A growing number of individuals in Anguilla are affected by dementia and one of the most common types of dementia is Alzheimer’s disease. This condition can take a heavy toll on those affected and those who care for such individuals.
What is Alzheimer’s disease?
Alzheimer’s disease is a progressive disease that destroys memory and other important mental functions. It destroys brain cells and nerves disrupting the transmitters which carry messages in the brain, particularly those responsible for storing memories. Alzheimer’s disease was first described by Alois Alzheimer in 1906.
During the course of Alzheimer’s disease, nerve cells die in particular regions of the brain. The brain shrinks as gaps develop in the temporal lobe and hippocampus which are responsible for storing and retrieving new information. This in turn affects people’s ability to remember, speak, think and make decisions. The production of certain chemicals in the brain, such as acetylcholine, is also affected. It is not known what causes nerve cells to die but there are characteristic appearances of the brain after death. In particular, ‘tangles’ and ‘plaques’ made from protein fragments are observed under the microscope in damaged areas of brain. This confirms the diagnosis of Alzheimer’s disease.
Symptoms
Typically, Alzheimer’s disease begins with lapses of memory, difficulty in finding the right words for everyday objects or mood swings. As Alzheimer’s progresses, the person may:
• Routinely forget recent events, names and faces and have difficulty in understanding what is being said
• Become confused when handling money or driving a car
• Undergo personality changes, appearing to no longer care about those around them
• Experience mood swings and burst into tears for no apparent reason, or become convinced that someone is trying to harm him/her.
As the disease progresses, people may also:
• Adopt unsettling behaviour like getting up in the middle of the night or wander off and become lost
• Lose their inhibitions and sense of suitable behaviour, undress in public or make inappropriate sexual advances
Diagnosis
A reasonably accurate diagnosis of Alzheimer’s disease can be made by taking a careful history of the person’s problem from a close relative or friend, together with an examination of the person’s physical and mental status. There is, however, no simple test to make a diagnosis and Alzheimer’s can only be confirmed with certainty by examining the brain after death. When making a diagnosis, it is important to exclude other treatable conditions that cause memory loss such as depression, urinary infection, vitamin deficiency and brain tumour.
Treatment
Current Alzheimer’s medications can help for a time with memory symptoms and other cognitive changes. Two types of drugs are currently used to treat cognitive symptoms.
Study results have been mixed about whether diet, exercise or other healthy lifestyle choices can prevent or reverse cognitive decline. These healthy choices promote good overall health and may play a role in maintaining cognitive health, so there is no harm in including these strategies in a treatment plan for individuals with Alzheimer’s. Regular exercise, a diet low in fat and rich in fruits and vegetables are helpful for cognitive health.
Social engagement and intellectual stimulation may make life more satisfying and help preserve mental function.
Adapting the living situation to the needs of a person with Alzheimer’s is an important part of any treatment plan. For someone with Alzheimer’s, establishing and strengthening routine habits and minimizing memory-demanding tasks can make life much easier.
Can you prevent Alzheimer’s disease?
At this time there is no proven way to prevent Alzheimer’s disease. Research into prevention strategies is ongoing. The strongest evidence so far suggests that you may be able to lower your risk of Alzheimer’s disease by reducing your risk of heart disease.
Many of the same factors that increase your risk of heart disease can also increase your risk of Alzheimer’s disease and vascular dementia. Important factors that may be involved include high blood pressure, high blood cholesterol, excess weight and diabetes.
Keeping active — physically, mentally and socially — may make your life more enjoyable and may also help reduce the risk of Alzheimer’s disease.
Conclusion
Alzheimer’s disease is a chronic neurodegenerative disease that usually starts slowly and gets worse over time. The most common early symptom is difficulty in remembering recent events (short-term memory loss). Symptoms will vary in severity, and sometimes they can be very challenging for the individual and those who take care of individuals with Alzheimer’s. If you notice a friend or relative with symptoms suggestive of Alzheimer’s, you should encourage or take them to see a doctor for a complete evaluation. The earlier the diagnosis is made the better it is for treatment plans going forward.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB, BS, DGO, MRCOG, is an Obstetrician/Gynaecologist and Family Doctor who has over thirty two years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
