Alzheimer’s Disease – The Details About The Illness | Stages, Reasons, Symptoms, Diagnostics, Treatment
Alzheimer’s disease is a progressive form of senile dementia that leads to the disappearance of cognitive abilities. It belongs to the group of acquired neurodegenerative pathologies. The disease occurs more often in patients over the age of 65. Diseases starting earlier than 60 years old are less often noted. The disease develops gradually and imperceptibly.
The patient first has disorders of short-term memory and attention. Then the symptoms steadily increase. A person’s attention, memory, and speech are grossly impaired. The patient cannot develop new skills and reproduce old ones. His psychomotor coordination is impaired, his orientation in time suffers.
The patient is disoriented in space, place and self. One of the symptoms is to identify disorders of thinking. All pathological processes are caused by the destruction of brain cells. There are two types of Alzheimer’s disease:
- the first is the early onset of the disease with the onset of clinical manifestations after 65 years old;
- the second type with the onset of symptoms before 65 years old.
The diagnosis is established based on the clinical picture after the exclusion of diseases with a similar clinical picture. The diagnosis is confirmed posthumously during autopsy. The number of neurofibrillary plexuses and senile plaques is determined.
The disease’s course is divided into 4 phases, with a progressive clinical picture with cognitive and functional disorders. The following stages are distinguished:
- Predementia. The first manifestations of Alzheimer’s disease are often similar to a reaction to stress or normal age-related changes. Changes in cognitive functions are detected 8 years before the expanded stage during neurocognitive testing. Problems begin with the inability to assimilate new information. Patients cannot concentrate. Planning suffers, there is no cognitive flexibility. Abstract thinking is disrupted, semantic memory is reduced.
- Early symptoms of dementia. Memory deterioration is progressing, violation of all types of perception in Alzheimer’s disease leads to confirmation of the diagnosis. Memory decreases unevenly. Old memories of his life and long-learned facts are preserved. Recently learned facts are quickly forgotten. Speech disorders appear. There are defects of executive functions, motor disorders, perception disorders. There is a depletion of vocabulary, reduced fluency of speech. There is an awkwardness when using fine motor skills, problems with coordination increase. A person is able to perform only simple tasks independently.
- Moderate symptoms of dementia. Patients have a progressive deterioration of the condition. The possibility of independent actions is reduced. Speech disorders become obvious, vocabulary is sharply depleted. The person incorrectly selects the meaning of the word. Reading and writing skills are lost. Coordination is disrupted with complex sequential movements. A person does not cope with most of the usual tasks. The patient does not recognize close relatives. Long-term memory is deteriorating. Neuropsychiatric changes appear – irritability, vagrancy, emotional lability, spontaneous aggression.
- Severe dementia. At this stage of the disease, the patient is dependent on outside help. He uses single phrases and words when communicating. Then the speech disappears completely. The reaction to the emotional appeal to them is preserved. Sometimes there are episodes of aggression, which are replaced by apathy and exhaustion. Even the simplest actions are impossible without outside help. The patient’s muscle mass decreases. He moves with difficulty, often unable to get out of bed.
Death occurs from concomitant causes – bedsore ulcers, pneumonia and other diseases.
Reasons of Alzheimer’s disease
The only factor responsible for the occurrence of Alzheimer’s disease has not been identified. It is believed that there is a hereditary predisposition to the disease. Now several hypotheses are being put forward for the changes in the brain:
- Cholinergic. Cognitive deficits are associated with a slowdown in the formation of the neurotransmitter acetylcholine. The theory is considered outdated, but it is not completely abandoned.
- Amyloid. The main factor in the development of changes in the brain in Alzheimer’s disease is the deposition of beta-amyloid protein in its tissues. Mitochondrial DNA defect is found in half of patients. The gene encoding its formation is located on chromosome 21. The early onset of the disease is associated with defects in the genes PSEN1, APP, PSEN2. Beta-amyloid plaques appear in the brain, slowing down the speed of cognitive reactions. This hypothesis is recognized as the main one. Amyloid accumulation triggers a chain of neurodegenerative disorders.
- The Tau hypothesis. It is believed that a cascade of pathological changes initiates a deviation of the tau protein structure. In it, hyperphosphorylated filaments are connected. Neurofibrillary tangles are forming in neurons. Then the microtubules disintegrate. The transport system in the cells is being destroyed. This disrupts the signal transmission system between neurons.
- Infectious. It is believed that the development of the disease is associated with the causative agent of periodontitis. Bacteria colonize brain tissues, which increases the production of Amyloid beta.
Researchers note that high sugar intake accelerates the development of cognitive impairment. This worsens the course of the disease.
The initial signs of changes are almost noticeable. The manifestations of the disease develop gradually and slowly, they are as follows:
- the patient has difficulty remembering recent events;
- there are emotional disorders;
- poor recognition of well-known items;
- higher cortical functions are disrupted;
- reducing the possibility of orientation in space;
In the future, the patient’s cognitive disorders increase. A person is incapable of making decisions. Mathematical operations are hardly performed, which makes it difficult to count money. Speech becomes incoherent. There are long pauses, which are associated with a long selection of words. The following clinical picture is characteristic of the late stage of the disease:
- unrecognizability of loved ones;
- shuffling gait;
- loss of ability to move independently;
- degradation of personality;
- disorientation in place and time;
- lack of opportunities for mental activity.
With severe dementia, the patient is completely dependent on outsiders. He can’t serve himself. Acquired skills disappear, articulate speech is lost. Aggression alternates with apathy and exhaustion.
If a disease is suspected, patients address a psychotherapist or neurologist. The doctor examines the patient, studies his anamnesis, talks with the patient and his relatives. The main criterion for making a diagnosis is the presence of a decrease in memory and cognitive abilities. It is assigned additional research methods:
- CT and MRI of the brain;
- analysis of cerebrospinal fluid for betta-amyloid protein;
- the “NuroPro” test;
- genetic testing;
- determination of blood levels of beta-amyloid;
- positron emission tomography.
The patient is tested to determine cognitive abilities – digital, Sage-test, clock image.
Alzheimer’s disease treatment
To date, no treatment has been found that can stop the development of Alzheimer’s disease. There are medications that slow down the progression of symptoms. These include the following drugs:
- NMDA antagonists;
- cholinesterase inhibitors;
- beta-secretase inhibitor.
Neuroleptics and medications that enhance cerebral circulation are prescribed to relieve symptoms. A low-calorie diet enriched with protein is prescribed. It is recommended to reduce the amount of sugar and salt. You need to eat fatty fish, foods with a high content of B vitamins, selenium, zinc.
Psychotherapeutic support plays an important role in improving the patient’s well-being. It is important for the patient to have no stressful situations, to stay in comfortable conditions. It is necessary for him to create a positive emotional attitude.
Category: Alzheimer’s Disease
Tags: Alzheimer's disease, human health, treatment program