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Alzheimer's disease

Overview

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Alzheimer's disease is the most common form of dementia, which describes the loss of mental abilities, such as memory and reasoning.

Alzheimer's disease is a progressive condition, meaning it will continue to get worse as it develops. Unfortunately, there is no cure for the condition, although there is treatment that can slow down the development.

Early stages of the condition may begin with minor memory problems and difficulty saying the right words. These symptoms can then lead to frustration and mood swings.

Symptoms change as the condition develops, and it may lead to confusion, personality changes and a total change in behaviour.

What causes the symptoms of Alzheimer's disease?

Alzheimer's disease attacks nerves, brain cells and neurotransmitters (chemicals that carry messages to and from the brain).

The destruction of these parts causes clumps of protein to form around the brain's cells. These clumps are known as 'plaques' and 'bundles'. The plaques and bundles then start to destroy more connections between the brain cells, which makes the condition worse.

How common is Alzheimer's disease?

Age plays a large part in the development of Alzheimer's disease, although it is not the only cause.

It is most common in people over the age of 65, affecting around one person in 20. The risk increases with age, and people over 80 years old are thought to have a one in five chance of developing the condition.

It is rare for the condition to affect people below the age of 65, although it does occur in around one in every 1,000 people aged 65 or under.

Causes
 

It is still unknown what actually causes the deterioration of brain cells, although there are several factors that are known to make an impact on the development of Alzheimer's disease.

 

Age

 

Age is the greatest factor in the development of Alzheimer's disease. The likelihood of developing the disease doubles every five years after the age of 65. However, it is not just older people who are at risk of developing the condition.

 

Family history

 

Alzheimer's disease can also be inherited, although the risk is only marginally higher than that of someone who has no family history of the condition. If Alzheimer's disease is inherited, symptoms may start at a relatively early age (between the ages of 35 and 60).

 

Down's syndrome

 

People with Down's syndrome are at a higher risk of developing Alzheimer's disease. This is because people with Down's syndrome have an extra copy of chromosome 21, which contains a protein that is found in the brain of those with Alzheimer's disease. Therefore, people with Down's syndrome have a higher-than-average amount of the protein, which could contribute to developing Alzheimer's disease.

 

Whiplash and head injuries

 

It has been found that people who have had severe whiplash or head injuries could be at a higher risk of Alzheimer's disease.

 

Aluminium

 

Aluminium is a naturally occurring substance that can be found in food and plants. It can also be added to products, such as pans, packaging and medicines. The body only absorbs a minimal amount of aluminium, which often leaves the body in urine.

It was suggested that aluminium could be a possible cause of Alzheimer's disease as research discovered that the 'plaques' and 'tangles' in Alzheimer's disease contained aluminium. However, further research has failed to prove a link between aluminium and Alzheimer's disease.

Diagnosis

The symptoms of Alzheimer's disease can be similar to the symptoms of other health conditions; for example:

  • vitamin deficiency,
  • thyroid problems,
  • infection,
  • anxiety,
  • brain tumour and
  • depression.

Therefore, diagnosis usually involves ruling out other conditions, as there is no basic test for diagnosing Alzheimer's disease.

Your GP may refer you to a specialist to help with the diagnosis. You may have blood tests and a physical examination in order to rule out other medical conditions that could be causing your symptoms.

If your GP or specialist suspects Alzheimer's disease, you may be given a memory assessment and possibly a brain scan, which will look for changes in the brain

Treatment

There is currently no cure for Alzheimer's disease, although there are various medications available on prescription that can help delay the development of the condition.

Medication that may be prescribed includes:

  • donepezil (brand name Aricept),
  • rivastigmine (brand name Exelon),
  • galantamine (brand name Reminyl), and
  • memantine (brand name Ebixa).

You GP may prescribe donepezil, rivastigmine and galantamine to treat the early stages of Alzheimer's disease.

They work by preventing a chemical breakdown in the brain. When nerve cells are damaged by brain deterioration, they release a chemical called acetylcholine. By preventing the breakdown of acetylcholine, brain deterioration is also slowed down.

Memantine can be prescribed when Alzheimer's disease is in a more developed form. It works by blocking chemicals that are often released in large amounts in people with Alzheimer's disease. These chemicals can damage nerve cells and block messages getting to and from the brain.

It is likely that you will be monitored by a specialist if any of these medications are prescribed.

Prevention
 

Although there is no way of preventing Alzheimer's disease, there are things you can do to avoid the onset.

It is recommended that you stop smoking, avoid drinking large amounts of alcohol, and get a healthy balanced diet.

You should also aim to get 30 minutes of exercise each day. This improves physical and mental health, as well as having many more benefits.

There is current research into the claim that medications such as non-steroidal anti-inflammatory drugs (NSAIDs) hinder the onset of Alzheimer's disease. This research is continuing

Symptoms

It is particularly difficult to diagnose Alzheimer's disease because many of the symptoms are similar to other conditions.

No case of Alzheimer's disease is ever the same, as different people react in different ways to the condition. However, there are commonly three stages to the condition:

  • mild,
  • moderate, and
  • severe.


Mild Alzheimer's disease

Common symptoms of mild Alzheimer's disease include:

  • confusion
  • poor memory and forgetfulness,
  • mood swings, and
  • problems with speech.

These symptoms are a result of gradual loss of brain function. The first section of the brain to start deteriorating is often the part that controls the memory and speech functions.

Moderate Alzheimer's disease

As Alzheimer's disease develops into a moderate stage, it can also cause:

  • hallucinations,
  • delusions,
  • obsessive or repetitive behaviour,
  • thinking you have done or experienced something that never happened,
  • disturbed sleep, and
  • incontinence.

The person affected may have trouble remembering very recent things. Problems with language and speech could also start to develop at this stage. This can make the person with Alzheimer's disease feel frustrated and depressed, leading to mood swings.

Severe Alzheimer's disease

Someone with Alzheimer's disease in its severe form may seem very disorientated and show signs of major confusion.

This is also the stage where people are most likely to experience hallucinations and delusions. They may think they can smell, see or hear things that are not there, or believe that someone has stolen from them or attacked them when they have not. This can be distressing for friends and family, as well as the person with Alzheimer's disease.

The hallucinations and delusions are often worse at night, and the person with Alzheimer's disease may start to become violent, demanding and suspicious of those around them.

As Alzheimer's disease becomes severe, it can cause other symptoms, such as:

  • difficulty swallowing,
  • difficulty changing position or moving from place to place without assistance,
  • loss of appetite or loss of weight,
  • increased vulnerability to infection, and
  • complete loss of short-term and long-term memory.

During the severe stage, people often start to neglect their personal hygiene. It is at this stage where most people with Alzheimer's disease will need full-time care as they can do very little on their own.

Alzheimer's disease and life expectancy

One feature of Alzheimer's disease is that it affects a person's ability to look after themselves when they are ill, so a condition can develop rapidly if left untreated. A person with Alzheimer's may also be unable to tell someone if they feel unwell or uncomfortable.

Alzheimer's disease can shorten life-expectancy. This is often due to developing another condition, such as pneumonia, as a result of having Alzheimer's disease. Therefore, Alzheimer's may not be the only cause of death, but it may contribute towards it.