Types and Treatment for Alzheimer’s disease | Neurology

Alzheimer's disease

What is Alzheimer’s disease?

Alzheimer’s disease is a liberal disorder that causes brain cells to waste away (degenerate) and expire. Alzheimer’s disease is the most common cause of dementia – a continuous decline in social, behavioral, and thinking skills that disrupts a person’s ability to function independently.

The first signs of the disease may be forgetfulness of recent conversations or events. As the disease progresses, a person with Alzheimer’s disease will grow severe memory injury and lose the ability to perform daily tasks.

Current medications for Alzheimer’s disease may temporarily improve symptoms or slow the rate of decline. At times these treatments can help people with Alzheimer’s disease maximize function and maintain freedom for a time. Different agendas and services can help support persons with Alzheimer’s disease and their caregivers.

Types of Alzheimer’s disease

  • Early-onset Alzheimer’s
  • Vascular dementia
  • Dementia with Lewy bodies
  • Frontotemporal dementia
  • Mild cognitive impairment
  • Posterior cortical atrophy
  • Progressive primary aphasia

Causes of Alzheimer’s disease

Scientists believe that for most people, Alzheimer’s disease is caused by a grouping of genetic, lifestyle, and eco-friendly factors that affect the brain over time.

Less than 1 percent of the time, Alzheimer’s disease is caused by specific genetic changes that virtually guarantee that a person will develop the disease. These rare occurrences generally result in the onset of the disease in middle age.

The exact causes of Alzheimer’s disease are not fully understood, but at their core are problems with brain proteins that do not function normally, disrupt the work of brain cells (neurons), and trigger a series of toxic events. Neurons get damaged, lose connections to each other, and eventually die.

The damage frequently starts in the region of the brain that controls memory, but the process begins years before the first symptoms. The loss of neurons spreads in a somewhat predictable pattern to other regions of the brain. In the late stage of the disease, the brain has shrunk significantly.

Researchers focus on the role of two proteins:

  • Plates: Beta-amyloid is a leftover fragment of a larger protein. When these fragments clump together, they appear to have a toxic effect on neurons and disrupt cell-to-cell communication. These clumps form larger deposits called amyloid plaques, which also include other cellular debris.
  • Tangles: Tau proteins play a role in a neuron’s inside transport and provision system to transport nutrients and other essential materials. In Alzheimer’s disease, tau proteins change shape and establish themselves into buildings called neurofibrillary tangles. The tangles disrupt the passage system and are toxic to cells.

Risk factors for Alzheimer’s disease

Age: Older age is the biggest known risk factor for Alzheimer’s disease. Alzheimer’s disease is not part of normal aging, but as you get older, the chance of developing Alzheimer’s disease increases.

Family history and genetics: Your risk of developing Alzheimer’s disease is somewhat higher if a first-degree relative, your father or brother, has the disease. Most of the genetic mechanisms of Alzheimer’s disease between families remain largely unexplained, and the genetic factors are likely complex.

Down’s syndrome: Many people with down syndrome develop Alzheimer’s disease. This is likely related to having three duplicates of chromosome 21 and the next three copies of the gene for the protein that leads to the creation of beta-amyloid. The signs and indications of Alzheimer’s disease tend to appear 10 to 20 years earlier in people with Down’s syndrome than in the general populace.

Sex: There seems to be little difference in risk between men and women, but overall there are more women with the disease because they usually live longer than men.

Mild cognitive impairment: Mild cognitive impairment (MCI) is a decline in memory or other thinking skills that is greater than would be expected for a person’s age, but the decline does not prevent a person from functioning in social or work settings.

Past head trauma: People who have suffered a severe head injury are at increased risk of Alzheimer’s disease.

Bad sleep patterns: Research has shown that poor sleep patterns, such as trouble falling asleep or staying asleep, are related to an increased risk of Alzheimer’s disease.

Lifestyle and heart health: Research has shown that the same risk factors associated with heart disease can also increase the risk of Alzheimer’s disease. These include:

  • Lack of exercise
  • Obesity
  • Smoking or exposure to secondhand smoke
  • Hypertension
  • High cholesterol
  • Poorly controlled type 2 diabetes

All of these factors can be modified. Therefore, changing your lifestyle habits can alter your risk to some extent. For example, regular exercise and a healthy low-fat diet rich in fruits and vegetables are associated with a lower risk of developing Alzheimer’s disease.

Symptoms of Alzheimer’s disease

  • Memory loss that disrupts daily life
  • Challenges in planning or problem solving
  • Difficulty completing familiar tasks
  • Confusion with time or place
  • Problems understanding visual images and spatial relationships
  • Mood and personality changes
  • Withdrawal from work or social activities
  • Decreased or poor judgment
  • Losing things and losing the ability to retrace steps
  • New problems with words when speaking or writing

Diagnosis of Alzheimer’s disease

A key component of a diagnostic evaluation is self-assessment of symptoms, as well as information that a close family member or friend can provide about symptoms and their impact on daily life. Also, a diagnosis of Alzheimer’s disease is based on tests your doctor performs to assess memory and thinking skills.

Laboratory and imaging tests can rule out other potential reasons or help your doctor better describe the disease-causing of your dementia symptoms.

The entire suite of diagnostic tools is designed to detect dementia and determine with relatively high precision whether the cause is Alzheimer’s disease or another condition. Alzheimer’s disease can be diagnosed with the whole certainty after death when a microscopic checkup of the brain reveals the characteristic plaques and tangles.

Tests

A diagnostic study would likely include the following tests:

Physical and neurological exam

Your doctor will accomplish a physical exam and will likely assess general neurological health by testing the following:

  • Muscle tone and strength
  • Ability to get up from a chair and cross the room
  • Sense of sight and hearing
  • Coordination
  • Balance

Lab tests

Blood tests can help your doctor rule out other possible causes of memory loss and confusion, such as a thyroid disorder or vitamin deficiencies.

Mental state and neuropsychological tests

Your doctor may conduct a short mental status test or a more extensive set of tests to assess memory and other reasoning skills. Longer forms of neuropsychological tests can provide additional details on mental function compared to people of similar age and level of education. These tests are also important to establish a starting point for tracking the progression of symptoms in the future.

Mental image

Brain imaging is now primarily used to identify visible abnormalities related to conditions other than Alzheimer’s disease, such as strokes, trauma, or tumors, which can cause cognitive changes. New imaging applications, currently used primarily in major medical centers or in clinical trials, can enable physicians to detect specific brain changes caused by Alzheimer’s.

Images of brain structures include the following:

Magnetic resonance imaging (MRI): MRI uses radio waves and a strong magnetic field to produce detailed images of the brain. Magnetic resonance imaging is used primarily to rule out other conditions. While they may show shrinkage of the brain, the information does not currently add significant value to making a diagnosis.

Computed tomography (CT): A CT scan, a specific X-ray technology, produces cross-sectional images (slices) of your brain. It is currently used primarily to rule out tumors, strokes, and head injuries.

Imaging of disease processes can be done with positron emission tomography (PET). During a PET scan, a low-level radioactive tracer is injected into the blood to reveal a particular feature of the brain. PET images can include the following:

Fluorodeoxyglucose (FDG) positron emission tomography scans show areas of the brain where nutrients are poorly metabolized. Recognizing patterns of degeneration (areas of low metabolism) can help separate between Alzheimer’s disease and other types of dementia.

Amyloid PET images can measure the load of amyloid deposits in the brain. These images are largely used in research but can be used if a person has unusual or very early-onset dementia indicators.

Tau Pet images, which measure the load of neurofibrillary tangles in the brain, are only used in research.

In special circumstances, such as rapidly liberal dementia or very early-onset dementia, other trials may be used to measure abnormal beta-amyloid or tau in cerebrospinal watery.

Future diagnostic tests

Investigators are working on tests that can amount the biological proof of disease processes in the brain. These tests can improve the accuracy of diagnoses and allow an earlier diagnosis before symptoms appear.

Treatment for Alzheimer’s disease

Drugs

Current Alzheimer’s medicines can help for a time with memorial symptoms and other cognitive changes. Two kinds of drugs are currently used to treat cognitive symptoms:

Cholinesterase inhibitors: These drugs work by increasing levels of the cell-to-cell message by preserving a chemical messenger that is depleted in the brain by Alzheimer’s disease. The improvement is modest.

Cholinesterase inhibitors may also expand neuropsychiatric indications, such as agitation or depression. Frequently prescribed cholinesterase inhibitors contain donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon).

The main side things of these drugs include diarrhea, nausea, loss of appetite, and sleep disturbances. In people with cardiac conduction disorders, thoughtful side effects may include cardiac arrhythmia.

Memantine (Namenda): This drug works in different brain cell communication network and reduces the progression of symptoms with moderate to severe Alzheimer’s disease. It’s sometimes used in combination with a cholinesterase inhibitor. Relatively rare side effects include dizziness and confusion.

Sometimes other medications such as antidepressants may be directed to help control the behavioral symptoms linked with Alzheimer’s disease.

Prevention

Alzheimer’s disease is not a preventable condition. However, several lifestyle risk factors for senile dementia can be modified. Evidence suggests that changes in diet, exercise, and habits (steps to reduce the risk of cardiovascular disease) can also reduce the risk of developing senile dementia and other disorders that cause dementia. Heart-healthy lifestyle choices that can reduce Alzheimer’s risk include the following:

  • Exercise regularly
  • Eat a diet of fresh food, healthy oils, and foods low in saturated fat
  • Follow treatment guidelines for managing high blood pressure, diabetes, and high cholesterol
  • If you smoke, ask your physician to help you quit

Studies have shown that well-maintained thoughtful skills later in life and a reduced risk of Alzheimer’s disease are linked with participating in social events, reading, dancing, playing board games, creating art, playing an instrument, and other activities. that require mental and social commitment.

Complications

Loss of memory and language, impaired judgment, and other cognitive changes affected by Alzheimer’s disease can involve treatment for other conditions. Somebody with Alzheimer’s disease may not be able to:

  • Communicate that you are experiencing pain, for example, due to a dental problem
  • Report symptoms of another illness
  • Follow a prescribed treatment plan
  • Note or describe the side effects of medications

As Alzheimer’s disease progresses to its later stages, brain changes begin to affect physical functions, such as swallowing, balance, and bowel and bladder control. These effects can increase weakness in added health problems such as:

  • Inhaling food or fluids into the lungs (aspiration)
  • Pneumonia and other infections
  • Falls
  • Fractures
  • Pressure ulcers
  • Malnutrition or dehydration

When to contact the doctor

Several conditions, including those that can be treated, can lead to memory loss or other symptoms of dementia. If you are concerned about your memory or other thinking skills, speak with your doctor for a complete evaluation and diagnosis.

If you are concerned about the thinking skills you observe in a family member or friend, discuss your concerns and ask if you can go to a medical appointment together.

Departments to consult for this condition

  • Department of Neurology

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