Alzheimer's disease

Alzheimer’s disease is a progressive, biochemical, degenerative disorder of the brain and it is the most common form of Dementia. The patient with Alzheimer’s disease experiences frequent loss of memory, cognitive functions, inability to understand other’s language, etc. Alzheimer’s disease is common in the older age group and it is incurable, and due to the inability to perform daily activities, the patient may need caregivers and palliative care in the advanced stages. Currently, there is no effective medical treatment for Alzheimer’s disease; but medical management can delay the development of Alzheimer’s disease. Many patients develop the disease in the age group of 50–62 years.

Causes of Alzheimer’s disease

The reason for the development of Alzheimer’s disease is overproduction and decreased elimination of a biochemical called Beta Amyloid protein. The biochemical pathology of Alzheimer’s disease is the protein mis-folding that leads to accumulation of the beta amyloid protein without the respective degrading enzymes. This can damage the brain nerve cells that results in the initiation of the disease. However, other factors such as advanced age, genetic factors and family’s medical history of Alzheimer’s disease, decreased blood supply and oxygen supply to the brain due to blood pressure, stroke and other carotid circulatory failures can contribute to the development of Alzheimer’s disease.

Symptoms

• Acute and short-term memory loss
• Cognitive inability, poor judgments, mood swings.
• Changes in sleep patterns and difficulty in reading and speaking
• Behavioral changes and sudden social withdrawal
• Confusion, delirium, loss of initiative and aggression.

Diagnosis

There is no disease-specific laboratory or radiological diagnosis for Alzheimer’s disease. But some of the co-existing disorders that can contribute to Alzheimer’s disease can be diagnosed, and it can be clinically correlated with the existing symptoms. These include decrease in blood circulation to the brain, stroke-like medical conditions, encephalitis, Parkinson’s disease and other neurological problems of the brain.

Treatment Options

The available medications can treat the symptoms temporarily but the medicines cannot cure or delay the development of Alzheimer’s disease. Some of the medicines prescribed for Alzheimer’s disease are cholinesterase inhibitor and partial glutamate blockers. The cholinesterase blockers such as Galantamine, Rivastigmine, Taccrine and Donepezil are useful to mask the symptoms of Alzheimer’s disease. The Partial glutamate antagonist such as Memantine can be useful. Other medicines such as anti-anxiolytic drugs, sedatives, stimulants and mood stabilizers can be useful for the symptomatic treatment. Some of the alternative therapies such as Yoga, music therapy and brain function stimulation such as cognitive rehabilitation are reported to be useful; but there is no scientific evidence for the beneficial effects of these therapies.

Prognosis

The prognosis of Alzheimer’s disease is usually progressive and it invariably results in a decrease in the brain functions and neurological synaptic transmission that result in permanent disability. Most of the patients in the initial stages can manage to do their daily activities but in the advanced stages they need a caregiver for medical, palliative care assistance and to alleviate the psychological stress.

Prevention Strategies

There is no effective prevention method for Alzheimer’s disease but some of the modifiable risk factors of the disease can be prevented, which can decrease the incidence of Alzheimer’s disease. These include prevention of blood clotting by using Aspirin-like drugs under medical supervision, monitoring the cardiovascular and stroke biomarkers to prevent the incidence of Alzheimer’s disease, refraining from smoking and alcohol with low carbohydrate and oil-free diets and intake of foods rich in antioxidants can be helpful to some extent in prevention of Alzheimer's disease.

When to see a doctor

If you feel something abnormal in your daily activities, frequent memory loss, inability to tell the words or word-finding difficulties, cognitive disabilities including poor judgment, abnormal psychological behaviors such as aggression, confusion, disability to do a particular or daily activity, you may need to seek medical advice immediately.