Alzheimer’s Disease – At A Glance

Alzheimer’s disease is a slow, progressive neurodegenerative disorder which worsens over several years and an average person survives up to a decade following the diagnosis.
This is the commonest cause of dementia in UK.

Dementia is a syndrome associated with declining brain function, affecting the intellectual and social abilities to an extent that it can interfere with the activities of daily living.

Patients presentation may vary from individual to individual. Researchers have found that the disease process begins long before the symptoms appear and this stage is called as preclinical Alzheimer’s disease where the patient’s remain asymptomatic and only diagnosed at the research setup.

Cause Of Alzheimer’s Disease

The exact cause is not clearly understood.
But multiple factors can increase the risk of developing this condition, such as….

  • Advancing age
  • Family history
  • Lack of physical and mental activities 
  • Life style – Obesity, smoking, alcohol 
  • Hypertension, DM, hyperlipidaemia – Increases the risk
  • Down syndrome – Increases the risk

Stages Of Alzheimer’s Disease

Mild Alzheimer’s disease

  • Majority of the patients become diagnosed at this stage
  • Patients presents with….
    • Loss of memory of recent events (Newly learnt information is easily forgotten)
    • Difficulty in planning, organizing and making decisions
    • Misplacing valuable objects
  • The patient can still care for himself (Independent)

Moderate Alzheimer’s disease
  • Longest stage and can last for many years in a slowly progressing manner
  • Patients presents with….
    • Worsening of memory loss 
    • Personality changes – Become low mood / socially withdrawn / aggressive / demanding
    • Confused
    • Problems with speech and language
    • Changes in sleep pattern
    • Hallucinations, delusion
  • Patient require assistance to perform activities of daily living (Dependent)

Severe Alzheimer’s disease

  • Final stage of Alzheimer’s disease
  • Patient presents with….
    • Loss of ability to communicate
    • Disorientation
    • Decline in motor function (Unable to walk, sit, swallow)
    • Bladder and bowel impairment 
    • Increased risk of infection – RTI
  • Patient require assistance to perform activities of daily living (Dependent)

Diagnosing Alzheimer’s Disease

Early diagnosis carries better prognosis as they will be able to live an independent life for a longer time. 

If someone notices a memory loss, it is wise to visit your GP, who will assess your symptoms and plan your further management

Dementia is not only caused by Alzheimer’s disease, but also by several other factors as well, such as depression, anxiety, drugs, alcohol, etc….

Therefore, after obtaining the relevant history, haematological investigations would be conducted to exclude the other possible causes and necessary referrals will be made afterwards.

The specialist will perform cognitive assessment tests to evaluate the brain function by performing various of tasks using pen and paper and by asking several questions.
Imaging techniques like MRI / CT scan will be performed to exclude other possibilities. 

Treatment Of Alzheimer’s Disease

There is no cure for Alzheimer’s diease, but medications are there only to relieve the symptoms.

  1. Acetylcholinesterase (AChE) inhibitors – Donepezil, galantamine and rivastigmine
    • It improves communication between nerve cells of the brain
    • Should be given in all stages of the disease
  2. Memantine 
    • Give to patients who cannot tolerate AChE
  3. Antipsychotics, antidepressants – For patients with personality changes 
  4. Other therapies 
    • Cognitive stimulation therapy
    • Cognitive rehabilitation
    • Reminiscence

Prevention Of Alzheimer’s Disease

  • Reducing the risk factors of cardiovascular diseases
    • Cessation of smoking and alcohol
    • Healthy balanced diet
    • Exercise 
    • Control of diabetes
  • Be mentally and physically active
  • Be socially involved – Avoid isolation 
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