Alzheimer's disease: what is it, the first symptoms, signs, causes, treatment

Introduction

Everyone has heard of Alzheimer's today. However, the general public is not always well informed and the disease continues to be the subject of many misconceptions. Origin, development, symptoms, treatment, risks, prevention ...

In this article, you will find all the information you need to better understand Alzheimer's.

What is Alzheimer's Disease?

Alzheimer's disease (also called Alzheimer's senile dementia) is a neurodegenerative disease that slowly and gradually destroys our brain cells. Opened it

Alois Alzheimer, the neuropathologist who first diagnosed this disease in one of his patients in 1906.

Currently, doctors still do not understand exactly how and why Alzheimer's disease develops. One way or another, cells in different parts of the brain are damaged and killed. Brain damage contains abnormalities called beta amyloid plaques and neurofibrillary tangles (tau-proteins).

The death of brain cells leads to dementia in the elderly(dementia), characterized by memory loss, intellectual disability, disorientation, changes in mood and behavior.

As the disease progresses, the person loses control over speech, bladder and bowels. In most cases, patients die from infectious diseases such as pneumonia or other diseases. Most people with Alzheimer's live for about 8-10 years after diagnosis, but some of them live as long as 20.

Each case of Alzheimer's disease affects at least two lives: the patient's life and the life of a spouse or child. which should gradually take on the entire burden of the patient as the disease progresses.

Caring for a patient with senile dementia of the Alzheimer's type is very demanding and takes a lot of energy and nerves. Ultimately, many carers are forced to make the difficult decision to place their loved one in a care facility.

Causes and development of Alzheimer's disease

In 1906, Alois Alzheimer discovered the disease that now bears his name. This condition causes the gradual disappearance of neurons in areas of our brain that control certain abilities, such as memory, speech, reason, or attention.

A real coup!

Having disappeared, neurons can no longer effectively program a certain number of actions. Result: some abilities weaken and gradually reduce a person's independence. And if Alzheimer's is more common in older people, this is not a normal consequence of aging!

"Not just a memory disease ..."

Alzheimer's disease is often associated with memory loss. Indeed, neurons located in the region of the hippocampus, the center of memory, are the first to suffer. But this is not just a memory disease.

As it develops, other parts of the brain may be affected, making it harder to communicate, perform multiple actions at the same time and perform daily tasks.

Science tells us more

The disease causes two types of damage to the central nervous system:

1. A dysfunction of a protein essential for neurons called tau.
2. The appearance of the so-called "senile" plaques associated with another protein (beta-amyloid), which is deposited outside the neurons.

Gradually, these lesions spread and affect the upper parts of the brain. The disease is becoming more and more visible.

Evolution on a case-by-case basis

Each case is specific, so the stages of Alzheimer's disease are felt at different rates for everyone. However, there are three main stages in the development of the disease:

• Easy stage: Approximately 25% of the hippocampus shrinks and the relationship between short-term and long-term memory becomes more complex. The person has a slight forgetfulness of names or recent events that get worse over time.
• Moderate stage: Other parts of the brain are affected, causing speech, gesture and recognition disorders. A person needs help with certain activities (getting around, managing a budget, paying bills, cooking ...).
• Heavy stage: progression of lesions and recovery of information is almost impossible: past events and information disappear from memory. A person loses independence in almost all daily activities.

"I often have memory loss, do I have Alzheimer's?"

This is a question that many people ask themselves... and the answer is no!

Sometimes forgetting about appointments, colleagues' names or phone numbers is quite common. Alzheimer's disease combines several disorders, such as speech, attention, and memory disorders.

"Alzheimer's disease is not inherited in 99% of cases."

Who is most susceptible to this disease?

As already mentioned today, the exact origin of the disease remains little known, but researchers have identified the circumstances that contribute to the development of Alzheimer's disease. They are associated with genetic predisposition and multiple environmental factors called "risk factors".

Risk factors that can lead to the disease:

• age: older people suffer (mostly over 65);
• gender: the risk of developing the disease is higher in women after 80 years;
• predisposition to vascular diseases;
• Traumatic brain injury: Studies have shown that people who have suffered a concussion are more likely to suffer from this condition;
• diabetes, lipid disorders, high blood pressure, smoking;
• family history: the disease is hereditary in only 1% of cases.

However, even if no one in your family has Alzheimer's, you can still develop it.

Alzheimer's disease symptoms

Alzheimer's disease can manifest itself differently in different people. As well as its development. There is a lot of talk about changes in so-called cognitive functions, including memory, however emotions and behavior can also be affected by the disease.

When the symptoms are "cognitive"

The word "cognitive" is the medical term for everything related to intelligence and cognition.

Specifically, so-called cognitive symptoms are associated with memory, speech, recognition, judgment, reasoning, or understanding.

Therefore, the common misconception that Alzheimer's disease only affects memory is wrong: it is much broader.

"Memory is the first obvious disorder."

Memory

This is the first obvious disorder, hence the popularity with the general public. At the beginning, the disease affects the so-called episodic memory: forgetting recent events, meetings ...

Subsequently, other types of memory are affected; working memory, semantic memory, procedural memory... Result: it becomes difficult to immediately store information, memorize new names, stories or locations.

Speech disorder

The most serious, after memory impairments, are speech disorders. They lead to difficulties in communication and a gradual misunderstanding of what was said in a conversation.

Speech disorders regress in 3 stages:

1. The vocabulary is reduced, a person remembers words for a long time, uses the same word, repeats.
2. The person says only one word, or makes one sound, or uses jargon that doesn't make sense.
3. The person doesn't speak anymore.

Gesticulation

The usual gestures in everyday life become difficult to perform. The frustration begins with difficult tasks, such as writing, and then spreads to simple tasks, such as chewing or swallowing food. It is this disorder that is the reason for the loss of independence of the sick person.

Impaired recognition

Recognition disorders, or "agnosia", do not allow a sick person to fully realize what is in front of him. These difficulties are most often visual, but can also be related to smell, hearing, and even touch.

Executing tasks

To control and carry out complex or new tasks, so-called "executive" functions are required. This is the ability to plan, reason, focus. As Alzheimer's disease progresses, these functions stop working.

As a result, the person tends to give up difficult tasks such as budget management, payment billing, travel arrangements, meeting with friends... in the end, and the inability to do two things simultaneously.

Feelings and emotions

• The person is experiencing unreasonable anxiety or fear. The sick person expresses new fears about things that have not bothered them before, such as their finances or the future.
• Apathy or loss of motivation. A person loses interest in everything or almost everything, even in certain tasks that fall under independence. Emotions are also dulled. A person becomes more indifferent to what is around. This is the most common emotional disorder, but it often goes unnoticed because the person is isolated.
• Irritability or changeable mood. This leads to sudden tantrums or tantrums with delays or expectations.
• Euphoria or uncontrollable joy. Happiness for no apparent reason is an unexpected but destabilizing aspect of Alzheimer's. The patient may find funny things where they are inappropriate.
• Depression or dark thoughts. Sometimes it manifests itself in various forms: sadness, pessimism, devaluation... A sick person is discouraged, crying, thinks that he has no future, that he is a burden for loved ones and loved ones, and he is even visited by washing about suicide.

"This behavior is often a reaction of fear."

Behavior

• Aggression or excitement. It manifests itself in violent words and actions, refusing to eat, washing, going to bed at night... This behavior is often a reaction to fear and misunderstanding.
• Inappropriate behavior. By this we mean wandering, compulsive checking of things.
• Sleep and eating disorders. Insomnia, inversion of day-night rhythm... Sleep is often disturbed. From a nutritional point of view, illness can lead to loss of appetite, changes in dietary habits, and therefore weight loss.
• Disinhibition. The person allows inappropriate behavior and / or speech in society.
• Delusions and hallucinations. The patient may have delusional delusions, for example, that people want to offend or kidnap him. Hallucinations may also occur: the patient sees, hears or feels something that does not exist.

Diagnostics

The first thing to do is consult with your general practitioner and tell him about the signs that you may have noticed. It is he who will be able to make the first assessment of the situation and refer you to a more specialized doctor.

"Several examination methods are used to make an accurate diagnosis."

Multidisciplinary diagnosis

Diagnosing Alzheimer's disease is a long and difficult process, especially due to the progressive development of symptoms.

Sometimes it is difficult to distinguish between benign and disease-related, and then, in the second stage, identify its cause (depressive syndrome, thyroid problem or neurodegenerative disease). This step is important because some of the causes may be treatable.

To make an accurate diagnosis, several examination methods are used.

Neuropsychological assessment:

• Method: A series of tests tailored to the patient in the form of questions or simple tasks to perform.
• Objective: To assess the patient's cognitive impairments (memory, speech, thinking, etc.) and identify symptoms as soon as possible.

Brain imaging:

• Method: Using an MRI (magnetic resonance imaging) or CT scan to observe the general appearance and volume of certain areas of the brain.
• Objective: to recognize problems in certain parts of the brain and the absence of other diseases.

Neurological examination:

• Method: the doctor asks the patient to perform any movements, bend, wrinkle his face, etc.
• Purpose: to identify possible neurological problems in a person that affect walking, speech, etc.

General Medical Assessment:

• Method: complete examination of the patient, including laboratory tests.
• Objective: To ensure that the patient does not have another brain or nervous system disease or condition that requires a different therapy.

Treatment

There are no drugs yet that can cure Alzheimer's disease. Currently, treatment only slows the progression of the disease.

However, to improve the quality of life of patients, various therapeutic measures have been developed, including drugs that improve the condition of patients.

Medications

There are four drugs available on the market inhibitorsdesigned to slow the progression of the disease and reduce certain behavioral problems.

The effect is visible: both relatives and doctors say “moderate but significant»Improvement of daily activities, speech, reason, memory ...

In some cases, there is even a lasting improvement in attention and independence!

1. Aricept - an inhibitor used during mild to moderate illness. The agent that affects the body during sleep is used in a dose of no more than 10 milligrams. It is contraindicated for those suffering from ischemic heart disease, asthmatics and ulcers. Side effects of use can be fainting, headaches, dizziness, nausea, insomnia, dyspepsia.
2. Reminyl - an inhibitor of the general spectrum of action. It is used to treat mild to moderate disease. It is intended for the treatment of patients with vascular problems and insufficient circulation in the central nervous system. The remedy is contraindicated in patients renal failure, chronic diseases liver. Side effects may include dizziness, nausea, weight loss, insomnia, and fainting.
3. Exelon - an inhibitor that blocks several acetylcholine enzymes that affect the development of dementia and memory loss. The inhibitor is intended for patients with severe dementia. The drug is contraindicated in patients with memory loss at a young age, it is not prescribed in combination with other drugs. Side effects include nausea, vomiting, insomnia, seizures, angina, weight loss, stomach ulcer, pancreatitis.
4. Memantine - a drug intended for the treatment of severe dementia. The medicine is contraindicated for pregnant and lactating women, as well as for persons under 18 years of age. Side effects include fungal infections, dizziness, drowsiness, hallucinations, and thromboembolism.

Inhibitor drugs are divided into several groups depending on the active ingredient. With poor tolerance or serious contraindications, the drug is replaced by another, from a group of the same type.

The effect of the use of the drug occurs for 7-8 weeks regular admission with a standardized dose. If there are no results from taking a drug, a drug of a different group is prescribed.

An overdose of medication can lead to:

• myocardial infarction;
• epileptic seizure;
• bronchospasm;
• parkinsonism;
• motor dysfunction;
• lethal outcome.

Contraindications to the use of inhibitor drugs:

• chronic, severe diseases of the respiratory system bronchial asthma, pneumonia, tuberculosis);
• epileptic seizures;
• obstruction of the conductivity of the urinary tract;
• intestinal adhesive disease;
• severe current heart disease.

Statistics on Alzheimer's drug treatment.

• Studies have shown that women are more likely to suffer from side effects from medication than men.
• Inhibitor drugs are more effective in the early stages.
• An overdose of drugs can lead to an aggravation of the course of the disease.
• Regular intake of inhibitors can cause severe illness depression.

"The drugs are available by prescription."

Prevention and recommendations

Loss of memory, development of dementia, distortion of one's own "I" - these are the problems that the patient is hard to endure alone.

To protect yourself from the disease, we recommend the following measures:

• Compliance with a healthy lifestyle. In case of impaired cognitive processes in the body, it is worth forgetting about smoking, drugs, and excessive alcohol consumption forever. Addiction to alcohol provokes negative brain changes. Brains are smoothed out, cerebral vessels are damaged. With frequent smoking and drug use, the vascular system of the organ of thinking contracts, the activity of nerve cells is weakened, the trunks of the peripheral nervous system become inflamed.
• Avoiding brain injury. After severe injuries, protein plaques are formed, due to which thinking changes, memory is deformed.
• Proper nutrition. A balanced diet with the use of foods enriched with vitamins and microelements has a positive effect on the body. The human organ of thought begins to work more actively. This is due to a significant reduction in cholesterol levels. The walls of the vessels of the brain are strengthened, elasticity increases.
• Active brain activity. Regularly reading, memorizing, learning languages, doing crossword puzzles, knitting and conducting useful leisure activities the organ of thinking is in the process of constant work, which means that it is actively supplied with blood and filled with oxygen. Ironically, people with a college degree are less likely to develop dementia. Such individuals constantly feed their brains with useful information.
• Sports activities. Such types of outdoor activities as swimming, running, walking, normalize blood pressure, psychologically discharge, strengthen the vascular system.

If the disease still occurs to an elderly person, it is contraindicated to remain alone. Due to short-term interruptions in memory, a person falls into a panic, having no answers to basic questions about who he is and what to do.

You should not make new acquaintances: the patient will not remember a new person, but will receive psychological and emotional stress. As a result of this, panic attacks.

Serious misconceptions about Alzheimer's disease

Even if Alzheimer's is better known and studied today, many misconceptions are still widespread ...

• This is a natural consequence of old age.

Not right! This is a very specific disease, and today it is incurable. This causes a slow and gradual disappearance of neurons.

• Only the elderly are ill with it.

Lie. The percentage of patients with age is higher, but the disease also affects more than 50,000 people in the world under the age of 65!

• My family member is sick, so I will get sick too.

Lie. Only 1% of cases are "hereditary", that is, when the disease was passed on by the parents.

• I solve crosswords and sudoku every day... I'm protected!

Lie. While they are great for developing the brain, there is no research that proves that such exercise protects against Alzheimer's disease. On the other hand, they can slow down its development!

• Close to the patient is especially difficult, because the sick person is not aware of anything.

Not right! The disease progresses, and sick people often, at least from time to time, become aware of memory loss and their failures. This often causes a lot of concern.

• Today this disease is easily diagnosed.

Lie. The diagnosis process is complex and lengthy. General practitioner, i.e. The personal therapist often plays an important role: it is he who can detect the appearance of the first signs.

• In case of Alzheimer's disease, I will still be cured!

True False. Today there is no medicine that can cure the disease! Other medication solutions only help relieve certain symptoms. Finally, non-drug therapy (psychosocial care) helps patients adapt to life with the disease.