Alzheimer’s Dementia: Symptoms, Causes, treatments, Diagnosis and Recent developments

Symptoms of Alzheimer’s Dementia :

In the initial stage of the disease the following symptoms are seen.

·           Difficulty in speech/language (To understand and to speak meaningfully).

·           Loss of memory (difficulty in remembering recent events). Many a times the past memory remains intact; till late.

·           The decision making power reduces.

·           The orientation of time and places gets affected Depression, loss of interest in life, excessive anger. As the disease progresses the patient finds difficulty in carrying out routine day-to-day activities.

·           The patient starts forgetting his day-to-day incidents and the names of his near and dear ones.

·           The patient makes mistakes in recognizing his relatives, friends and familiar things, and starts keeping things in wrong places.

·           Becomes dependent in matters like cooking, cleaning or shopping.

·           Needs help even while bathing and wearing clothes. There is difficulty in talking or communicating and also in moving around, patient loses road sense.

·           The patient suffers from hallucinations.

·           He/She has difficulty in eating and drinking.

·           He/She may find it difficult to analyze situations.lThere is difficulty in walking.

·           Due to change in temperament, he/she gradually loses touch with near and dear ones.

·           Loses control of bowel and bladder movements.lBehaves abnormally in public.

Medically this disease can be divided into three stages and in the final stage the patient becomes completely dependent.

Causes and treatments :

The exact cause of Alzheimer’s disease is not known. But the brain cells, which control a patient’s thinking, memory, language, etc., are destroyed. The reason of this destruction is not decreased blood circulation, infection or aging.

It is a well known fact that many famous people like former American President Ronald Reagan, Rita Heyworth, Sugar Ray Robinson, E B White and others have suffered from this disease.

An accurate treatment for this disease has not yet been found. However, extensive research is being carried out to design drugs to decrease the intensity of the symptoms. If the disease is diagnosed in the initial phase, it can help the patient to a great extent. The patient and his relatives should have proper information and education regarding the disease in order to cope with day-to-day problems and difficulties.

Diagnosis :

Along with the earlier mentioned symptoms, various cognitive tests for testing the patient’s memory, understanding, linguistic co-ordination can confirm the diagnosis of dementia. Mini mental status examination, word list memory test, work recall test and various neuropsychological measures are used to diagnose the disease and its intensity.

Blood tests, blood sugar levels, thyroid test, liver and kidney functions, vitamin B 12 and folic acid levels etc. can also help in diagnosis, as they are usually normal in these patients.

E.E.G. can help the confirmation of the diseases like Jacob Creutzfeldt disease as well as Frontotemporal dementia.

Sometimes CT scan, MRI, MR Angio, SPECT, PET etc. neuroimaging methods are also required for the diagnosis.

Recent developments :

Research is going on to determine the causes and treatment for Alzheimer’s. In 5 to 10% of the cases, it is hereditary. For example if the patient has E-4 Apolipoprotein gene on the 19th chromosome, there are high chances of his offsprings suffering from Alzheimer’s disease.

The formation of neurofibrillary tangles in the neurons of the brain and accumulation of plaques of a protein called Beta-amyloides outside the cells, causing damage and edema in the fragile brain cells, is the pathological hallmark of Alzheimer’s disease. But the reason behind this process is still unknown. It is possible that a protein named APOE and other biochemicals called TAU are responsible for this entire process. The latest research is focused on stalling these processes.

Donepezil (Donecept, Donep) is an effective medicine for patients of Alzheimer’s disease. Amongst newer medicines there are Rivastigmin (Exelon) and Galantamine (Reminyl) with even better results. Similar other medicines are also being studied. Tacrine (cognex) is now less used because of its side-effect profile.

Other treatments like genetic engineering and cloning are still in experimental stage. In our country, cost is a problem and therefore Piracetam (Normabrain; Nootropil) or Ergot group of medicines are more popular to these costly newer drugs.