Definition & Clinical Appearance
Alzheimer’s disease results from the gradual degeneration of nerve cells (neurons) in the parts of the brain that process cognitive information.
Signs and Symptoms
• Increasing forgetfulness and short-term memory loss.
• Difficulty making decisions.
• Impaired judgement, new difficulty making mathematical calculations or handling money.
• Decreased knowledge of current events.
• Anxiety, withdrawal, and depression as awareness of deficits becomes frightening and embarrassing.
• Language difficulties, including rambling speech, frequent inability to name familiar objects, long pauses to find the right word, and repetition of the same words, phrases, or questions.
• Loss of ability to communicate verbally or to write and understand written language.
• Delusions, hallucinations, paranoia, or irrational accusations.
• Agitation and combativeness.
• Unusual quiet and social withdrawal.
• Wandering or getting lost in familiar places.
• Urinary and fecal incontinence.
• Inappropriate social behavious, indifference to others.
• Failure to recognise friends and family.
• Inability to dress, eat, bathe, or use a bathroom without assistance.
• Walking difficulty or multiple falls.
Aetiology
Good evidence indicates that a genetic component predisposes some individuals to Alzheimer’s disease, but there are likely several distinct causes. The mechanism of the disease is characterized by the death of neurons in certain areas of the cerebral cortex of the brain, especially those in which integration of new information and retrieval of memory take place. In people with Down Syndrome, Alzheimer’s disease occurs at an earlier age.
Contributing Factors
Metabolic imbalance, drug effects, depression and vitamin deficiencies.
Start of Pathology / Onset
Alzheimer’s disease affects about 10 percent of people over the age of 65, more than 10 percent of those between 75 and 85, and by some estimates, upward of 50 percent of those over 85. Location The nucleus basalis in the brain affecting the CNS. Complications Severe cognitive impairment results in complete dependence upon caregivers. On average, patients die within 10 years of onset, often from complications such as malnutrition or pneumonia.
Prophylaxis / Prevention
There is no proven way of preventing Alzheimer’s disease
Prognosis
Short term memory loss, mental deterioration.
Medical Treatment
Donepezil (Aricept), galantamine (Reminyl), and rivastigmine (Exelon), inhibitors of the enzyme acetylcholinesterase, provide modest improvement in some patients with mild to moderate Alzheimer’s disease. Side effects include nausea and loss of appetite. Insomnia, depression, aggression, and other psychological manifestations may be treated with various medications. Much of the responsibility to care for a patient with Alzheimer’s falls into the hands of the primary caregiver. Supportive counselling, day care, visiting nurses, and eventual inpatient nursing facilities may help to ease the caregiver’s burden.