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Understanding Alzheimer’s

Hannah Stewart
Understanding Alzheimer’s
You don’t recognize your daughter, you have forgotten how to tie your shoelaces, you find yourself in the middle of the street and you don’t know how you got there – for most of us, these scenarios seem surreal and far removed from our daily lives. These are the effects of a neurological disorder called Alzheimer’s disease in which the death of brain cells causes memory loss and cognitive decline. A fast growing condition, the World Health Organization (WHO) estimated that 35.6 million people live with Alzheimer’s as of 2012, and by 2050 its prevalence is set to quadruple by which time 1 in 85 persons worldwide will be living with the disease.

Dr. Atta G.A. Alkaznaji, neurology specialist at Burjeel Hospital, Abu Dhabi, sheds light on the disease.

Alzheimer’s Overview:

  • Alzheimer’s is the most common form of dementia, a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. The disease accounts for 60 to 80 percent of dementia cases.

  • Alzheimer’s greatest risk factor is old age and the majority of those stricken with the disease are 65 years or above. However, it is not a disease solely for the old as up to 5 percent of those stricken with the illness have early onset Alzheimer’s and has been seen in people in their 40s and 50s.

  • As Alzheimer’s is a progressive disease, the dementia worsens over time with individuals losing their ability to hold a conversation and respond to their environment.


Causes

Like all forms of dementia, Alzheimer’s is caused by brain cell death. The total brain size shrinks with the disease and the tissue has progressively fewer nerve cells and connections.

Postmortems and autopsies of affected brains also show tiny inclusions in the nerve tissue called plaques and tangles and these are believed to be the prime suspects in damaging and killing nerve cells.

  • Plaques are founds between the dying cells of the brain and are formed from the buildup of a protein called beta-amyloid. These block cell to cell signaling at synapses which activates immune system cells that trigger inflammation and devour disabled cells.

  • Tangles are twisted fibers of another protein called tau that builds up inside the brain cells. This affects the supply of nutrients and other essentials through the cells which eventually die.

  • Memory, thinking and planning parts if the brain are most affected, and develop more plaques and tangles.. This results in individuals developing serious problems in memory and thinking that interferes with life. They get confused, have trouble handling money, expressing themselves and organizing their thoughts.

  • Plaques and tangles spread to the areas involved in speaking and understanding speech and the sense of where your body is in relation to objects around you. Individuals experience personality and behavioral changes during this stage and have trouble recognizing friends and family members.


Risk Factors

  • Age: The disorder is more likely to affect older people – a greater proportion of 85 year olds have it than over 65 year olds.

  • Family history – Having a family member affected by Alzheimer’s means you have a higher risk of having the disease.

  • Females are more likely to be afflicted by the disease than males.


Signs and Symptoms

For a doctor to diagnose someone with of Alzheimer’s, he must confirm a dementia  which is defined as; “cognitive or behavioral symptoms that show a decline from previous levels of functioning and performing and interferes with the ability to function at work or at usual activities.”

Some of the more common symptoms include:

  • Worsened ability to take in and remember new information. For example, misplaced personal belongings or getting lost on a familiar route.

  • Impairments to reasoning, complex tasking and exercising judgment. For example, poor understanding of safety risks and inability to plan complex or sequential activities.

  • Impaired visuo-spatial abilities (but not from for example eye sight problems). For example the inabilities to operate simple implements or orient clothing to the body.

  • Impaired speaking, reading and writing. For example difficulty thinking of common words while speaking.

  • Changes in personality or behavior: For example out of character mood changes and loss of empathy.


Tests and Diagnosis

Alzheimer’s disease is not simple to diagnose as there is no single test to diagnose it. First doctors rule out other problems by asking for a detailed history of the patient, family members should be involved for accurate details, do physical examinations for signs of other problems like a stroke, heart and/or metabolic dysfunction conditions and by checking for neurological function. Depending on this comprehensive analysis, a doctor may order blood and urine tests and brain scans.

If there is no evidence of another issue a doctor will then carry out cognitive tests. Some of these are the abbreviated mental test score, the general practitioner assessment of cognition and the mini mental state examination.

Treatment 

There is no known treatment of Alzheimer’s disease; however advancements have been made in the management of the disease. Medications used to support the patient either to modulate the disease or to control agitation and behavioral changes. Activities and programs for care have been developed and support groups and services formed. Support groups are key, not only for patients but also their families and caregivers.
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