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Alzheimer's Disease is responsible for more than 50% of dementia cases in the elderly. This form of dementia causes the nerve cells in the memory centers of the brain to die. Alzheimer's has also been found to be associated with a characteristic tangling of fibers within nerve cells and a build up of A-beta-amyloid (a kind of protein) 'plaques' in the brain. The extensive build up of these tangles and plaques may gradually damage the ability to remember, think, speak, learn and make decisions.
Alzheimer's usually affects people older than 60 years of age although the disease has been known to affect people in their 40s. There is no way to diagnose how quickly the disease will progress. Severe Alzheimer's may take from 2 to 20 years to develop. Complicating the diagnosis of Alzheimer's is the fact that its
early symptoms - forgetfulness and lack of concentration - resemble the natural signs of aging.
Alzheimer's commonly starts with memory lapses, mood swings and difficulty with finding the right words. As the disease progresses the individual will become even more confused and find it increasingly harder to understand what others are saying to them. They will find it difficult to bathe, clothe and feed themselves. In the late, severe stages of Alzheimer's, they may lose control of their urinary and bowel functions, become unable to talk and grow less and less able to move without help. People with Alzheimer's will likely become dependent on a caregiver and eventually need 24 hour support.
Causes of Alzheimer's Disease
It is not known exactly what causes Alzheimer's disease. Currently accepted wisdom about risk factors for the disease includes the following:
Symptoms of Alzheimer’s Disease
Alzheimer's is often diagnosed much later than it appears because family and friends mistake the early symptoms of Alzheimer's as signs of depression or general aging. For example, memory loss or 'forgetting things' is a symptom of Alzheimer's but it is also commonly accepted as a sign of getting older. When forgetfulness
begins to impair productive daily functioning, advice should be sought.
If you notice the following behaviors in your care recipient, please notify a medical professional:
Types of Alzheimer’s Disease
There are currently 2 known types of Alzheimer's Disease:
Sporadic Alzheimer's Disease: Sporadic Alzheimer's is the most common type of the disease (between 90 - 95% of those affected). While external causes may be responsible for this type of the disease, scientists haven't ruled out potential genetic connections to Sporadic Alzheimer's, either.
Familial (Autosomal Dominant) Alzheimer's Disease: Familial Alzheimer's is less common than sporadic Alzheimer's (5 - 10% of those affected). This type of the disease is passed on through dominant inheritance meaning that if one of your parents has a particular gene (i.e., that may be responsible for Alzheimer's), you will have up to a 50% chance of getting the disease. A history of dementia in the family over several generations is a strong indicator of this type of Alzheimer's. If a particular gene is linked to Alzheimer's disease in a family, relatives may have the option of undergoing testing for that gene to determine their own risk of developing the disease.
Treatment for Alzheimer’s Disease
Management can be extremely difficult. At this time there are no known cures for Alzheimer's Disease. Treatment generally focuses on quality of life issues, alleviating symptoms in the mild to moderate stages of the disease and providing institutional care when home care ceases to be feasible.
Acetylcholinesterase inhibitors are one class of drugs used to treat Alzheimer's. These drugs regulate the brain's production of acetylcholinesterase, a body chemical that breaks down acetylcholine, another chemical that is needed for the transmission of nerve impulses. People with Alzheimer's usually have low levels of acetycholine. The acetylcholinesterase inhibiting drugs include donepezil and tacrine. Studies have shown that these drugs can improve functioning in mild to moderate disease, though they do not seem to have value in the advanced stages. Tacrine can adversely affect the liver, so your physician may advise regular blood tests when using this medicine.
Some other acetylcholinesterase inhibitors now being studied include:
Side effects associated with these drugs include:
Unfortunately, the anticholinesterase inhibitors seem to have an effect only in Alzheimer's Disease and are not used for other causes of dementia.
Your care recipient may not be able to communicate information about any symptoms he or she is experiencing. Whenever possible, caregivers should be aware of the possibility of drug side-effects (as well as viral infections and other illnesses that may affect the care recipient). If your care recipient seems to be suffering physical distress, you should consult your physician.
Estrogen: As mentioned above, studies have found that women who are on estrogen (hormone) replacement therapy following menopause may have a lower
risk of getting Alzheimer's. There are as yet no direct studies that indicate that estrogen treatments are helpful to people who already have Alzheimer's.
Non-steroidal anti-inflammatory drugs (NSAIDs): These drugs such as aspirin and ibuprofen are commonly used for arthritis. There seems to be some evidence that long-term use of these drugs prevents decline of cognitive (understanding, problem-solving) abilities. The results of continuing research in this area are awaited.
Anti-oxidants: One clinical study found that taking 2,000 units of alpha tocophenol - a form of vitamin E - on a daily basis was as effective as donepezil in delaying the progression of moderate Alzheimer's. Vitamin E has few side effects.
Ginkgo biloba extract: Clinical studies have found that taking 120 - 240 mg of ginkgo biloba extract daily can produce a modestly positive effect in the Alzheimer's care recipient with minimal side effects. Ginkgo biloba is a blood-thinning agent that may exacerbate some side effects of other medications the care recipient may be taking - seek medical advice before using this drug.
Alzheimer's Disease Resources