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What is Alzheimer Disease?
Alzheimer Disease is a progressive degenerative irreversible dementia.
* progressive - increasing. The amount of damage done by the disease increases over time.
* degenerative - breaking down. The nerve cells in the brain degenerate or break down.
* irreversible - no known cure. Damage done to the brain cells cannot be repaired.
* dementia - a set of symptoms which includes loss of memory, understanding, and judgement.
* People used to call dementia 'senility'. There are many causes of dementia, and the most common one is Alzheimer Disease.
Alzheimer Disease causes gradual breakdown in the nerve cells of the brain. The brain changes and no longer works as it used to. As a result, people with Alzheimer Disease become less and less able to make sense of information from the outside world and to send messages to their bodies. People with Alzheimer Disease become unable to think, remember, understand, and make decisions as before. They will have trouble with everyday activities such as getting dressed, cooking a meal, or washing the car. Eventually, they become unable to look after themselves and will develop other illnesses such as pneumonia, which will cause death.
Alzheimer Disease was discovered in 1906 by the German neurologist, Alois Alzheimer. He published a paper describing the case of a 55 year old woman with dementia. In the article Alzheimer described the plaques and tangles in the brain which have become the markers for Alzheimer Disease.
o Alzheimer Disease is not a normal part of aging.
o The majority of people with Alzheimer Disease are over the age of 65, though individuals have been diagnosed as young as 30.
o Alzheimer Disease knows no boundaries, it affects men and women of all races, religions and socio-economic backgrounds.
o To date, the cause of Alzheimer Disease is not know.
o To date, there is no treatment to slow or stop the progression of the disease
There is no simple test to diagnose Alzheimer Disease. In fact, the only sure way of knowing a person has Alzheimer Disease is by examining the brain cells after death. When doctors are trying to find out if someone has Alzheimer Disease, their first task is to determine if there is some treatable cause that could be the reason for the changes in behaviour.
Treatable causes such as depression, thyroid or heart disease, reactions to medications, alcohol, malnutrition, a grief reaction, head injury or an eye or ear problem have to be ruled out before determining a person has Alzheimer Disease.
It is imperative that every person suspected of having Alzheimer Disease receive a thorough assessment which should include a detailed history, physical examination, lab tests, memory and skills test. In order to determine if the symptoms are progressive, the assessment may take 6 months to one year.
The first signs of Alzheimer Disease are usually subtle changes in behaviour. Alzheimer Disease is a disease that affects each individual differently. The type and severity of symptoms, the order of appearance and rate of progression is different for each person. The changes seen in people with Alzheimer Disease include: Changes in mental abilities of memory problems
Most of us have forgotten names of people or where we have put forms, the forgetting of recent events and forgetting the connection between things. The table below will help to explain the differences between normal forgetfulness and the memory loss associated with Alzheimer Disease.
Normal Forgetfulness Alzheimer Memory Loss
1. Forgets details not events
2. Will remember later
3. Can use notes/cues
4. Can recognize people/places
5. Can follow directions
6. Knows day and time
1. Forgets recent events
2. Does not remember he has forgotten
3. Cannot when the disease has advanced
4. Gradually there is no recognition
5. Eventually cannot follow directions
6. Gradually becomes unaware of day or time
* unable to learn new things
* difficulty making decisions
* difficulty understanding what is being said,
and in turn expressing him/herself
* problems with doing simple tasks that he/she
has been doing Any or all of these difficulties may result in the individual being confused or disoriented.
Changes in Emotion and Mood
A person with Alzheimer Disease has less expression, is less lively and more withdrawn. At the same time, he/she loses the ability to control moods and emotions. These changes may vary, change rapidly and become harder to predict. Sometimes the person may be sad, angry, laugh inappropriately, or worry a great deal over small things. At other times he/she may be suspicious of people he/she is close to. It may appear that the persons whole personality has changed.
Changes in Behaviour
The changes in mental abilities and moods will result in changes in behaviour. The kinds of behaviour changes and the length of time they are present are different for each person. Any behaviour will be greatly influenced by the individual's physical abilities. These behaviours may include: pacing or wandering, repetitive actions, hiding things, disturbed sleep to mention a few. It is important to know that these changes are not intentional, they are caused by the disease.
Changes in Physical Abilities
Over time Alzheimer Disease will cause a deterioration in physical ability, both in coordination and mobility. These difficulties will create problems performing activities of daily living such as bathing, dressing, eating. Slowly the person will become less and less able to move about. Bladder and bowel control will eventually be lost. Gradually people with Alzheimer Disease become totally dependent on those around for all their needs.
Scientists around the world are looking for the cause of Alzheimer Disease. While the cause has not been found, scientists continue to learn more about the disease. Two things we do know about Alzheimer Disease are that as you grow older the chances of developing the disease increase, and that if you have a family member with the disease, your chances of developing the disease are greater than someone with no affected relative. Researcher now believe that the cause of Alzheimer Disease is multifactorial. Therefore the search for the cause is taking place on many fronts:
Genetics There are two types of Alzheimer Disease: Familial Alzheimer Disease (FAD) and Sporadic Alzheimer Disease. Familial Alzheimer Disease is a rare form of Alzheimer Disease, 5 to 10% of cases, which is known to be inherited. It is passed on from through generation to the next by a dominant inheritance pattern, which means that if a parent is affected, each child has a 50% chance of receiving the defective gene. Sporadic Alzheimer Disease occurs in the rest of the cases. Recent findings have shown that the pattern of a specific allele APOE 4 can determine if an individual is at higher risk than another to develop Alzheimer Disease.
External Environment Researchers are looking to the environment to see if there is something in the air, soil, or water that may trigger Alzheimer Disease. The Aluminium theory is one which most people are familiar with. To date, very little is understood about Alzheimer Disease to say with any certainty that Aluminium is the cause. There is no evidence either to indicate that using aluminium pots and pans will cause Alzheimer Disease. Other areas being explored include: the use of pesticides, fertilizers, zinc, mercury.
Internal Environment Scientists are exploring the chemical imbalances in the brains of people with Alzheimer Disease, possible viral or immunological causes.
The search also goes on for a treatment which will slow or stop the progression of the disease through drug therapy.
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