Alzheimer’s Disease
Alzheimer’s disease is a progressive neurologic disorder that causes the brain to shrink (atrophy) and brain cells to die. Alzheimer’s disease in the most common cause of dementia- a continuous in thinking, behavioral and social skills that affects a person’s ability to function independently.
One of the main feature of the condition is the presence of plaques and tangles in the brain. Another feature is a loss of connection between the nerve cells,arnesons, in the brain.
These features mean that information cannot pass easily between different areas of the brain or between the brain and the muscles or organs.
As the symptoms worsen, it becomes harder for people to remember recent events, patient develop severe memory impairment and lose the ability to carry out everyday tasks.
Signs & Symptoms –
Alzheimer’s disease is a progressive condition, meaning that the symptom get worse over time.Memory loss is a key feature and this tends to be one of the first symptoms develop.
The symptoms appear gradually, over months or years.If they develop over hours or days, a person may require medical attention, as this could indicate a stroke.
Symptoms of Alzheimer’s disease include –
• Memory loss- A person may have difficulty taking in new information and remembering information.This can lead to-
¤ repeating questions or conversations
¤ losing objects
¤ forgetting about events or appointments
¤ wandering or getting lost
• Cognitive deficits- A person may experience difficulty with reasoning, complex tasks and judgement. This can lead to-
¤ a reduced understanding of safety and risks
¤ difficulty making decisions
¤ difficulty with money or paying bills
¤ difficulty completing tasks that have several stages, such as getting dressed
• Problems with recognition – A person may become less able to recognize faces or objects or less able to use basic tools. These issues are not due to problems with eyesight.
• Problems with speaking, reading or writing –A person may develop difficulties with thinking of common words, or they may make more speech, spelling or writing errors.
• Personality or behavior changes – A person may experience changes in personality and behavior that include-
¤ becoming upset, angry or worried more often then before
¤ a loss of interest in or motivation for activities they usually enjoy
¤ a loss of empathy
¤ compulsive, obsessive or socially inappropriate behavior
Causes –
Alzheimer’s disease develops due to death of brain cells. It is a neurodegenerative condition, which means that the brain cells death happens over time.
In a person with Alzheimer’s,the brain tissue has fewer and fewer nerve cells and connections, and tiny deposits, known as plaques and tangles, build up on the nerve tissue.
Plaques develop between the dying brain cells. They are made from a protein known as beta amyloid.The tangles, meanwhile, occur within the nerve cells.They are made from another protein, called tau.
The damage most often starts in the region of the brain that controls memory, but the process begins years before the first symptom appears. The loss of neurons spreads in a somewhat predictable pattern to the regions of the brains. By the late stage of the disease,the brain has shrunk significantly.
Stages-
Alzheimer’s disease can range from mild to severe. The scale ranges from a state of mild impairment, through to moderate impairment, before eventually reaching severe cognitive decline.
• Mild Alzheimer’s disease –
People with mild Alzheimer’s disease develop memory problems and cognitive difficulties that may include the following –
¤ taking longer than usual to perform daily tasks
¤ difficulty handling money or paying the bills
¤ wandering and getting lost
¤ experiencing personality and behavior changes, such as getting upset or angry more easily, hiding things or pacing.
• Moderate Alzheimer’s disease –
In moderate Alzheimer’s disease,the parts of the brain responsible for language, senses, reasoning and consciousness are damaged. This can lead to following symptoms –
¤ difficulty performing tasks with several stages, such as getting dressed
¤ difficulty recognizing friends or family
¤ greater memory loss and confusion
¤ an inability to learn new things
¤ difficulty coping with new situations
¤ impulsive behavior
¤ hallucinations ,delusions or paranoia
• Severe Alzheimer’s disease –
In Severe Alzheimer’s disease, plaques and tangles are present throughout the brain, causing the brain tissue to shrink substantially. This can lead to –
¤ an inability to communicate
¤ dependency on others for care
¤ being unable to leave bed all or most of the time
Alzheimer’s v/s Dementia –
Risk Factors –
• Age – Increasing age is the greatest known risk factor for Alzheimer’s disease.
• Family history and genetics
• Down Syndrome – sign and symptoms of Alzheimer’s tend to appear 10 to 20 year’s earlier in people with Down syndrome then they do for the general population.
• Sex – Women are more at the risk of Alzheimer’s disease than men.
• Mild cognitive impairment- Mild cognitive impairment(MCI) is a decline in memory or other thinking skills that is greater than normal for a person’s age.People who have MCI have a significant risk of developing dementia.When the primary MCI deficit is memory,the condition is more likely to progress to dementia due to Alzheimer’s disease.
• Head trauma – People who have had a severe head trauma have a greater risk of Alzheimer’s disease.
• Air pollution – Air pollution exposure – particularly from traffic exhaust and burning wood- is associated with greater dementia risk
• Excessive alcohol consumption – Drinking large amounts of alcohol has long been known to cause brain changes.
• Poor sleep patterns – Difficulty falling asleep or staying asleep, an associated with an increased risk of Alzheimer’s disease.
• Lifestyle and heart health – Lack of exercise, Obesity, smoking, high blood pressure, high cholestrol and poorly controlled type2 diabetes increases the risk of Alzheimer’s disease.
• Lifelong learning and social engagement –life long involvement in mentally and socially stimulating activities reduces the risk of Alzheimer’s disease.
Complications –
Memory and language loss, impaired judgement and other cognitive changes caused by Alzheimer’s can complicate treatment for other health conditions. A person with Alzheimer’s disease may not be able to-
• Communicate that he or she is experiencing pain
• Explain symptoms of another illness
• Follow a prescribed treatment plan
• Explain medication side effects
Diagnosis –
• Physical and neurological exam- Your doctor will perform a physical exam and likely assess overall neurological health by testing the following –
¤ Reflexes
¤ Muscle tone and strength
¤ Sense of sight and hearing
¤ Ability to getup from a chair and walk across the room
¤ Coordination
¤ Balance
• Lab tests – Blood tests may help your doctor rule out other potential causes of memory loss and confusion, such as thyroid disorder or vitamin deficiencies.
• Mental status and neuropsychological testing- Your doctor may give you a brief mental status test to assess memory and other thinking skills.
• Brain Imaging – MRI Scan , CT Scan and PET scan can detect specific brain change scaused by Alzheimer’s disease.
Treatment-
Thereis no known cure for Alzheimer’s disease. It is not possible to reverse the death of brain cells.
• Drugs-
Drugs called Cholinesterase inhibitors can ease Cognitive symptoms, including memory loss, confusion, altered thought processes and judgement problems. They improve neural communication across the brain.
Three common drugs are used to treat the symptomsof Alzheimer’s disease are –
• donepezil (Aricept), to treat all stages
• galantamine (Razadyne), to treat mild to moderate stages
• rivastigmine (Exelon), to treat mild to moderate stages
Another drug, called memantine (Namenda), has approval to treat moderate to severe Alzheimer’s disease.
• Creating a safe and supporting environment-
For someone with Alzheimers, establishing and strengthening routine habits and minimizing memory demanding tasks can make life much easier.
You can take these steps to support a person’s sense of well being and continued ability to function –
¤ Have the person with Alzheimer’s carry a mobile phone with location capability so that a caregiver can track its location.
¤ Always keep keys, wallets, mobile phones and other valuables in the same place at home, so they don’t become lost.
¤ Keep medications in a secure location. Use a daily checklist to keep track of dosages.
¤ Use a calender or whiteboard in the home to track daily schedules.
¤ Arrange for finances to be on automatic payment and automatic deposit.
¤ Remove excess furniture, clutter and throw rugs.
¤ Install sturdy handrails on stairways and in bathrooms.
¤ Reduce the number of mirrors. People with Alzheimer’s may find image in mirrors confusing or frightening.
¤ Making sure that the person with Alzheimer’s carries identification or wears a medical alert bracelet.
¤ Keep photographs and other meaningful objects around the house.
Ayurvedic Perspective –
According to Ayurveda, it is nervous system disorder under vatavyadhi which can be correlated with Alzheimer’s caused due to imbalance of vata.Vata dosha imbalances the body and brain tissues and ultimately causes Alzheimer’s disease.
Beneficial Herbs –
• Aswagandha – It increases memory and ability of learning. It is used as tonic for nervous system.
• Brahmi – It can be used as memory restorative agent in treatment of Alzheimer’s.
• Guduchi – It plays important mechanism for immunostimulation. It has property of memory enhancing.
• Shankhpushpi – It is used in stress, anxiety, mental fatigue and insomnia.
• Jyotishmati – It is used for sharpening the memory and to increase concentration.
• Yasthimadhu– The water extract of Yashtimadhu helps to prevent brain cell death.
Effective Medications –
• Vatagajankusha Ras
• Amapachka Vati
• Saraswatarhishta
Yoga and Meditation-
Performing yoga and meditation improve symptoms of Alzheimer’s disease. As a result of this brain forms new connections and recover from the injuries which occurs in the disease. Patients doing yoga& mediation may find peace and feel happier.
Kirtan kriya which is explained in meditation has following benefits –
¤ Reverses memory loss
¤ Improves sleep quality
¤ Increases energy levels
¤ Regulates inflammatory genes
¤ Improves psychological and spiritual well being
¤ Activates significant anatomical areas of the brain
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