Categories: Neurology

Alzheimer’s disease

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 –

Mild Stage

  • 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
  • Seizures
  • Sleeping
  • 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
  • Exercise
  • Behavioural intervention
  • Decreasing consumption of alcohol
  • Healthy lifestyle
  • Decreasing stress

Hospitalisation is essential for patients in a severe stage with certain other medical condition.

Dr. Urmila Das | Consultant Neurologist | Narayana Multispeciality Hospital, Jessore Road, Kolkata

Narayana Health

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