About Alzheimers

Jeff Stats asked:


Along with the development of modern technologies, going to the moon and other exciting developments humans face the threat of diseases that affect the process of life and can be lethal in some cases. One of the illnesses that have a great affect on people’s behavior is Alzheimer’s disease (AD). Alzheimer’s disease is the degenerative disease of the brain among old people from which there is no recovery. Slowly the disease attacks the brain cells in all parts of the brain and some surrounding structures, so the an ill person loses the previous abilities to govern emotions, understand mistakes, coordinate his movements and finally a person loses all of his memory and ability to mentally function (B. Heights 2002).

AD is named after German doctor Alois Alzheimer. Dr. Alzheimer noticed changes in the brain tissue of a woman that died of an unusual mental illness. He found abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary tangles). Today, these plaques and tangles in the brain are considered hallmarks of AD. Many scientists have found other brain changes in people with AD. There is a loss of nerve cells in areas of the brain that are vital to memory and other mental abilities. There also are lower levels of chemicals in the brain that carry complex messages back and forth between nerve cells. AD may disrupt normal thinking and memory by blocking these messages between nerve cells (H. Simon).

Scientists are finding specific biologic factors (Peter, Konrad, and Ballenger 2000) involved with the AD. Different environmental and genetic aspects take part in causing AD. However, the actual cause of the disease is still unknown. The greatest known risk factors for late-onset Alzheimer’s are increasing age and a family history of AD. Researches all over the world are trying to find other factors that can cause AD.

AD is nowadays the fourth leading cause of death among the adults. Nearly four million Americans have it. The number doubles every five years in people over sixty five years old. By the age of eighty five almost half of Americans have AD. Some studies show that women have much higher risk of being affected by the AD than men (most of these studies were conducted on European and Asian populations, the U.S. studies, however, found no major differences). If there is a gender difference, then it is because of estrogen which is the main female’s hormone that is responsible for protecting against memory losses and normal mental functioning as compared to normal age. When a female gets older, the drop of estrogen level takes place after menopause and that could explain the higher risk of AD for older women than for men. From the other side, some of testosterone, male hormone, converts into estrogen and that could protect men. People that have a family history of the disease are above the average risk level for AD. Researchers have found that ApoE4 gene could be responsible for late and early onset cases. Some studies discovered that African Americans and Hispanics are at higher risk than Caucasian Americans, AD happens less often in Native Americans Crees and Cherokees and in Asians than in regular American population. Genes may have dissimilar effects in different populations (Tanzi and Ann B. 2000).

High blood pressure and high cholesterol levels can be in fact even more risky than ApoE4. At a very high risk are also people that inherit the Down syndrome. Some other risk factors are: 1) lower education and economic groups, 2) small head size, 3) Depression, 4) head injury.

A very dangerous thing about AD is that brain is being damaged for years before even the symptoms appear. The early symptoms that appear might be so mild that people could hardly notice them. The first one could be forgetfulness. People with AD may have troubles with recalling names of people that they know or remember latest events or solve simple math problems. As the disease progresses people may face

• Unreasonable weight losses

• Incontinence

• Changes in sexuality

• Difficulties in walking

• Depression, apathy, irritability

Half of all patients that have AD face the psychotic problems that can include hallucinations, visions. It is a complex form of the disease that is probably based in the genetic level. Many other medical conditions have similar to Alzheimer’s symptoms. It is crucially important to identify the right disease to succeed in future treatments of it. However, we have not yet developed a test that would diagnose AD with the hundred percent guarantee. So, right now diagnosis involves ruling out other disorders the following questions about the state of a patient:

• Do psychologist tests indicate dementia?

• Does the patient have problems with using language, walking, perception?

• Has memory gotten greatly worse?

• Is the patient over 40?

• Does his/her behavior changes daily?

• Does the patient have a family history of AD?

• Are there other symptoms like depression, weight loss, hallucinations?

Other steps that are involved in making a decision involve laboratory tests (EEG and tests to rule out other diseases) and psychological testing to determine the presence of dementia.

There is no guarantee that some life styles will prevent AD, however, studies show that particular life styles can play very important role in preventing AD. It is crucial to prevent heart diseases. Calcium – Channel Blocker and other Anti – Hypertensive Agents can be used to protect the heart and consequently the brain. Statins which are the common drugs to lower the cholesterol level can also be used to lower the risk for AD. Another method that is used to prevent AD is the Hormone Replacement Therapy. Because of the difference in AD rates among different populations, researches are looking at dietary factors as a protection. In China and Nigeria where fat consumption is much lower than in the U.S. the risk for AD at the age of sixty five is only 1% compared to 5% in the U.S. Studies in Netherlands reported the relationship between dementia and cholesterol levels. Eating a lot of dark colored fruits and vegetables may slow the brain degradation. Blueberries are found to be the most helpful. In any case dark colored fruits and vegetables are good for health. Other studies showed that soy has estrogen which is thought to protect the memory. Some reported that small consumption of alcohol can be effective in stopping the brain aging. Not everybody agrees though. Caffeine has a good effect on women in terms of mental functioning. Much research on AD has showed that oxidation may have an impact in the disease process. Vitamin E may protect from mental decline. Other health behaviors like aerobic exercises or jogging are important in stopping the mental decline. The more person exercise the better. Another aspects that play role in the prevention of mental decline is lifelong learning and stress reduction.

Unfortunately, today we can only try to prevent AD and have no cures. However, there are drugs under investigation that are aimed to slow the progression of the AD. The bad thing is that improvements from some of these drugs can so little that a patient or his/her family would not even notice. The good thing is that even these drugs will help to postpone the necessity of taking a patient to a nursing home (Alzheimer’s Association). The only agents that are approved called selective Acetylcholinesterase inhibitors. They are designed to protect the cholinergic system which is responsible for memory and learning and is destroyed in AD. We have the following:

• Donepezil. Donepezil (Aricept) is taken once a day and has only modest benefits but it helps to slow loss of function and reduce caregiver burden. It works equally in patients with or without ApoE4. It may even have some advantage for patients with moderate to severe Alzheimer’s disease.

• Rivastigmine. Rivastigmine (Exelon) targets two enzymes (the major one, acetylcholinesterase, and butyrylcholinesterase). It is taken twice a day. This agent may be particularly beneficial for patients with rapidly progressing disease. This drug has slowed or slightly improved disease status even in patients with advanced disease. (Rivastigmine may cause significantly more side effects than donepezil, including nausea, vomiting, and headache.) As with all anticholinergics, the drug is not a cure.

• Galantamine (Reminyl). Galantamine not only protects the cholinergic system but also acts on nicotine receptors, which are also depleted during Alzheimer’s Studies report that it improves daily living, behavior, and mental functioning, including in patients with mild to advanced−moderate Alzheimer’s disease and those with a mix of Alzheimer’s disease and vascular dementia. Some studies have suggested that the effects of galantamine may persist for a year or longer and even strengthen over time.

• Tacrine. Tacrine (Cognex) was the first cholinergic protective drug. It needs to be taken four times a day, has only modest benefits, and has no benefits for patients who carry the ApoE4 gene. In high doses, it can also injure the liver. In general, newer cholinergic protective drugs that do not pose as great a risk for the liver are now used for Alzheimer’s (Castleman, Gallagher-Thompson, and Naythons 2000).

Half of the patients that have mild to moderate disease show sight improvement. Latest studies, however, show little difference in effectiveness among them. All these drugs have gastrointestinal side effects, including nausea. Anyway, these drugs still have some effect. Some researchers found that some patient could have no reactions to one particular drug, in this case the drug should be switched and there is actually a chance that it will work. There are also some alternative treatments that are being studied right now. One of them is Gingko Biloba. It is a common herb that increases blood flow to the brain. Its extract Egb 761 may slightly improve the memory of patients that have mild to moderate AD. Gingko Biloba has only minimal side effects. Turmeric also has properties that may protect from AD. Turmeric is a spice that has curcumin as one of its components which is thought to protect from AD. Studies have also found that melatonin, the natural hormone that has to do with sleep regulation, could break down beta amyloid, and it is able to pass through the blood – brain barrier. Studies reported that melatonin improves the sleep, and in some cases even slows the mental regression (H. Simon).

A number of other medical treatments are being investigated and show promise in early or late trials. Researches are focusing on agents that can prevent the build-up of beta amyloid, its toxic effects on nerve cells, or other mechanisms of the disease process. Among them are the following:

• N−methyl−D−aspartate (NMDA) blockers. NMDA blockers, such as memantine (Ebixa), bind to glutamate, an amino acid that excites nerves and, in excess, is a powerful nerve−cell killer. Memantine has shown some to be somewhat effective in improving symptoms and is being considered for approval in Europe and the US.

• Growth factors that stimulate nerve activity in the brain. Cerebrolysin (Cere) is an example of such drugs and is showing promise in clinical trials in improving mental function and other symptoms, with sustained effects even after the drug has been stopped. Leteprinim potassium (Neotrofin) activates genes that produce nerve−growth factor in the brain. Early human trials are suggesting that it may have positive effects on memory and behavior. Insulin and insulin growth factors may prevent beta amyloid accumulation.

• Antioxidants. Indole−3−propionic acid, or IPA (Oxigon), is a natural agent that may interfere with enzymes that contribute to the Alzheimer’s disease process.

• Huperzine alpha, another acetylcholinesterase inhibitor, improved mental function, behavior, and mood in Alzheimer’s disease patients in one Chinese study. Other research also suggests some benefits.

• Piracetam is a nerve protective agent called a nootropic. It has undergone a number of small studies, with few significant results. More research is needed to determine any benefits.

• Researchers are investigating immunotherapies that include vaccines, which use molecules in beta amyloid as targets for the body’s immune system, and antibodies that block proteins called CD40−CD40L, which are involved in amyloid deposition.

• Tetracyclines. Antibiotics known as tetracyclines, such as tetracycline itself, doxycycline, and minocycline, have anti−inflammatory properties that are now being investigated in a number of chronic inflammatory conditions (such as periodontal disease). They also may have activity against beta amyloid in the brain (H. Simon).

The worst thing about Alzheimer’s disease is that it is not fully investigated yet. None of the doctors can surely diagnose it. And what is even worse none can cure it. The worst thing is that AD lethal in all case. Using all the treatments that have been or are still being studied can only postpone the need for the nursing home (Terry, Katzman, Bick, Sisodia 1999).

The issue of Alzheimer’s disease is crucially important to me and should be to everyone. Mainly, because nobody is insured from getting AD and there is no certain way to escape it. Our modern medicine has been developing through ages and now it cures many dangerous diseases; however, it is simply helpless against the Alzheimer’s. If scholars completely investigate AD it will help to understand the brain and its impact on people’s behavior. Using that knowledge it would be possible to impact the brain and its functions. Unfortunately, all the studies that were conducted about AD and were presented above can not state something about AD with a hundred percent certainty. All the medications that are listed above do not stop AD; they can even hardly slow it. It is very unpleasing fact that mankind has greatly developed ways to make the brain progress but have not yet found any way to stop the regression of the brain.

Monica

loosing my mind ! asked:


Having watched my mum deteriate rapidly up till her death 2 weeks ago with Alzheimers, i wonder if i can do anything to slow it down?

Tina

Carol Stack asked:


Alzheimer’s is, sadly, a common form of dementia afflicting the elderly. This disease is inevitably fatal, and its progress horrifying. Alzheimer’s is a degenerative disease which takes away the last years that the afflicted has with their loved ones. The benefits of having family and friends present in ones old age is cruelly stolen from these sufferers, along with the debilitating physical and mental effects of the disease.

There are three distinct stages to the progression of Alzheimer’s disease, each with its own symptoms. These stages are early, middle and late. The symptoms of each stage are a bane to both patient and caregivers. It is in the early stage when the disease is generally recognized by the sufferer and when it is diagnosed by the physician.

Loss of memory is a common early symptom of Alzheimer’s, especially when it comes to smells. In studies, researchers have found a scratch and sniff test to be an effective screening tool for Alzheimer’s disease. However, not every doctor’s office has these sorts of tests available.

Detecting Alzheimer’s disease early, as with any disease, is crucial to slowing it’s progress. This leads to a longer life expectancy for the patient, with increased quality of life. The smell test is a great tool for early diagnosis, a test which one can only hope will become more widespread.

It is not uncommon to have the odd memory lapse as one ages, but these memory lapses are not like those experienced by those suffering from Alzheimer’s. The Alzheimer’s Association has created a checklist, which families and those who suspect they may suffer from the disease alike may consult when trying to determine if an evaluation by a physician is warranted. Like any disease, a doctor would much rather have a disease turn out not to be present after a visit than to have no contact with a patient who turns out to have the disease.

This checklist contains ten signs of possible Alzheimer’s. One is memory loss beyond that normally seen in older people and if this sort of memory loss is seen, it is probably time to consult with your physician.

Early warning signs of Alzheimer’s include having a hard time with everyday tasks like cooking or dialing the phone. Finding oneself literally at a loss for words (as in, common words are simply forgotten) is another symptom.

Those afflicted with the disease will commonly become lost and disoriented in surroundings which heretofore had been familiar to them. Lapses in judgment as well as memory are also common, for instance wearing shorts and a t-shirt in mid winter.

A hard time with mental tasks, losing things and mood swings also are common for those undergoing the onset of Alzheimer’s. Loss of motivation is also seen quite often, as are personality changes including increased anxiety and suspicion. The person might spend hours in front of the television.

If you recognize any of these symptoms in yourself or in a loved one, the best thing to do is make an appointment with a doctor and find out if it is Alzheimer’s or not. There is hope if it is diagnosed early.

Carolyn

Kunbi Balogun asked:


Over the age of 65 it affects about 1 in 20. The risk of developing Alzheimer’s continues to increase with age, so those aged 80 have a higher risk of developing it than those aged 65. By the age of 85 nearly 1 in 2 will have the disease. Women have a slightly greater chance of developing Alzheimer’s than men. It is thought that about 500,000 people in the UK are believed to have the disease. There is no known cure for Alzheimer’s disease and very few effective treatments are available.

The symptoms of Alzheimer’s disease can vary greatly, but those with the disease often have one or more of the following:

1. Problem with memory

2. Problems with speech and language

3. Confusion

4. Changes in mood and behaviour

5. Problem learning new information, ideas or skills

6. Difficulty performing simple everyday tasks

People afflicted with Alzheimer’s often suffer disturbances in circadian (daily) rhythm, which affects body functions such as sleep cycles, temperature, alertness and hormone production. As a result, impaired sleep and nocturnal restlessness place great burdens on the sufferer and the care giver. Sedatives are usually prescribed; however these have limited usefulness and are typically accompanied by side effects.

It is thought that daily exposure of Alzheimer’s patients to bright light may resolve circadian rhythm sleep disorders. According to the Sleep Review, clinical research has shown that exposure to very bright light in the day and darkness at night can consolidate rest and activity patterns in patients suffering from Alzheimer’s disease. In a 12-week trial involving 27 women and 5 men aged 60-95 years, 15 subjects received 1 hour of exposure to bright natural light each morning and 17 control subjects were exposed only to normal low-light conditions. Results obtained from this trial indicated a trend toward increased sleep efficiency (percentage of time in bed spent asleep), decreased nighttime wakefulness, and decreased nighttime activity in the intervention group, compared with the controls.

Although further research needs to be done in this area, existing research have produced very promising results, which is a real light at the end of the tunnel for Alzheimer’s Disease sufferers, caregivers and family members caring for such patients.

Useful links

Alzheimer’s Society

http://www.alzheimers.org.uk/

NHS Direct - Alzheimer’s disease

http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=14

Family Practice News Article - Light Therapy Aids Alzheimer’s Sleep Disorders

http://findarticles.com/p/articles/mi_m0BJI/is_17_30/ai_66168796

Sleep Review - Light Therapy and Alzheimer’s disease

http://www.sleepreviewmag.com/issues/articles/2003-01_01.asp

Disclaimer

This article is only for informative purposes. It is not intended to be a medical advice and is not a substitute for professional medical advice. Please consult your doctor for all your medical concerns. Kindly follow any information given in this article only after consulting your doctor or qualified medical professional. The author is not liable for any outcome or damage resulting from any information obtained from this article.

Cheryl

Juliet Cohen asked:


Alzheimer’s disease is a progressive, irreversible brain disorder. Alzheimer’s disease (AD) is the most common form of dementia among older people. Alzheimer’ destroys a person’s memory and ability to learn, reason, make judgments, communicate and carry out daily activities. Genetic factors are suspected, and dominant mutations in three different genes have been identified that account for a much smaller number of cases of familial, early-onset AD. People with dementia often have trouble thinking and speaking clearly, remembering recent events, and learning new things. Over time, it becomes hard for them to handle everyday activities and take care of themselves. Age is the most important risk factor for AD; the number of people with the disease doubles every 5 years beyond age 65. Three genes have been discovered that cause early onset (familial) AD. Other genetic mutations that cause excessive accumulation of amyloid protein are associated with age-related (sporadic) AD. AD is part of an immune response that is attempting to contain the disease. The former may be more likely, since research indicates that anti-inflammatory drugs can prevent or retard AD development.

Alzheimer’s disease advances at widely different rates. Family history is another risk factor of Alzheimer’s. Several risk factor genes may interact with each other and with non-genetic factors to cause the disease. Cardiovascular Risk Factors The same factors that increase the risk for heart disease and stroke, such as high blood pressure, may also increase the risk for late-onset AD. Most people with mild forgetfulness do not have AD. In the early stage of AD, people may have trouble remembering recent events, activities, or the names of familiar people or things. Oxidative damage refers to cell damage caused by excess free radicals, which are highly reactive chemicals. Free radicals are often formed as a by-product of metabolism, or chemical processes within the cell. Excess free radicals may cause substantial neuronal damage, contributing to AD development. Type 2 Diabetes. A link between AD and type 2 diabetes, the form of diabetes in which insulin levels are high. One theory is that too much insulin in the blood promotes inflammation and oxidative damage in the brain, both of which contribute to AD development.

Symptoms of AD include memory loss, language deterioration, impaired ability to mentally manipulate visual information, poor judgment, confusion, restlessness, and mood swings. Alzheimer’s disease may also include behavioral changes, such as outbursts of violence or excessive passivity in people who have no previous history of such behavior. In the later stages, deterioration of musculature and mobility, leading to bedfastness, inability to feed oneself, and incontinence, will be seen if death from some external cause (e.g. heart attack or pneumonia) does not intervene. Moderate -As the disease progresses to the middle stage, the patient might still be able to perform tasks independently, but may need assistance with more complicated activities. Severe — As the disease progresses from the middle to late stage, the patient will undoubtedly not be able to perform even the simplest of tasks on their own and will need constant supervision. They may even lose the ability to walk or eat without assistance. They might forget to eat and starve.

Treatment Alzheimer’s Disease Tips

1. Acetylcholinesterase (AChE)-inhibitors reduce the rate at which acetylcholine (ACh) is broken down and hence increase the concentration of ACh in the brain (combatting the loss of ACh caused by the death of the cholinergin neurons).

2. Ginkgo for the treatment of “cognitive impairment and dementia,” a Cochrane Review concludes that “there is promising evidence of improvement in cognition and function associated with Ginkgo According to this review the two randomized controlled studies that focused on Alzheimer’s patients both showed significant improvement in these areas.

3. Tramiprosate (3APS or Alzhemed) is a GAG-mimetic molecule that is believed to act by binding to soluble amyloid beta to prevent the accumulation of the toxic plaques.

4. R-flurbiprofen (MPC-7869) is a gamma secretase modulator sometimes called a selective amyloid beta 42 lowering agent. It is believed to reduce the production of the toxic amyloid beta in favor of shorter forms of the peptide.

5. Leuprolide has also been studied for Alzheimer’s. It is hypothesized to work by reducing leutenizing hormone levels which may be causing damage in the brain as one ages.

6. Antihistamine drug Dimebon has also recently been found to show beneficial effects against Alzheimer’s disease in preliminary trials

7. Vaccines or immunotherapy for Alzheimer’s, unlike typical vaccines, would be used to treat diagnosed patients rather than for disease prevention.

8. Proposed alternative treatments for Alzheimer’s include a range of herbal compounds and dietary supplements.

9. Cognitive and behavioral interventions and rehabilitation strategies may be used as an adjunct to pharmacologic treatment, especially in the early to moderately advanced stages of disease.

10. DNA-based therapy is also Treating Alzheimer’s Disease.

Ana

MIKE SELVON asked:


When the Alzheimers diagnosis first hits you, it can feel devastating and overwhelming. Alzheimers patients often feel angry and fall into the “Why Me?” syndrome, while caregivers suffer with helplessness and uncertainty about how the disease will progress. For the 5 million patients and their families, Alzheimer care can go on for as many as 20 years, so learning how to cope and seeking education on the matter is crucial.

The medical difficulty of Alzheimers is that no two patients progress at the same rate or exhibit the same Alzheimers symptoms. Some Alzheimers patients are prone to wandering off or forget that they are unable to drive a car.

Other earlier signs of alzheimers include misplacing keys, forgetting names and becoming irrationally upset without remembering why. In the worst stages, the patient can no longer speak or recognize friends and family.

“Each individual is so unique, so different, there is no black and white or this is how you take care (of the patient),” says Connie Kudlacek, former director of the Alzheimers Association Midlands Chapter. “Instead of focusing on the negatives, we need to look at the positives and find an opportunity to continue to nurture their personality and give them an opportunity for success, even in the later stages.”

The emotional difficulty of caring for someone with Alzheimers is the “losing and grieving while providing the care because Charlie isn’t Charlie anymore,” relates Professor Jacquelyn Frank at the Frank of Ulndy’s Center For Aging & Community. She describes the feelings as “anticipatory grief,” which refers to the fear of losing someone before they’ve even died, and “ambiguous loss,” which is the discordant feeling of caring for someone who is physically alive but socially lacking. Frank highlights the importance of airing out emotions in an Alzheimers support group to maintain a positive attitude in the face of such isolation and hopelessness.

Reducing frustrations is one tactic that will help you provide effective Alzheimer care. At first you may struggle with your loved one trying to bathe or feed them, but over time you’ll get to know their natural schedule of when they are most agreeable.

Established routines can help make the day less unpredictable and more manageable for the Alzheimers patient and you. Limiting difficult decision-making is very helpful for the Alzheimers caregiver. For instance, a closet full of clothes may be intimidating, whereas a choice between two outfits may be totally do-able.

You may sometimes feel like you’re walking on egg shells when communicating with a loved one who requires Alzheimer care. Frustrations can flare up tempers and it can be hard to understand the root of the problem. Sometimes Alzheimers patients forget words or substitute incorrect words. They can lose their train of thought, require more time deciphering your words or they may curse incessantly.

The stages of Alzheimers can change suddenly, without warning. You can help by remaining patient, making eye contact while listening, using visual cues and keeping your language simple, as well as avoiding criticism, interrupting and arguing.

There are many different Alzheimer care treatment options, depending on the severity of the illness and your budget. Many caregivers try to keep their loved one at home for as long as possible, looking into products that may safeguard them from an accident or heightened confusion. Other family members may try splitting their time with the patient so he or she is never left alone.

There are specialized caregivers, such as “Comfort Keepers,” who make house calls as well. There are adult day care centers, which allow family members to continue working their normal schedules while the Alzheimer patient receives care or participates in planned activities. Lastly, there are long term care facilities that fully address the needs of Alzheimers patients 24/7.

Nicholas

Supersecretary asked:


This patient has advanced alzheimers and was unable to eat or drink anything anymore. He was given about six months to live last November, until the family decided to have a G tube inserted. He still knows the names of his children, but is very confused the rest of the time. He sleeps all the time. Tody he contracted aspiration pneomnia.

Theresa