Alzheimer’s Disease Explained-

Every year, from 2012, the month of September is observed as World Alzheimer’s Month. The 21^st of September is World Alzheimer’s Day. It is only appropriate for us to know more about this disease that is increasing in prevalence every single day. It is highly important that those afflicted by this condition are provided much-needed CARE as most possibly, they will not even be in a position to understand what they are going through!

What is Alzheimer’s Disease?

Alzheimer’s disease is something that is becoming quite a common condition today. This disease is a neurological disorder caused due to the death of brain cells. The condition has a direct impact on memory and a significant decline in cognitive skills. It is most often referred to as a neurodegenerative disease in which the symptoms are initially mild but become severe with time.

Some key facts that you need to know:

• Alzheimer’s is the most common type of Dementia.
• Plaques that contain a beta-amyloid form in the brain of the patient.
• Symptoms may worsen up to a level where they do not recognize their own family members or are unable to perform their daily chores.
• It’s a matter of time before a person who is diagnosed with Alzheimer’s will need a full-time assistant.

Causes of Alzheimer’s disease

Just like any other type of dementia, the main cause of Alzheimer’s disease is the death of brain cells. A person with Alzheimer’s has fewer nerve cells and connections due to the development of plaques between the dying cells. There are many factors that lead to Alzheimer’s in a patient, as listed below: 

• Unavoidable factors for Alzheimer’s are aging, a family history of the disease, or the existence of certain genes.
• Avoidable factors are undergoing repeated traumatic brain injuries (TBI) and exposure to chemicals, either industrial ones, pesticides or toxic metals.

Symptoms of Alzheimer’s disease:

The first symptom that a person with Alzheimer’s feels is the decline in behavioral as well as cognitive functions. In most cases, this decline will affect the person quite drastically. He or she will not be able to perform normal day-to-day activities at work or at home. If any two of the following five symptoms are noticed, it’s time to consult a doctor immediately.

1. A decrease in the ability to understand or accept new information, which can become obvious when the person:

• Asks repetitive questions or keeps repeating conversations
• Misplaces belongings
• Develops a tendency to forget or keep up appointments
• Gets lost even when following a well-known, frequently traveled route.

2. Difficulty in accomplishing complex tasks, exercising judgments or going against simple reasoning, like:

• Not being able to understand simple safety risks
• Difficulty in managing finances
• Impaired decision-making
• Not being able to plan any complex or sequenced activities.

3. A decline in visuospatial ability when there are no existing sight problems. One could find it difficult to recognize known faces or even use simple tools that were being used often.

4. Difficulty or disruption in speaking, reading or writing. One may not be able to recollect common words, which may lead to hesitation in speaking.

5. An overall change in personality, such as extreme mood swings, a loss of empathy, and behaving very compulsively or obsessively, which may even include socially unacceptable behavior.

Early Signs

A change in a person’s sense of humor can be considered as an early sign of Alzheimer’s disease. In many cases, brain lesions can start forming during the middle ages. However, the symptoms can be seen only at a later stage in life. Early onset of the disease is noticed in people who have a family history of the disease. In such cases, even younger people, typically between the age of thirty and sixty could get affected. However, this only constitutes less than five percent of Alzheimer’s cases in the world.

Diagnosis

Unfortunately, there is no single test that can effectively be used to diagnose and conclude whether a person is suffering from Alzheimer’s or not. A procedure is in place, where doctors initially look for some symptoms or visual signs. However, they also require a complete check of the patient’s medical history before confirming the presence of this disease. The initial screening consists of:

• A neurological function test by checking the person’s balance, senses and reflexes
• Blood or urine test
• MRI or CT scan of the brain
• Depression screening
• Genetic testing

Once these tests are done, the actual diagnosis for Alzheimer’s is performed via a cognitive and memory tests.

Brain tests

Cognitive / Memory Test:

A confirmation of the symptoms in a person is done initially. This includes tests for gradual memory loss and a decline in the cognitive skills of the individual. The most common questions that are put forward to the afflicted person at this stage are:

1. What year is it?
2. Can you tell the time?
3. Do you remember your age?
4. Did you see the name of this hospital?
5. Which town do you live in?
6. Do you recognize the doctor or nurse?
7. Name the President or any other political person who holds office right now.
8. Backward counting from twenty to one
9. The dates of any historical events that you can recollect?
10. Can you repeat an address that I tell you now but do that at the end of the conversation?

Each question asked and the answer that follows is crucial in understanding the stage of Alzheimer’s the person is in. Though physical tests can reveal the presence of dead brain cells and plaques, the amount of damage can be summarized only after performing the following tests:

Genetic Testing:

In some cases, depending on medical history, the doctor may recommend a genetic test. The gene APOE-e4 is linked to a higher possibility of developing Alzheimer’s when a person crosses 55 years of age. Though the presence of this gene can be helpful in identifying the risk, it is not a hundred-percent proven solution. Hopefully, the developments in biological tests can soon provide a stand-alone test to identify people at risk of Alzheimer’s and can lead to preventive treatment.

Genetic Testing

Stages

There are three main stages a person who is diagnosed with the Alzheimer’s disease goes through. These are the pre-clinical stage, the middle or mild stage, and the advanced stage.

Pre-clinical Stage: This is the period when the actual disease sets in, but no symptoms are noticed. The brain cells start to degenerate and the plaques start developing between the dead cells, causing a further increase in the disease.

Middle Stage: This is when the symptoms start showing up and you start considering the option of getting a diagnosis done – but at this point, the disease is already halfway through!

Advanced Stage: This is the dementia stage where the patient starts finding it extremely difficult to remember their loved ones or even perform daily activities.

Difference between Alzheimer’s and Dementia?

Any disease that is caused due to a decline in the cognitive functions comes under the broad definition of Dementia. Alzheimer’s is the most common type of dementia. You can say that all Alzheimer’s are a form of Dementia, but not all cases of Dementia is considered Alzheimer’s. Other types of cognitive illness diseases that come under Dementia are Creutzfeldt-Jakob disease, Parkinson’s disease, and Huntington’s disease. It is possible for a person to have more than one type of dementia.

Treatment

There is no cure for Alzheimer’s. This is the main reason to be sure that we identify it correctly as this disease and not something else with similar symptoms. However, if someone is diagnosed with the disease, we can make some efforts to delay the process, to reduce the speed at which the brain cells are dying.

The most effective treatments are:

• Managing the conditions alongside treatment for Alzheimer’s
• Cognitive activities as well as day-care programs
• The assistance of support groups

Medications:

There are some drugs that can reduce the symptoms of Alzheimer’s and help the person to lead a better life while internally fighting the disease. Drugs like Tacrine, Rivastigmine, and Donepezil are effective in giving some relief to the symptoms due to the presence of cholinesterase in it. Another drug that is widely used either on its own or as a combination with cholinesterase is memantine, which is also an NMDA receptor antagonist.

Prevention

Factors that can eventually help in preventing the disease are:

• Exercising regularly
• Maintaining a healthy cardiovascular system
• Managing the risks of cardiovascular diseases, hypertension, blood sugar, obesity, and smoking
• Eating a healthy diet that consists of a variety of foods
• Lifelong learnings and cognitive training.

On a physical aspect, in order to avoid TBI, a person should:

• Use safety belt when traveling by car
• Take the required precautions when playing rough sports
• Follow all the instructions and take enough rest in case of any injury to the head.

Care for the Alzheimer’s Afflicted Person

To care for a person afflicted with Alzheimer’s Disease, one requires oodles of patience and great flexibility. The progress of the disease deteriorates the ability of your loved one to manage daily chores. The person becomes more and more dependent on the caregiver’s help and this can only further frustrate those involved. A deep understanding of the situation is required, along with sharing a lot of love.

Over a period of time, Alzheimer’s patients tend to become very dependent. It is imperative that you minimize distractions and maximize the worth of your communications. Be more flexible and adjust your expectations. For instance, if the person insists on wearing a particular shirt or dress always, you could procure similar ones! Your expectations matter more – so reduce expectations and be more flexible for the sake of either person’s well-being!

Minimize Frustration:

Here are some pointers for good caregiving:

It is but natural that a person with Alzheimer’s becomes distressed when performing simple tasks that have become very difficult. To minimize this frustration:

• Be lenient: Expect routines to be more elaborate than they used to be. Allow more time instead of trying to hurry things.
• Establish Schedules: Schedule routines, but with an amount of flexibility so as to reduce frustration. It is likely that a person learns to follow simple routines.
• Involve the patient: Let the patient do as much as she or he can and assist only when required – don’t force things. For instance, the person may be able to eat with the help of visual prompts.
• Give simple instructions: A person with Alzheimer’s comprehends crisp, short or single-step instructions. It is best to keep communication short.
• Offer variety: Offer multiple choices to a person with Alzheimer’s. For example, you may offer a choice between a cold or hot beverage, and sets of clothes to choose from.
• Avoid distractions. An Alzheimer’s patient gets distracted very easily. To help maintain focus on the task at hand, for example at mealtime, turn off distractions like the television.

Alzheimer’s Care

Personalized Care Is The Order Of The Day!

It must be noted that each individual affected by Alzheimer’s experiences symptoms and advancement differently. As a consequence, caregiving procedures too need to be varied. Personalize these very practical suggestions to meet your loved one’s distinct needs.

Bear in mind that your loved one’s behavior, reception, and response can be totally different from the way it was. Patience and flexibility are the key qualities that will help in addressing the challenges. To traverse a rather long road ahead, you also need good self-care and the presence of family and close ones. These, topped with a liberal sprinkling of love, can make your life blessed and the Alzheimer’s affected person’s less painful!