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In 2004, a film called The Notebook starring Ryan Gosling and Rachel McAdams was released. If you haven’t watch it yet, I strongly suggest you do. It will give you a glimpse of what it’s like to have Alzheimer’s in the most poignant and sweetest way possible; but make sure to have some tissues around because it surely is a tearjerker. Needless to say, every teardrop will be a waterfall. People who weren’t aware about Alzheimer’s disease (AD) probably learned all they needed to know after watching the film. And most of the viewers, myself included; have gained a fair insight about how it impacts the lives of patients especially their friends and family. This article will give you the A – Z about Alzheimer’s so that you can be more aware of the disease; and hopefully understand its implications.

What is Alzheimer’s Disease?

According to Alzheimer’s Association, Alzheimer’s Disease causes around 60 to 80% of all dementia. It is the most common type of dementia in the U.S. Unfortunately, the exact causes of it is still unknown though researchers suggest that it is caused by several factors; which we will tackle later in the article. In 2013, an estimated 7 million people in America had been diagnosed with dementia; and 5 million of them have Alzheimer’s. These numbers are expected to more than double by around 2050.

Alzheimer’s Disease is a neurological and neurodegenerative disorder wherein brain cells die overtime causing cognitive decline and loss of memory. Alzheimer’s happens when the brain formed plaques that contains beta – amyloid. The symptoms are mild at first but as the disease progresses overtime, it becomes more severe; patients have a hard time remembering recent events, and recognizing people they know including their family members. For most loved ones, it is too heartbreaking to handle. You still haven’t watched The Notebook? Do it now!

Symptoms and Stages of Alzheimer’s Disease

The person will be diagnosed with AD if he/ she experience a decline in behavioral; and cognitive function as well as performance. Such decline should interfere with their ability to function in doing daily activities or at work.

Symptoms

For one to be diagnosed with dementia, 2 out of 5 symptoms must be present. Check out the symptoms below:

  • Reduced ability to remember new information which can lead to misplacing personal things; getting lost on familiar routes, forgetting appointments or events etc.
  • Impairments to exercising judgment, reasoning and complex tasking which can lead to inability to manage money; poor understanding of safety risks as well as poor decision – making and planning abilities.
  • Impairment in visuospatial abilities due to eye sight problems; which can lead to inability in recognizing faces and using simple tools; or finding objects in direct view.
  • Impaired speaking, writing and reading.
  • Changes in behavior and personality which can lead to mood swings, social withdrawal, agitation, initiative, lack of interest or motivation.

If the symptoms above confirm dementia, the following causes can then confirm that one is diagnosed with Alzheimer’s:

  • The worsening of an individual’s normal level of cognition
  • A gradual onset especially if the symptom starts to surface over the course of hours or days because this could indicate severity. Make sure to seek medical attention as soon as possible.

Memory Loss

The most prominent symptom of Alzheimer’s is memory loss particularly in recalling new information and learning. Another early symptom is having language problems where one struggle to find the right words during a conversation.

Just recently, a study suggests that a change in an individual’s sense of humor could also be an early sign of Alzheimer’s Disease. Furthermore, researchers suggest that brain lesions may already be present even if symptoms haven’t surfaced yet until years later. If the disease is within the family, it can affect an individual as early as 30 years old though it only accounts to less than 5% of cases of Alzheimer’s.

3 Main Stages of Alzheimer’s

  • 1st Stage: Pre – Clinical – this is when symptoms haven’t appear yet.
  • 2nd Stage: Mild Cognitive Impairment – this is the stage when some symptoms begin to appear but are still mild.
  • 3rd Stage: Dementia
  • 4th Stage: Early – stage of Alzheimer’s

A diagnosis of the disease doesn’t usually become clear until the fourth stage. In addition to the stages above, there are also stages of Alzheimer’s based on the severity of the symptoms. It ranges from a state of no impairment to severe decline.

Diagnosis

No single test can detect and confirm Alzheimer’s Disease. Physicians will need to look at the symptoms, check the patient’s medical history, and perhaps do an overall check – up before ruling out other possible conditions, only then they will be able to make a diagnosis. Doctors will also check the patient’s neurological function including reflexes, balance, and senses. They can also assess an individual through suggesting MRI scan or CT scan of the brain, blood and urine test as well as depression screening. Genetic testing may also be done because there are times when symptoms of dementia are from an inherited disease like the Huntington’s Disease. Once the physician ruled out other possible illnesses, memory and cognitive tests will then be carried out in order to assess the individual’s ability to remember and think.

Cognitive Assessment

In order for physicians to confirm if an individual has an Alzheimer’s, the following factors must be present and it should to a point where daily activities are being affected.

  • Gradual memory loss
  • Progressive cognitive impairment

The following questions are usually asked in order to test an individual of their cognitive abilities:

  • How old are you?
  • What is the name of the hospital you are in?
  • Where do you live?
  • What is the year?
  • When is your birthday?
  • In which year did (a well - known historical event) happen?
  • Can you recognize two people? For instance, the physician or nurse?
  • Name the current president.
  • Count backwards from 20 down to 1
  • Repeat this statement that I will provide now (for instance, an address or a quote).

There are a number of assessment tools test online that assess the cognitive function and gives a hint if an individual is suffering from possible dementia or Alzheimer’s Disease.

Genetic testing

Sometimes, doctors also use genetic testing to assess if an individual has Alzheimer’s Disease. The APOE – e4 gene is linked with higher chances of individuals over the age of 50 years old developing Alzheimer’s Disease. Using the genetic testing early can indicate the likelihood of an individual developing AD. However, the results may not be totally accurate or reliable. In the future though, biological tests could make it possible to detect individuals who may be at risk of having Alzheimer’s Disease.

Causes and Risk of Alzheimer’s Disease

As mentioned earlier, AD including all other types of dementia is primarily caused by death of brain cells which means that overtime death of brain cells are progressively happening. What happens to patients diagnosed with AD is that the tissues in their brain cells start to have fewer nerve cells and connections over time. Autopsies have shown that the nerve tissues of people with AD have tiny deposits called plaques. These plaques are made up from a protein called beta – amyloid and it builds up on the tissue and are located between the dying brain cells. The tangles made from a protein material called tau are also found within the brain cells. Scientists haven’t fully understood yet why these tissues build up and cause death of the brain cells but they believe that various factors are involved.

Risk Factors

There are some unavoidable risk factors associated in developing AD. This includes the following:

  • Old age
  • Medical history of Alzheimer’s Disease in the family
  • Genetic factors

Here are some things that can help prevent AD:

  • Regular Exercise and a healthy diet
  • Cardiovascular system health maintenance
  • Management of cardiovascular diseases as well as other illnesses like obesity, diabetes, high – blood pressure, and smoking.
  • Lifelong learning
  • Cognitive training
  • Staying mentally and socially engaged is believed to reduce developing Alzheimer’s

Is there a Cure for Alzheimer’s?

Unfortunately, Alzheimer’s cannot be cured because once brain cells die, it can’t be reversed. The good news is that there are therapeutic interventions that can make it much easier for people to live with AD. Here are the vital elements of caring for patients with Alzheimer’s:

  • Effectively managing any other conditions happening alongside AD.
  • Day – care programs and activites
  • Being involved in support groups related to AD or dementia.

No drugs are currently available to treat Alzheimer’s Disese though some medications can reduce symptoms and also help improve the quality of life. In the U.S. they approved symptomatic relief medications for patients suffering from AD. These are called Cholinesterase inhibitors such as Donepezil (Aricept), Tacrine (Cognex), Rivastigmine (Exelon). A drug called Memantine (Namenda) can also be used independently since it is an NMDA receptor antagonist, or along with a cholinesterase inhibitor.

The quality of life for patients with Alzheimer’s is downgraded which is why care and full – time assistance is needed since the individual wouldn’t be able to live independently. In 2016, a study suggested that in the future, the advancement of science may enable people with early Alzheimer’s to have their memories restored – thanks to the initial results of a mouse study. There could be light at the end of the tunnel for those who will develop the disease in the future.

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