Alzheimer's
Medical

Alzheimer’s Disease – Causes, Symptoms, Treatment and Prevention

Alzheimer’s Disease – Causes, Symptoms, Treatment and Prevention

AUTHOR : NEHA SHARMA

Alzheimer’s disease is the most common type of dementia, accounting for around 60% of all dementia cases. Alzheimer’s disease affects 28,000 New Zealanders, and the number is expected to rise to 70,000 by 2031.

There is no known cure for Alzheimer’s disease, nor are there any effective ways to prevent it from developing. Support and symptom management are the main goals of treatment.

In the end, the situation is resolved. 

Causes

Brain cells begin to degrade in Alzheimer’s disease.The body produces a protein called amyloid to try to stop the process. However, as amyloid deposits accumulate in the brain, the condition worsens. These amyloid deposits are known as “plaques,” and they cause brain cells to shrivel up and create “tangles,” which leads to structural alterations in the brain and cell death.Plaques and tangles block the generation of neurotransmitters, which are crucial brain chemicals. The brain shrinks over time due to the loss of brain cells. 

Alzheimer’s disease has no known origin, but some experts now believe that a combination of environmental and genetic risk factors causes an aberrant chemical process in the brain that leads to Alzheimer’s-type dementia over decades. The following are some of the known risk factors for getting the disease:

  • Increasing age
  • Down’s syndrome
  • History of a head injury
  • Risk factors for blood vessel disease such as smoking
  • Family history of Alzheimer’s disease
  • Obesity
  • High blood pressure
  • High cholesterol
  • Insulin resistance.

There is evidence that females have a somewhat higher prevalence of Alzheimer’s disease than males, however this could be due to their longer life expectancy.

According to research, the following elements may play a significant influence in the development of the condition: 

1. Genetic factors, such as the presence of specific genes or variations in their expression.

2. Environmental variables, such as long-term exposure to certain solvents in the environment, such as insecticides, glues, and paints.

3. Autoimmune factors and specific viruses are also being investigated..

Signs and Symptoms

Alzheimer’s disease causes degenerative changes in the parts of the brain that control thought, memory, and language, resulting in a gradual deterioration of a person’s behaviour and mental function.Physical functions like bowel and bladder control are frequently disrupted. 

Individual differences in the nature of symptoms and the rate at which deterioration progresses are common in Alzheimer’s disease. For each person, the types of behaviour changes and the amount of time symptoms are present are distinct. Alzheimer’s disease usually has a gradual onset of symptoms. The time between the commencement of the disease and death can be anything between five and twenty years. 

Symptoms commonly experienced during the early stages of Alzheimer’s disease include: 

  • Mild forgetfulness – especially short-term memory loss
  • Mood changes, including irritability and anxiety
  • Difficulty processing new information and learning new things
  • Loss of spontaneity and initiative
  • Confusion about time and place
  • Communication difficulties
  • Decline in ability to perform routine tasks

As Alzheimer’s disease progresses the following symptoms may develop: 

  • Increasing short-term memory loss and confusion
  • Difficulty recognising family and friends
  • Shorter attention span and feelings of restlessness
  • Difficulty with reading, writing and numbers
  • Possibly neglectful of hygiene
  • Loss of appetite
  • Personality changes (eg: aggression, significant mood swings)
  • Requires increasing assistance with daily tasks

Towards the later stages of the disease the following symptoms may be experienced: 

  • Inability to understand or use speech
  • Incontinence of urine / faeces
  • Inability to recognise self or family
  • Severe disorientation
  • Increasing immobility and sleep time

For family members and acquaintances, the changes brought on by Alzheimer’s disease can be increasingly distressing. It becomes even more challenging as the person’s condition worsens and they lose their ability to recognise loved ones. 

Although a person’s talents deteriorate as the disease progresses, it’s generally beneficial to concentrate on the ones that remain, such as touch and hearing, as well as the ability to respond to emotion.

Diagnosis

Alzheimer’s disease cannot be diagnosed with a single test. To rule out other probable reasons, the diagnosis entails a thorough examination of medical and psychological history. As a result, a number of tests are needed to make a definitive diagnosis, which may include: 

  • A neurological and physical examination
  • Blood and urine tests
  • Brain scans
  • Mental status assessment to determine the level of mental deterioration
  • Caregiver interview to determine the level of dependency

Brain scans to determine the anatomy and function of the brain may be recommended. CT (computerised tomography) and MRI (magnetic resonance imaging) are two types of scans that may be employed (magnetic resonance imaging).

Treatment

Because Alzheimer’s disease has no known cure, treatment focuses on symptom management and providing support to the patient and their family. This could involve the following:

  • Treating medical conditions that may contribute to confusion or physical decline eg: lung disease or anaemia.
  • Encouraging stimulating activities in order to encourage the person to continue their normal activities as much as possible.
  • Providing memory aids and memory triggers such as calendars and written reminders.
  • Encouraging social interaction to help prevent feelings of loneliness and depression.
  • Contacting support groups that may be able to offer family/caregivers assistance.
  • Encouraging regular routine to reduce confusion.
  • Not smoking.

Medications

Medications like sleeping pills and tranquilizers can help reduce symptoms like insomnia and agitation. However, because they frequently produce more uncertainty, their use should be limited.

In certain people, a class of drugs known as cholinesterase inhibitors has shown some promise in reducing the advancement of the disease. These drugs work by preventing the breakdown of acetylcholine, a memory-enhancing neurotransmitter. Donepezil (Donepezil-Rex), rivastigmine (Exelon), and galantamine are cholinesterase inhibitors that are accessible in New Zealand (Reminyl).

Another medicine, memantine (Ebixa), has lately become available in New Zealand. Memantine differs from cholinesterase inhibitors in that it aims to prevent an excessive quantity of calcium from entering brain cells. Calcium levels in the brain cells are higher than normal, which damages them and inhibits them from receiving messages from other brain cells. Donepezil is the only medicine that is currently subsidised by the government for the treatment of Alzheimer’s disease.

Other drugs for the treatment of Alzheimer’s disease are still under development. Therapies that prevent the formation of amyloid deposits in the brain are being explored, as well as the usage of anti-inflammatory and hormone medications. Alternative medicines, such as antioxidants like Vitamin E, selenium, and herbal extracts, are also being studied (ginko baloba in particular).

Prevention / Risk Reduction

There are no known strategies to prevent Alzheimer’s disease from developing. Epidemiological data suggests, however, that living a healthy lifestyle helps lower the incidence of Alzheimer’s disease. Regular physical activity and exercise may have a protective effect on brain health and may decrease Alzheimer’s disease progression. Although there are no specific dietary guidelines for Alzheimer’s disease, a Mediterranean-style diet (which includes plant foods like vegetables, fruits, beans, whole grains, nuts, olives, and olive oil, as well as some cheeses, yoghurt, fish, poultry, and eggs) has been shown to reduce the risk of Alzheimer’s disease, as well as cardiovascular disease and type 2 diabetes. For more diet information, refer to our Healthy heart diet.

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