Alzheimer’s disease is a neurodegenerative disorder & the most common cause of dementia. There is a continuous decline in thinking, behavioural & social skill leading to a decrease in functioning independently. This disease is named after Dr Alois Alzheimerin 1906. This condition usually affects aged 65 yrs or over & 10% of cases occurring in younger people. Staging – Mild, Preclinical, Moderate & Severe.
The common symptoms of Alzheimer’s are –
- Memory loss
- Confusion about localisation of familiar places
- Taking a longer time to accomplish normal daily tasks
- Trouble handling money & paying bills
- Judgment problem leading to bed decision
- Loss of spontaneity and sense of initiation
- Mood & personality changes increased anxiety
Moderate Stage – Increasing damage of the areas of the brain leading to
- Problem recognizing faces of friends & family members
- Difficulty with language – Reading, Writing, Working with numbers
- Difficulty organizing thoughts & logical timing
- Restlessness, agitation
- Hallucination, Delusion
- Loss of impulse control
- The problem is getting out of chair/ setting table
Latex/ Severe Stage
- Weight loss
- Lack of bowel & bladder control
- Tremor, Slowness etc
Preclinical Alzheimer’s disease – The patient presents with mild cognitive impairment (MCI), the affected regions begin to atrophy these brain changes occurs decades before any signs/symptoms appear.
Pathology /Whats happens inside the brain – Certain area of the brain which is essential for memory, language, executive functions and getting atrophied slowly, start in entorhinal cortex – near formation hippocampus (essential to short term & long term memories). Then progresses to affect various regions off cerebral cortex, leading to others dysfunction. Senile plaques (SP) & Neurofibrillary triangles (NFT) are the hallmark of the disease.
How to diagnosis
- Clinical examinations – Mainstay to diagnosis
- Lumbar Puncture – Increasing phosphorylated Tau and decreasing amyloid in cerebrospinal fluid. But routinely not recommended.
- Imaging – To rule out potential other causes of dementia-like Sub deural chronic haematoma, NPH etc.
- Various imaging modalities are MRI brain, FDG Pet, Functional MRI
- Another blood test to rule out the often causes of dementia is relatively treatable.
Treatment It’s a progressive disorder. Only symptomatic treatment is available, no drug to half the progress of the disease. Research is going on & there are some experimental treatments.
The patient can get benefit from
- Cognitive rehabilitation
- Dietary management
- Increasing sleep
- Behavioural intervention
- Decreasing consumption of alcohol
- Healthy lifestyle
- Decreasing stress
Hospitalisation is essential for patients in a severe stage with certain other medical condition.