Psychology and Psychiatry

Alzheimer's disease

Alzheimer's disease is one of the common dementias associated with a neurodegenerative disease. The disease is found in older people, but there are cases of occurrence at an early age. Alzheimer's disease occurs individually with a set of extensive symptoms. The first signs are usually associated by mistake with stress or age. Often at an early stage, the first thing that is alarming is the disorder of short-term memory. When consulting with specialists, they analyze the behavior and specify a series of cognitive tests and MRI to clarify the diagnosis. The development of the disease is characterized by loss of long-term memory. The gradual disappearance of body functions inevitably provokes a lethal outcome. Individual prediction is difficult because there are many variations in the course of this state.

Alzheimer's disease is a very complicated disease of the central nervous system, which has symptoms such as loss of memory and logical thinking, speech inhibition. Every day it becomes more difficult for patients to do basic things: to dress, wash, absorb food. There is a degeneration of the nerve cells of that part of the brain that processes cognitive information. The disease was named after the German scientist, physician Alois Alzheimer, who discovered it in 1906. To this day, the causes of this state and its exact course are not fully understood.

Alzheimer's disease progresses gradually, at first, ill-considered actions are attributed to old age, but then they enter a stage of critical development. A person eventually becomes helpless, like a child. At the last stage of the disease, it is completely dependent on the help of others. Sometimes the ability to normal walking, habitual sitting is lost.

Alzheimer's disease is the scourge of the XXI century. It is incurable, spreading around the world faster than another terrible disease - AIDS. After determining the diagnosis, the patient's life span ranges from seven to eight years, rarely up to ten to twelve. Since 2000, there has been a rapid increase in the disease. This is probably due to the increase in life expectancy, as well as the aging trends of the population. This condition terrifies people.

Celebrities who are not spared Alzheimer's disease - this is Rita Hayworth, Charlton Heston, Peter Falk, Annie Girardot, Sir Sean Connery, Ronald Reagan. The progressive state is characterized by violations of higher mental functions - memory, thinking, emotions, and identification of oneself as a person. Over time, physical problems appear - strength and balance are lost, as well as the functions of the pelvic organs. Gradually, the person disappears as a person, loses the ability to self-service and begins to depend entirely on outside care. This disease in 70% of cases is the cause of dementia.

Alzheimer's Disease Causes

To date, there is no complete understanding of the causes, as well as the course of the disease. Research suggests the association of this condition with the accumulation of neurofibrillary tangles, as well as plaques in brain tissue. Classical methods of therapy can alleviate the symptoms, but do not allow to stop or slow the development of this condition. One of the main factors of the disease is age. After 60 years, the probability of developing the disease increases. People engaged in mental work have a much lower incidence of Alzheimer's disease than those who work in physically difficult areas.

Research suggests that the genetic component provokes a predisposition for Alzheimer's disease in some people. What happens in the brain? Neurons die off in the central part of the cerebral cortex. Atrophic processes take place in brain cells, during which a person forgets his address and surname, cannot remember relatives and close people, is lost in a familiar atmosphere for a long time, tries to leave home. The actions of the patient defy logic, you never know what to expect from him.

The causes of the disease can be head injuries, which entailed a brain tumor, poisoning by toxic substances.

Alzheimer's disease in children may also develop. It is associated with another genetic disease - Down Syndrome.

Is Alzheimer's Disease Inherited? This question often worries close relatives. Unfortunately, this condition is hereditary with a delayed onset. Other adverse factors may aggravate the situation and provoke its appearance: bad habits, bad ecology.

Alzheimer's symptoms

For the early stage of Alzheimer's disease are characterized by such symptoms:

- inability to remember the events of the recent prescription, forgetfulness;

- lack of recognition of familiar objects;

- disorientation;

- emotional disorders, depression, anxiety;

- indifference (apathy).

For late-stage Alzheimer's disease, the following symptoms are characteristic:

- crazy ideas, hallucinations;

- inability to recognize relatives, close people;

- problems with upright walking, turning into a shuffling gait;

- in rare cases - seizures;

- loss of ability to move and think independently.

Alzheimer's disease also includes the following symptoms: difficulties during actions such as decision making, reasoning, performing mathematical operations, and also counting money; the patient also has a decrease in knowledge, anxiety when realizing the existing difficulties and fear of them, incoherence of speech, lack of ability to recognize familiar objects, pauses when choosing the right words, repetition of phrases, questions.

Alzheimer's disease is recognizable by the following features: unusual calm, wandering, avoiding previous contacts and social life, rapid excitability, incontinence, indifference to others, fecal incontinence, loss of the ability to communicate orally, as well as understand the written, unrecognizability of friends and family members.

Signs of Alzheimer's disease are marked by delusions, hallucinations, difficulty in walking, as well as frequent falls, ease of getting lost in familiar places, inability to dress, wash, eat, take a bath by yourself.

Alzheimer's disease often includes the symptoms of such a serious disease as paranoia.

Diagnosis of Alzheimer's Disease

Currently, there are no diagnostic methods, other than autopsies, that accurately determine the disease.

Diagnosis of Alzheimer's disease is based on the history of the disease, and also includes all the data on the mental health of relatives.

The main diagnostic criterion is gradual memory loss, as well as the lack of cognitive ability. Other diseases that cause memory loss are also detected. These data can be identified after taking a snapshot of the brain, as well as after various laboratory tests. These studies include: computed tomography of the brain, blood test.

The disease begins with mild forgetfulness and then spreads to other functional areas. In the end, this leads to the inability to overcome the difficulties of everyday life. Clinic of the disease, which still does not fully reflect the whole complex of symptoms, as well as severity, is close to dementia syndrome. It is considered sufficient violations of colloquial speech, as well as the presence in the daily life of multiple cognitive changes.

Determining the degree of dementia through an assessment to lead an independent life. A mild degree is characterized by an independent activity, although limited, but independence in ordinary life remains.

Dementia of moderate severity is limited by independence and the patient needs outside help on a daily basis.

Severe dementia is marked by a complete lack of independence and the patient requires constant care, as well as observation.

The occurrence, as well as the rate of spread of various functions, is individual for each patient. Examination of patients includes standardized diagnostic methods. The data is summarized in a standard form, which is necessary to determine the diagnosis. Neuropsychological testing is the most differentiated method in diagnosis. The individual tests are based on the standard data of age groups. At the same time, there is no universal test for all aspects.

Severe functional impairment in patients is not possible to diagnose. Technological tools are not able to establish a diagnosis without certain clinical studies. The only exception is genetic tests that establish this condition based on mutational changes. They are used when heredity plays a dominant role. Today, it is possible to identify neuropathological degeneration of brain structures at a developed stage, after the appearance of significant cognitive abnormalities in everyday life.

An important task of doctors, along with early diagnosis, is determining the stage of a given condition. If we differentiate the course of the disease according to the degrees of the violation, the disease is divided into three stages and each segment is equal to three years. But the duration of the development of the disease is purely individual and may be different. Diagnosis of the disease is possible after a reliable, as well as an objective intravital diagnosis. This condition is difficult to predict and warn.

Alzheimer's disease stage

Patients with this diagnosis die on average six years after diagnosis, but sometimes the duration of the disease varies up to 20 years.

The basis of diagnosis is a system that determines the symptoms characterizing the seven stages. This system was created by Dr. Barry Reisberg, MD, who is the director of New York University.

This context marks some stages corresponding to the widely used: mild, moderate, and also moderately heavy and heavy stages.

Stage 1 Alzheimer's disease is marked by the absence of disorders. Patients have no problems with memory, and the disease itself is not expressed obviously.

Stage 2 Alzheimer's disease is marked by a slight decrease in mental abilities. This is both a normal age-related change and an early sign of Alzheimer's disease. Patients feel slight lapses in memory, forget familiar names, words, keys, places, glasses, other household items. These problems do not appear obvious or obvious to friends, colleagues, relatives.

Stage 3 Alzheimer's disease includes a slight decrease in mental abilities.

The early stages of Alzheimer's disease are not diagnosed in all individuals. Relatives, friends, colleagues are already beginning to notice shortcomings. Problems with concentration and memory become noticeable during clinical trials. The difficulties are as follows: incorrect spelling of names, words; difficulties in solving social problems; lethargy; the inability to retell the text read; reduced ability to organize and also plan.

Stage 4 Alzheimer's disease is marked by a moderate decrease in mental abilities. A thorough physical examination reveals the following shortcomings: loss of ability to perform calculations in the mind, inability to manage finances, lost memories.

Stage 5 Alzheimer's disease is marked by moderate severity, as well as a decrease in mental abilities, gaps in memory, and a lack of mental abilities.

Patients need some daily help. This stage is marked by the forgetfulness of the address, telephone number, season, difficulties in calculating the mind, difficulty dressing for the season, but patients retain knowledge of themselves and remember their name, as well as the names of their relatives and children. They do not need maintenance during meals or toilets.

Stage 6 Alzheimer's disease is marked by a strong decrease in mental abilities. Memory gets worse, there are significant personality changes. Sick need to constantly help. At this stage, patients forget their recent experience, events, remember their personal history in part, sometimes forget the names of relatives, but distinguish friends from strangers. Sick need help with dressing, because they make mistakes when dressing, putting on shoes. Patients have sleep disorders, they need help in the toilet, there are episodes of urinary incontinence, feces, personality changes, as well as behavioral symptoms. Patients become suspicious, they often attend hallucinations, anxiety and delirium. The patient often tears his clothes, behaves aggressively, antisocial. He has a tendency to wander.

Stage 7 Alzheimer's disease involves a significant reduction in mental abilities.

The last stage of Alzheimer's disease is marked by a loss of ability to respond to the environment, ability to speak, and also control movements. Patients do not recognize the word, but phrases can speak. Sick need always the presence of people, as well as assistance from them. Without assistance, they can not walk. Patients without support do not sit, do not smile, they have a tone of the head and neck muscles. Reflexes turn into abnormal, and the muscles all tense. There are problems with swallowing.

Along with the proposed stages, there is another system for assessing the disease. Alzheimer's disease has four of the following stages: pre-dementia, early dementia, moderate dementia, severe dementia.

Predeference

It is characterized by the first cognitive difficulties: not performing complex everyday tasks, there are disorders in memory - difficulties in recalling the information learned earlier, inability to assimilate information, problems with concentration, cognitive flexibility, planning and abstract thinking, semantic memory is disturbed. Apathy appears.

Early dementia

The stage is marked by a progressive decrease in memory, the appearance of agnosia. Patients have speech disorders, apraxia (movement disorders). Old memories of personal life, learned facts are lost, the memory of the sequence of actions (for example, how to dress) is lost. There is aphasia (poor vocabulary, reduced fluency), poor coordination in writing, drawing.

Mild dementia

The ability to act independently due to progressive deterioration of the condition decreases. Much more disturbed coordination of movements. Speech disorders become obvious; a person often selects incorrect words to replace forgotten ones. Reading skills are lost, as well as writing. This stage is characterized by an increase in memory problems; the sick person does not recognize close relatives. Long-term memory also deteriorates, and abnormalities become noticeable, vagrancy, irritability, evening exacerbation, emotional lability, crying, spontaneous aggression, resistance to care and care appear. Incontinence develops.

Severe dementia

The last stage of Alzheimer's disease is characterized by complete dependence on the help of other people. Language proficiency is reduced to the use of individual words and single phrases. Loss of verbal skills retains the ability to understand speech. For this stage is characterized by the manifestation of aggression, apathy, exhaustion. The patient needs help, he moves with difficulty, loses muscle mass, unable to get out of bed, eat independently. The lethal outcome is due to a third-party factor (pneumonia, pressure ulcer).

Alzheimer's Disease Treatment

The treatment of this disease is very difficult, since Alzheimer's disease affects the occipital region of the brain, where the centers of vision, touch, and hearing are located, which are responsible for making decisions. The same changes occur in the frontal lobes, which are responsible for the ability to music, languages, calculations. All that we experience, think, feel is in the entorhinal cortex. What worries us deeply, and also seems to us uninteresting or boring, causing us joy or sadness — happens here. There is no one medicine that can cure a person. In the treatment of cognitive impairment, cholinesterase inhibitors are used - Rivastigimn, Donepezil, Galantamine and NMDA-antagonist - Memantine.

How to treat Alzheimer's disease? In the complex treatment of effective substances and antioxidants that improve microcirculation, blood supply to the brain, hemodynamics, as well as reducing cholesterol. Medical preparations are prescribed by neurologists and psychiatrists. Psychiatrists treat a person for symptoms.

Relatives have the hardest, they need to understand that the patient's behavior is triggered by illness. С их стороны по отношению к больному важно терпение, уход.The last stage of Alzheimer's disease is the most difficult in the care: the patient needs to create safety, provide nutrition, prevent infections and pressure sores. It is important to streamline the daily routine, it is recommended to make a reminder letter for the patient, and in everyday life to protect him from stressful situations.

Stimulating methods of treatment are: art therapy, music therapy, solving crossword puzzles, communicating with animals, exercise. Relatives should maintain the physical activity of a sick person as long as possible.

Alzheimer's disease prevention

Unfortunately, the prevention of Alzheimer's disease is not effective. You can slightly reduce the signs of the disease by dieting, prevention of cardiovascular diseases and intellectual burden. Shown in a diet of seafood, fruits, vegetables, all kinds of cereals, olive oil, folic acid, vitamins B12, C, B3, red wine. Some products have anti-amyloid action - grape seed extract, curcumin, cinnamon, coffee.

A more severe course of this condition is provoked by high cholesterol, diabetes, hypertension, smoking, low physical activity, obesity, and depression. Learning foreign languages ​​acts as a stimulation of brain activity and delays the onset of the disease.

Alzheimer's Disease Care

Caring for the sick is very important and it falls on the shoulders of relatives. Alzheimer's disease is incurable due to the degenerative course of this condition. The heavy burden of patient care has a significant effect on the psychological, social, and economic life of the person who does this.

Difficulties causes feeding. With the loss of the ability to chew food, the food is crushed to a mushy state, if necessary, fed through a tube. Depending on the stage of the condition, various complications arise (pressure sores, diseases of the teeth, as well as oral cavity, eating disorders, respiratory, hygiene problems, skin and eye infections). Often, without professional intervention is complete. The main task before death becomes relief of the patient's condition.