Alzheimer Disease: Symptoms, causes, diagnosis and treatment

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Alzheimer's disease
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Alzheimer's disease

• Alzheimer's disease  is a neurological disorder
  in which the death of brain cells causes memory
  loss and cognitive decline. A neurodegenerative
  type of dementia, the disease starts mild and
  gets progressively worse.Alzheimer's disease is
  the most common cause of dementia.
• The word dementia describes a set of symptoms
  that can include memory loss and difficulties
  with thinking, problem-solving or language. These
  symptoms occur when the brain is damaged by
  certain diseases, including Alzheimer's disease.
• Alzheimer's is a progressive disease. This means
  that gradually, over time, more parts of the
  brain are damaged. As this happens, more symptoms
  develop. They also become more severe.
• In 2010, some 4.7 million people of 65 years of
  age and older were living with Alzheimer's
  disease in the US.

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Symptoms of Alzheimer's disease

• Early signs of Alzheimer's
• Memory loss that disrupts daily life
• Challenges in planning and problem solving
• Confusion with time and place
• Difficulty completing familiar task at home,
  place or leisure.
• Trouble understanding visual images and spatial
  relations.
• New problems with words in speaking and writing.
• Decreased or poor judgement.
• Withdrawal from work or social life
• Misplacing things and decreasing the ability to
  retrace steps
• Changes in mood and personality

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Symptoms

• Several different parts of the brain can be
  destroyed, which can provide different symptom
• Posterior cortical atrophy (PCA)-It occurs when
  there is damage to areas at the back and
  upper-rear of the brain.
• These are areas that process visual information
  and deal with spatial awareness.
• Early symptoms of PCA are often problems
  identifying objects or reading, even if the eyes
  are healthy. Someone may also struggle to judge
  distances when going down stairs, or seem
  uncoordinated (for example when dressing).
• Logopenic aphasia -itinvolves damage to the areas
  in the left side of the brain that produce
  language.
• The person's speech becomes laboured with long
  pauses.

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Symptoms
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• Frontal variant Alzheimer's disease-It involves
  damage to the lobes at the front of the brain.
• The symptoms are problems with planning and
  decision-making.
• The person may also behave in socially
  inappropriate ways or seem not to care about the
  feelings of others.

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Stages of Alzheimer's disease

• The progression of Alzheimer's can be broken down
  into three basic stages12
• Preclinical (no signs or symptoms yet)
• Mild cognitive impairment
• Dementia.
• These three stages can be further broken down
  into seven stages.

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Causes of Alzheimer's disease

• Alzheimer's disease damages and kills brain
  cells. A brain affected by Alzheimer's disease
  has many fewer cells and many fewer connections
  among surviving cells than does a healthy brain.
• The total brain size shrinks with Alzheimer's -
  the tissue has progressively fewer nerve cells
  and connections
• People with Alzheimer's also have a shortage of
  some important chemicals in their brain. These
  chemical messengers help to transmit signals
  around the brain.
• Tiny inclusions in the nerve tissue, called
  plaques and tangles.
• Plaques are found between the dying cells in the
  brain - from the build-up of a protein called
  beta-amyloid.
• The tangles are within the brain neurons - from a
  disintegration of another protein, called tau.

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Risk factors of Alzheimer's disease

• Risk factors associated with Alzheimer's disease
  may include-
• Age - the disorder is more likely in older
  people, and a greater proportion of
  over-85-year-olds have it than of over-65s.
• Family history (inheritance of genes) - having
  Alzheimer's in the family is associated with
  higher risk. This is the second biggest risk
  factor after age.
• Having a certain gene (the apolipoprotein E or
  APOE gene) puts a person, depending on their
  specific factors.
• Neurological disorders- People with previous
  neurological disorders, such as Parkinson's or
  multiple sclerosis are at higher risk of
  Alzheimer's.
• Infectious diseases Some brain infections such
  as chronic syphilis, chronic HIV, or chronic
  fungal meningitis can cause dementia.
• Tumours Many primary and metastatic brain
  tumours can cause dementia.

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Risk factors of Alzheimer's disease
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• Metabolic Disorders Thyroid dysfunction, some
  steroid disorders, and nutritional deficiencies
  such as vitamin B12 deficiency or thiamine
  deficiency are sometimes associated with
  cognitive impairment.
• Psychiatry disorder In older persons, some forms
  of depression can cause problems with memory and
  concentration that initially may be
  indistinguishable from the early symptoms of
  Alzheimer's disease
• Side effects of medications Many medicines can
  cause cognitive impairment, especially in elderly
  patients. Perhaps the most frequent offenders are
  drugs used to control bladder urgency and
  incontinence
• Factors that increase blood vessel (vascular)
  risk - including diabetes, high cholesterol and
  high blood pressure.
• Prior head injury- Increases the risk to many
  fold.
• Sleep disorders.

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Treatments of Alzheimer's disease

• Medications-Current Alzheimer's medications can
  help for a time with memory symptoms and other
  cognitive changes. Two types of drugs are
  currently used to treat cognitive symptoms
• Cholinesterase inhibitors. These drugs work by
  boosting levels of a cell-to-cell communication
  by providing a neurotransmitter(acetylcholine)
  that is depleted in the brain by Alzheimer's
  disease.
• Commonly prescribed cholinesterase inhibitors
  include donepezil (Aricept), galantamine
  (Razadyne) and rivastigmine (Exelon). The main
  side effects of these drugs include diarrhea,
  nausea, loss of appetite and sleep disturbances.
  In people with cardiac conduction disorders,
  serious side effects may include a slow heart
  rate and heart block.
• Memantine (Namenda). This drug works in another
  brain cell communication network and slows the
  progression of symptoms with moderate to severe
  Alzheimer's disease. It's sometimes used in
  combination with a cholinesterase inhibitor. Side
  effects may include constipation, dizziness and
  headache.

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Treatments of Alzheimer's disease
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• Anti-anxiety and anti-depressant drugs- This
  drugs can release the symptoms for a particular
  time period. But this drugs can cause serious
  side effects as a confusion, dizziness, even
  severity of the symptoms.
• Creating a safe and supportive environment-
  Alzheimer patients undergo mood swings, and
  certain emotional ups and downs. The patients
  should be handled with care and support from
  their surroundings and most importantly from
  family. Support from the close and loved ones can
  be their most important and successful treatment.
• Exercise and diet- Leading a healthy and active
  lifestyle can help the patients to overcome their
  symptoms and lead a normal healthy life.

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Diagnosis of Alzheimer's

• Lab test-Blood tests may help your doctor rule
  out other potential causes of memory loss and
  confusion, such as thyroid disorders or vitamin
  deficiencies.
• Mental status and neuropsychological
  testing-Conducting a brief mental status test to
  assess the memory and other thinking skills.
• Brain imaging-Images of the brain are now used
  chiefly to pinpoint visible abnormalities related
  to conditions other than Alzheimer's disease -
  such as strokes, trauma or tumors - that may
  cause cognitive change.
• Brain-imaging technologies include
• Magnetic resonance imaging (MRI)
• Computerized tomography (CT)
• Positron emission tomography (PET)
• Cerebrospinal fluid. In special circumstances
  such as rapidly progressive dementia or very
  young onset dementia, a cerebrospinal fluid
  examination may be performed. The spinal fluid
  can be tested for bio markers that indicate the
  likelihood of Alzheimer's disease.

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