Alzheimer's disease

 

With old age, there is a decline in mental and physical functions. Some older people forget names, misplace things from time to time, which is a normal part of aging. But, when this starts affecting the daily life of the person, it leads to “dementia.”

Dementia is a condition in which there is a loss of memory, confusion, difficulty in problem-solving or judgment of a person.

One of the most common causes of dementia is Alzheimer’s disease (AD). This is a disease of the brain which gradually begins after the age of 60 years but worsens soon over a period. This disease leads to the death of a large number of nerve cells in the brain.

 

In AD, there is a failure of functioning of nerve cells in the brain. This is due to abnormal material (protein) accumulation in the brain which disturbs the communication between brain cells and leads to shrinkage and death of the brain cells. But, why this happens is still unknown.

 

1. Age: People aged 65 years and above are more prone.

2. Family history: Studies have shown that people whose siblings, parents, or relative had Alzheimer's disease are more likely to develop it.

3. Genetic: Studies have shown that people who inherit genes like APOE-e4, APOE-e2, and APOE-e3 may have a risk of developing AD. 

4. Other diseases: People with heart disease, diabetes, stroke, high blood pressure, and high cholesterol have a higher risk of developing AD.

5. Head injury: Strong association of developing AD, if a person has had a serious head injury at some point in his life.

 

 
Some people with initial stage of AD have only mild memory loss and can carry out their day to day activities. This is known as mild cognitive impairment.
As the disease progresses, the person may show early and then late signs.

Early signs:

1. Difficulty in remembering things

2. Difficulty in calculation

3. Repeatedly asking same questions many times

4. Loss of sense of direction

Late signs:

1. Forgetting to do day to day activities like brushing teeth, combing hair, buttoning the shirt, etc.

2. Disorientation in time, place, and person

3. Unable to name common things as desk, house, chair, names of fruits, etc.

4. Unable to find the way back home

 

 

Diagnosis is by:

1. History and examination: Doctor would ask the patient and the family members staying with the patient about the general health, medical history, history of head injury, family history, and recent changes in memory, behavior and personality.

2. Simple tests: Memory test, simple problem solving test, and counting

3. Medical test: Complete blood count, urine analysis, and tests for any underlying health conditions (diabetes, blood pressure, etc.)

4. Scans: Brain scan [computed tomography (CT) and magnetic resonance imaging (MRI)] to determine the cause memory loss. 

 

Complications and When Should You See a Doctor

Complications include:

1. Restlessness: Not able to sit in one place, not able to concentrate on one thing for long

2. Wandering: Person can just walk out of the house and not be able to get back due to loss of sense of direction. This might lead to person getting hurt or even getting lost.

3. Sleep disturbances: Disturbed sleep would lead to pain, irritability, and might lead to wandering at night which would predispose the person to injury.

 

 

It is advisable to contact a medical professional when the patient or family member:

1. Develop forgetfulness which is interfering in his/her daily activity

2. Cannot concentrate on things for a long time

3. Has difficulty in doing simple calculations

4. Has disturbed sleep

5. Has loss of direction