Alzheimers disease is among the common causes of dementia(Dementia is associated with decline in memory which is severe enough to reduce the person ability to perform everyday activities).It affects a person’s ability to carry out everyday activities.
In Alzheimers disease there is impairment in- memory, organizing thoughts and reasons, ability to see accurately or ability to use language.
In Alzheimers disease progressive death of brain cells occurs. The brain has abnormal areas containing clumps (senile plaques) and bundles (neurofibrillary tangles) of abnormal proteins which destroy connections between brain cells. This affects the parts of the brain that control functions such as thought, memory, and language.Dementia occurs as a result of low level of certain chemicals that carry messages around the brain.
The risk of Alzheimer’s disease increases after 70 years of age. Alzheimers disease is not a normal part of ageing.
Other risk factors for Alzheimer’s disease include high blood pressure (hypertension), coronary artery disease, diabetes, and elevated blood cholesterol. There is also a genetic risk for late onset cases.
It is a slow progressive degenerative disease. The person affected with Alzheimers disease is dependent on others for assistance.Stages of Alzheimer's disease
• Mild cognitive Impairment
The symptoms that appear first are mistakenly thought to be due to stress or age related forgetfulness. Mild cognitive difficulties are revealed on neuropsychological testing. The most noticeable symptom is memory loss of recent activities.The symptoms are not severe enough to affect daily life.
• Mild Alzheimer’s
At first mild Alzheimers disease represent as memory loss, such as forgetting the names of people and objects, forgetting the things where the patient has placed. The memory loss occurs with regularity.
On progression of the disease the symptoms becomes more noticeable to others.Patient repeat questions, forgets recent activity and get lost in familiar places.
• Moderate Alzheimer’s
Patient at this stage starts having trouble in recognizing friend and even family members. They have difficulty in following instructions and in performing tasks that they once did with ease.Patient takes naps during the day. As the disease progresses they spend much of their day time asleep.
At this stage they may develop personality changes. They may experience delusion, hallucination, paranoia and compulsive behaviors.
• Severe Alzheimer’s
Patient becomes unable to respond to persons around them. They become dependent on others to provide their basic needs as they loose ability to talk walk and care for themselves. Swallowing becomes difficult; they have trouble in controlling their urine and bowel movements.
Alzheimers disease is more common in women than in men.The risk of developing the disease increases after the age of 70.
The progressive death of brain cell occurs in the Alzheimer’s disease, but the exact cause why this happens is unknown.The number of factors is believed to cause the disease:
• Increasing age is a risk factor, though does not alone cause it.
• Scientists have identified certain genes, which are very strongly related to Alzheimer’s.
• A family history of the disease is another known risk.
• Other risk factors for Alzheimer’s include, disorders of blood circulation, hormonal imbalance, head trauma, emotional stress, alcohol abuse, metabolic defects, nutritional deficiencies, and even some infections.
• Patient repeat statements, forget conversations or events, forget the names of family members and everyday objects.
• People with Alzheimer’s disease lose their current life circumstances.Their ability to interpret what they see, making it difficult to understand their surroundings,all these problems may leads to getting lost in familiar places.
• They have difficulty in identifying objects.Their ability to read and write also decreases with time.
• Patient has difficulty in recognizing numbers.
• Their decision making and judgment power declines.
• People with advanced Alzheimer’s may forget how to perform basic tasks such as dressing and bathing.
• Changes in personality and behavior occur: Depression,Anxiety,Social withdrawal, Mood swings,Distrust in others, increased stubbornness, Irritability and aggressiveness,Changes in sleeping habits, wandering.
There is no specific diagnostic test for Alzheimer’s disease, but there are several tests to complete the evaluation.
• A medical history and family history.
• A mental status evaluation to assess ability to do simple math problems, sense of time and place; ability to remember and communicate.
• CT scan and MRI to investigate other causes of dementia.
• Blood and urine tests to check other abnormality in body.
• Chronic traumatic encephalopathy.
• Age associated memory impairment.
• Cerebrovascular disease.
• Alcohol abuse.
• Vitamin deficiency.
• Hyperthyroidism and hypothyroidism.
Following measures should be taken in case of Alzheimer’s disease:
• Medicines: Cholinesterase inhibitors, memantine.
• 30-minute walk can help to improve and maintain the health of joints, muscles and heart.
• Well balanced diet and plenty of fluids should be given to patient as they themselves may forget to take.
If Alzheimers disease develops early in life it gets worse quickly.Final phase of disease lasts from few months to several years.In last stage the patient becomes bed ridden.
• Loss of muscle function that makes you unable to move your joints.
• Loss of ability to interact.
• Loss of ability to function or care for self.
• Malnutrition and dehydration.
• Harmful or violent behavior toward self or others.
• Falls and broken bones.
• Other complications related to immobility.
• Infection, such as urinary tract infection and pneumonia.
• Patient finds fault in everybody.
• Extreme sensitiveness to attention of others.
• Wants to commit suicide but there is lack of courage.
• Irritable and vindictive.
• Great weakness of memory
• Impaired vision
• Heavy coated tongue with foul breath.
• Complete lack of development of brain and other organs with forgetfulness.
• Very slow in action.
• Worried about performance.
• Irritable, angry and morose.
• Extreme mental sensitiveness is due to grief.
• Patient is not communicative.
• Changeable mood.
• Desire for solitude
• Coward with shamefulness, disgust and despair.
• Sudden alteration of mood.
• Averse company but wants someone present.
• Guided by whims.
• Great depression of spirits.
• Oversensitive to external impressions.
• Dread of death when alone.
• Restless and indifferent.
Following are the guidelines for managing Alzheimer’s patient:
• Maintain a fixed daily routine.
• A well balanced diet should be given to patient.
• Encourage patient to maintain good personal hygiene.
• Regular medical check up is advisable.
• Patient should be provided with a card on which house address and phone number is written in case if the patient forgets it and wanders.
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