Alzheimer's disease?
There is no cure for Alzheimer's disease and as the condition becomes more severe, it can become less painful for the sufferer but more painful for his or her family and friends. Every effort should be made to maintain quality of life and people close to the sufferer can often gain some comfort from performing simple but essential measures to ensure a dignified existence.
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