Alzheimer's Disease
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(Alzheimer's Dementia)
Definition
| Areas of the Brain Affected by Alzheimer's Disease |
|
| Copyright © Nucleus Medical Media, Inc. |
Causes
- Plaques—Abnormal deposits of a substance called beta amyloid in different areas of the brain
- Neurofibrillary tangles—Twisted fibers (called tau fibers) within the nerve cells
Risk Factors
- Age: 65 and older
- Previous serious, traumatic brain injury
- Lower educational achievement
- Down's syndrome
- Down's syndrome in a first-degree relative
- Women under age 35 who give birth to a child with Down's syndrome
- Smoking
- Family history of Alzheimer's disease
- Presence of a certain type of protein (APOE-e4)
- Depression
- Elevated levels of homocysteine
- Heart disease
- Poor nutrition and vitamin deficiency in childhood
- Excess metal in the blood, especially zinc, copper, aluminum, and iron
- Certain viral infections
- Diabetes
- High cholesterol
Symptoms
- Early—Loss of memory, reasoning, understanding, or learning, but does not interfere with independence
- Intermediate—Increased mental loss, personality changes, and increased dependence on others for basic needs
- Severe—Loss of personality and bodily functions with total dependence on others for care
-
Increasing trouble remembering things, such as:
- How to get to familiar locations
- What the names of family and friends are
- Where common objects are usually kept
- How to do simple math
- How to do usual tasks, such as cooking, dressing, bathing, etc.
- Having difficulty concentrating on tasks
- Having difficulty completing sentences due to lost or forgotten words (may progress to complete inability to speak)
- Forgetting the date, time of day, or season
- Getting lost in familiar surroundings
- Having mood swings
- Being withdrawn, losing interest in usual activities
- Having personality changes
- Walking in a slow, shuffling way
- Having poor coordination
- Losing purposeful movement
Diagnosis
- Neurological exams—Tests of your nervous system
- Psychological and mental status testing
- CT scan —A type of x-ray that uses a computer to make pictures of your brain
- MRI scan —A test that uses magnetic waves to make pictures of your brain
- Electroencephalogram (EEG) —A test that measures electrical currents in your brain
- Blood tests and urine tests
- Lumbar puncture —To test for levels of certain brain proteins that increase with Alzheimer’s disease and to rule out other disorders
- Positron emission tomography (PET) scan of the brain—A test that makes images showing activity in your brain
Treatment
Medications for Symptoms and Disease Progression
- Cholinesterase inhibitors—Recommended for mild-to-moderate Alzheimer's disease (may be called donepezil [Aricept], rivastigmine [Exelon], galantamine [Reminyl])
- N-methyl-D-aspartate (NMDA) receptor antagonist—For moderate-to-severe Alzheimer's disease (may be called memantine )
- Gamma-secretase inhibitors
- Tau fiber aggregation inhibitors
- Herbs and supplements (such as vitamin E , ginkgo biloba )
Lifestyle Management
- Creating an environment in which you can receive the care you need
- Keeping your quality of life as high as possible
- Keeping yourself safe
- Helping yourself learn to deal with the frustration of your uncontrollable behavior
- Providing a calm, quiet, predictable environment
- Providing appropriate eyewear and hearing aids, and easy-to-read clocks and calendars
- Playing quiet music
- Doing light, appropriate exercise to reduce agitation and relieve depression
- Encouraging family and close friends to visit frequently
Psychiatric Medication
- Depression
- Anxiety
- Confusion, paranoia, and hallucinations
Caregiver Support
Prevention
- Eat a healthy diet that includes fish.
- Drink alcohol, but in moderation. This means no more than two drinks per day for a man, and one drink per day for a woman.
- Exercise regularly .
- Engage in mentally stimulating activities.
RESOURCES
Alzheimer's Association http://www.alz.org
Alzheimer's Disease Education and Referral Center http://www.nia.nih.gov/alzheimers
References
Albanese E, Dangour AD, et al. Dietary fish and meat intake and dementia in Latin America, China, and India: a 10/66 Dementia Research Group population-based study. Am J Clin Nutr . 2009;90(2):392-400.
Alzheimer's disease. Activity based prevention strategies. EBSCO DynaMed website. Available at: http://dynamed.ebscohost.com/about/about-us . Updated July 11, 2012. Accessed August 22, 2012.
Alzheimer's disease and non-Alzheimer’s dementia. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary . Updated July 7, 2012. Accessed August 22, 2012.
Alzheimer's disease. EBSCO DynaMed website. Available at: http://dynamed.ebscohost.com/about/about-us . Updated July 11, 2012. Accessed August 22, 2012.
Alzheimer's disease medications fact sheet. National Institute on Aging website. Available at: http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-medications-fact-sheet . Updated July 2010. Accessed August 22, 2012.
American Academy of Neurology website. Available at: http://patients.aan.com/disorders/index.cfm?event=viewampdisorder%5Fid=844 . Accessed August 22, 2012.
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Hayden KM, Welsh-Bohmer KA. Epidemiology of cognitive aging and Alzheimer’s disease: contributions of the Cache County Utah study of memory, health, and aging. Curr Top Behav Neurosci . 2011 Aug 2.
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