Alzheimer’s Disease: Alzheimer’s is the most common form of dementia, Alzheimer’s, is a chronic neurodegenerative disease that usually starts slowly and gets worse over time – a general term for memory loss and other intellectual abilities severe interfere with daily life. Alzheimer’s disease accounts 60 to 80 percent of dementia cases.
The first symptoms of Alzheimer’s vary in person to person. For many, the decline in non-recollection aspects of cognition, such as word-finding, vision issues, and impaired reasoning or judgment. Studies denote that such early detection may be possible, but more research is needed before the diagnosis of Alzheimer’s disease in everyday medical practice.
Mild Alzheimer’s Disease
When Alzheimer’s disease progresses, people experience more preponderant memory loss and other cognitive difficulties. The problem may include wandering and getting disoriented, trouble in handling money and paying bills, reiterating questions, taking longer to daily tasks, and personality and behaviour changes. People are often diagnosed with this stage.
Moderate Alzheimer’s Disease
In this stage, damage occurs in the areas of the brain that control language, recognized sensory processing, reasoning, and conscious thought. Memory loss and mystification(confusion) grow worse, and people commence to recognized family and friends. They may unable to learn new things, carry out multistep tasks such as getting dressed or cope with new situations. In integration, people at this stage may have delusions, hallucinations, paranoia and may behave impulsively.
Severe Alzheimer’s Disease
Ultimately, plaques and tangles spread throughout the encephalon(brain), and encephalon tissue shrinks significantly. People with astringent Alzheimer’s cannot communicate and completely dependent on others for their care. Near the cessation, the person may be in bed most of the time as the body shuts down.
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Risk factors for Alzheimer’s Disease
Risk factors are characteristics of a person, lifestyle, environment, and genetic background that contribute to getting a disease. Risk factors are not causes of disease. Risk factors represent an incremented chance, but not the certainty, that Alzheimer’s disease will develop.
Some risk factors are modifiable, which denotes they can be changed, other risk factors are non-modifiable, which betokens they cannot be changed.
Modifiable risk factors
Smoking
Cigarette smoking is causally cognate to a wide range of diseases including many forms of cancer, cardiovascular disease, and diabetes. The evidence is strong and consistent that smokers are at a 45% higher risk of developing Alzheimer’s. They are at a higher risk of developing vascular dementia and even other forms of dementia. Additionally, ex-smokers reduce their risk by not smoking. This is an inspiriting finding for dementia obviation, suggesting, as with other adverse impacts of smoking, that the incremented risk of dementia can be avoided by quitting smoking.
High blood pressure
People with high blood pressure in midlife are on average more liable to develop dementia compared to those who have normal blood pressure. High blood pressure affects heart, arteries and blood circulation so it increments the risk of developing Alzheimer’s, categorically vascular dementia. Research has shown that treating high blood pressure with physical activity and the better diet can bring the risk down.
Diabetes
Research showed that type 2 diabetes in midlife is associated with incremented risk of dementia, Alzheimer’s disease, vascular dementia, and cognitive impairment. People who have type 2 diabetes are, on average, twice as liable to develop dementia compared to those without diabetes.
High cholesterol
People with high cholesterol levels in midlife are on average more liable to develop dementia compared to those with normal cholesterol. Research showed that people who have their high cholesterol treated with drugs have a lower risk of dementia. So treating high cholesterol is paramount for both heart and brain health. High cholesterol is a paramount risk factor for hypertension and diabetes and additionally contributes independently to cardiovascular risk.
Obesity and lack of physical activity
Overweight and lack of physical activity are consequential risk factors for diabetes and high blood pressure, and should, consequently, additionally be taken into consideration. Overweight in midlife may increase the risk of dementia and Alzheimer’s and, for that reason, should be addressed.
Other risk factors:
Alcohol
Alcohol is fifth-ranked among the most consequential risk factors for death and disability worldwide and it has been implicated a causal factor for more than 200 diseases and injuries, including non-communicable diseases such as liver cirrhosis, cancers, and cardiovascular disease.
People who drink moderate amounts of alcohol have a lower risk of developing dementia. Those who don’t drink alcohol at all have a marginally higher risk. Those who drink excessively have the highest risk.
Low level of formal edification
Research showed that education lowers the peril of dementia. The quality and quantity of education, that protect against dementia.
People with depression in later life or have a history of depression may additionally develop dementia. However, the relationship between depression and dementia is still unclear. Many researchers believe that depression is a peril factor for dementia.
Head injuries
People who experience severe or reiterated head injuries are at incremented risk of developing dementia. It is possible that deposits that form in a brain as a result of injury may be linked to the onset of dementia.
Non-modifiable risk factors:
Age
Alzheimer’s disease is not a common part of aging but age is the strongest risk factor for Alzheimer’s. But this does not betoken that most people develop the disease as they age. Most do not. Some younger people, in the 40s or 50s, are diagnosed with the early-onset form of a disease. After the age of 65, the peril of developing Alzheimer’s disease doubles approximately every five years. The older you become, the higher the risk.
It’s a well-established that aging can impair the body’s self-repair mechanisms, including in the brain. And, cardiovascular risk factors increase with age, such as heart disease, high blood pressure, and high cholesterol.
Gender Family history and genetics
Most Alzheimer’s does not run in families and is described as “sporadic”. Recherche cases of Alzheimer’s disease are inherited or “familial’.
Familial Alzheimer’s disease
Familial Alzheimer’s disease accounts for 5% of all cases of Alzheimer’s disease. This form of disease runs in families. If a person has the familial history of Alzheimer’s disease, each of his/her children has an incremented chance of inheriting the disease-causing gene and developing Alzheimer’s disease.
Familial Alzheimer’s is due to changes or alterations in categorical genes that can be directly passed on from parent to child. Three familial Alzheimer’s disease risk genes have been discovered so far: the PS1, PS2, and APP genes. If you have in any one of these genes, you will have a more preponderant chance of developing young onset familial Alzheimer’s disease. Researchers are probing for other genes that might be associated with familial Alzheimer’s disease.
Diagnosis of Alzheimer’s Disease
To diagnose Alzheimer’s, physicians may:
- Ask the person questions about overall health, past medical quandaries, ability to daily activities, and changes in behavior and personality
- Conduct tests of recollection(memory), quandary solving, attention, counting, and language
- Carry out tests, such as blood and urine, to identify other possible causes of the problem
- Perform brain scans, that may be computed tomography (CT), magnetic resonance imaging (MRI), to rule out other possible causes for symptoms.
Treatments of Alzheimer’s Disease
Drug treatments and non-drug treatments
Drug treatment for Alzheimer’s disease is paramount, but the benefits are small, and drugs should only be one part of a person’s overall care. Non-drug treatments, activities, and support are just as consequential in availing someone to live well with Alzheimer’s disease.
There are two types of drugs used to treat Alzheimer’s disease: acetylcholinesterase inhibitors (often abbreviated to just ‘cholinesterase inhibitors’) and NMDA receptor antagonists. The two types of drugs work in different ways-
The cholinesterase inhibitors are donepezil, galantamine, and rivastigmine.
- Donepezil was pristinely patented as the brand name Aricept but it is more widely available now as generic donepezil.
- Rivastigmine was patented as Exelon and is available as other brands, as well as generic rivastigmine.
- Galantamine was patented as Reminyl and is now withal available as generic galantamine and the brands Reminyl XL, Gatalin XL, Acumor XL, and Galsya XL.
The NMDA receptor antagonist is memantine. It was pristinely patented as Ebixa and is available as generic memantine. Other brand names for memantine include Maruxa and Nemdatine.
Side effects of the drugs?
Generally, cholinesterase inhibitors and memantine may be taken without an extravagant quantity of side effects. Not everyone experiences the same side effects.
The common side effects of donepezil, rivastigmine, and galantamine are the loss of appetite, regurgitating (vomiting) nausea, and diarrhea. Other possible side effects include headaches, dizziness, muscle cramps, fatigue, and insomnia. Side effects may less likely for people who start treatment by taking the lower prescribed dose for at least a month (visually perceive ‘Taking the drugs’).
The side effects of memantine are less prevalent and less rigorous than cholinesterase inhibitors. They include headaches, lassitude, raised blood pressure, dizziness, and constipation.
It is consequential to discuss any side effects with the medico and/or the pharmacist.
None of these drugs are addictive.
Support from Families and Caregivers
Alzheimer’s has no cure and it gradually renders people incapable of inclining for their own needs, caregiving essentially the treatment and must be punctiliously managed over the course of the disease.
During the early and moderate stages, modifications of the living environment and lifestyle can increment patient safety and reduce caretaker burden. Examples of modifications are the adherence to simplified routines, placing the safety locks, labeling of household items to cue the person with the disease or modified daily life objects.
If eating becomes problematic, food will require being prepared in smaller pieces or even pureed. When swallowing difficulties arise, the utilization of feeding tubes may require. In such cases, the medical efficacy and ethics of perpetuating eating are a paramount consideration of the caregivers and family members.
As the disease progresses, different medical issues may appear, such as pressure ulcers, malnutrition, oral and dental disease, hygiene quandaries, or respiratory, skin, or ocular perceiver infections. Conscientious management can obviate them, while professional treatment is needed when they do arise.
