Alzheimer's disease is an incurable neurodegenerative disease that affects mainly people of old age.
It develops due to the destruction of nerve cells that transmit impulses between brain structures. As a result, there is a rapid and irreversible deterioration of memory. A person suffering from this disease, subsequently loses the ability to self-service. That is, it begins to completely depend on others.
It is this pathological process that is considered the most common form of dementia - dementia - in the elderly. It occurs in 35-45% of cases, and it is especially common in developed countries.
In ancient Greece, doctors and philosophers explained the decline in human mental activity by the natural process of aging of the body. And only in 1901, a separate disease was noted and recorded by the German psychiatrist Alois Alzheimer, which was later named after him.
In 1907, when the patient Augusta Deter, who had been watched by Alzheimer, passed away, he published the results of his research. For 5 years after that, 11 more cases of symptoms, which were previously mentioned by a German doctor, were described in the medical literature. However, in some publications, the syndrome has already been called "Alzheimer's disease."
But it was Emil Kraepelin who was the first to do it. In 1910, when the 8th volume of his textbook on psychiatry was published, Alzheimer's disease was counted as a subtype of penile dementia. In parallel, the pathology was called "presenile dementia". The diagnosis of Alzheimer's disease for most of the twentieth century was given to patients 45-65 years old. That is, in relatively young people, doctors found signs of presenile dementia.
However, that all changed in 1977, when conference participants on the disease came to the conclusion that the pathological and clinical features of presenile and senile dementia did not differ much from each other. Although they did not exclude the possibility of etiological differences between these states.
Over time, the diagnosis of Alzheimer's disease began to be made regardless of the age of the patient. Thus, the term was formally adopted in the medical nomenclature. And today it means a disease that is diagnosed in patients of different age categories, and is manifested by a number of characteristic neuropathological symptoms.
Causes and risk factors
Factors predisposing to the development of Alzheimer's disease may be unavailable and may be altered. The first include:
- age of the patient (over 65);
- genetic predisposition;
- anomalies in the genetic code. In particular, if failures were found in the allele pae E4 of the APOE gene, then this is no longer a risk factor, but an actual statement of fact. If a similar violation was found in a child, then the probability of developing Alzheimer's disease in the future is almost 100%.
Factors that are reversible processes and can be changed even without medical intervention can be counted:
- Cognitive disorders (mild memory impairment) in young people. If the anomaly was promptly treated, and its progression was successfully stopped, the risk of developing Alzheimer's disease subsequently decreases significantly.
- Diseases of the heart, blood vessels and endocrine system, accompanied by the development of chronic hypoxia of the brain (atherosclerosis, hypercholesterolemia, hypertension, diabetes, etc.).
- Bad habits. In particular, this applies to smoking.
- Permanent head injuries or severe complications of head injury that lead to irreversible or chronic pathological processes in the brain.
It is interesting. Scientists have established a close relationship between human intellectual development and the risk of developing BA. In highly educated people, pathology occurs much less frequently. This is due to a large improvement in the neural networks of the brain that is used to solving complex problems.
The true causes of Alzheimer's disease today remain unidentified. However, researchers have made a big step towards solving such a difficult mystery by finding the genes that are responsible for a person’s susceptibility to dementia. Scientifically proven fact is that a large number of destroyed brain cells leads to a significant reduction in human mental abilities.
The first signs of Alzheimer's disease
The symptoms of Alzheimer's disease, which is at the initial stage of development, are rather blurred, therefore, it is extremely difficult to distinguish them from signs of cardiovascular or other neurological diseases. At first, a sick person manifests unusual behavior strangeness, which are often ignored by others. But it is precisely these abnormalities that speak of the initial stage of pathology — the prediction. It has symptoms in the form of:
- reducing the concentration of attention, confusion and confusion of the patient when there is a need to perform a task that requires attentiveness and active thinking;
- memory impairment, up to difficulties with the memories of the day before, yesterday or half a day ago;
- the inability to memorize new information or events (important and not so);
- difficulty concentrating on the tasks;
- forgetfulness, manifested in everyday life. For example, patients suffering from premediation often forget to perform hygienic procedures, clean up after themselves, or perform other simple actions. Self-service problems are one of the most alarming symptoms of the onset of Alzheimer's disease.
Confusion of thoughts, the inability to gather them "in a heap", frequent "freezes" or constant inhibition of thoughts when talking to people is also one of the symptoms of pre-determination. This should especially alert the loved ones, if before the person was an interesting interlocutor, and could support any conversation.
Similar symptoms can be noticed approximately 8 years before the development of the disease itself. Such a clinical picture is called a "mild cognitive impairment," and may signal the development of other neurological pathologies, as well as diseases affecting the blood vessels and the human brain.
People whose family history did not have such disorders, and who previously had no problems with the health of the cardiovascular system, can independently mark the onset of alarming symptoms. If earlier the solution of certain tasks or memorization of various information was given easily, it would not be difficult to note the deterioration of these processes. At the same time, the patient himself is able to notice them much earlier than the people around him, who can easily blame such deviations on the aging process of a sick person.
Symptoms and stages of Alzheimer's disease
Throughout its development, pathology passes through 4 stages. Each of them differs from the previous intensity of progression of cognitive and functional abnormalities.
The first manifestations of Alzheimer's disease at an early stage of its development are often confused with the approaching old age or the body’s specific reaction to a stressful situation. When conducting neurocognitive testing, abnormalities in the work of the brain are detected 8 years before the start of active progression of the disease.
These symptoms can occur when performing even the easiest tasks. Thus, patients experience significant memory impairment, as a result of which they cannot memorize elementary information or tell about events that occurred in the recent past.
In addition, at the early stage of Alzheimer's disease, the patient may experience abnormalities in the form of:
- inability to focus on specific actions;
- impairment of cognitive flexibility;
- violations of abstract thinking;
- reduce semantic memory, etc.
Apathy is often manifested in the pre-term stage, which is one of the most persistent symptoms of the early stage of Alzheimer's disease. The stage of "mild cognitive impairment" is also called the stage of "mild cognitive decline." However, today there are scientific debates about whether to leave such a designation of symptoms for the initial phase of the pathological process, or to allocate a separate diagnostic unit.
The gradual deterioration of memory and the progression of agnosia are the symptoms by which the diagnosis of Alzheimer's disease will sooner or later be confirmed. In some patients, the main symptoms of the disease are not memory problems, but speech disorders, inability to perform certain actions, and motor disorders occur.
The pathological process has different effects on all aspects of human memory. But:
- memories of old events, which are part of episodic memory;
- semantic memory associated with long-learned facts;
- implicit memory, which is responsible for the sequence of certain actions,
these are the aspects that are least subject to frustration. But this can not be said about recent events or new information. In this case, difficulties in memorizing appear as clearly as possible.
Aphasia is expressed in a significant reduction in the human vocabulary and a decrease in the fluency of his speech. As a result, the patient has serious difficulties with the written and oral expression of his thoughts.
At this stage of the development of the disease, a person is still quite capable of operating normally with elementary concepts in speech communication. But during the execution of tasks requiring the connection of fine motor skills of the hands, his movements become awkward. This indicates a violation of the coordination and planning of these very movements.
As the pathological process progresses, the patient is able to perform certain tasks independently. But when it comes to a situation where special cognitive efforts are required, the patient in almost all cases needs outside help or control.
The patient's condition is rapidly deteriorating, against the background of which his ability to independently perform certain actions is significantly reduced. The patient has paraphasia - a deviation characterized by the selection of incorrect words in return for phrases suitable for a particular situation. Gradually, the patient loses writing and reading skills.
Most of the daily tasks become a serious obstacle for a person - he simply cannot cope with them due to the lack of coordination of movements. Memory problems are exacerbated, the patient may not even recognize his closest relatives and people he knows.
There is a violation of long-term memory, which had not previously been subjected to negative changes. Because of this, abnormalities in patient behavior are becoming increasingly apparent.
The patient begins to suffer from neuropsychological disorders, manifested in:
- inclination to vagrancy;
- emotional lability, when anger gives way to high spirits, and laughter - crying and depressive state;
- evening exacerbations;
- unreasonable attacks of aggression and others.
In 30% of patients, various symptoms of delirium are pronounced. Sometimes, against the background of mental disorders, urinary incontinence may develop. Since such manifestations can lead to the development of stress in the next of kin of the patient, the latter, in the event of such deviations, it is better to place in the hospital.
Severe dementia is the last and most severe stage of Alzheimer's disease. At this stage, the patient can no longer act independently, and is completely dependent on outside help.
Gradually reduced vocabulary. At first, the patient is treated with stingy phrases, then with separate words. As a result, he completely loses his speaking skills. However, despite this, patients retain the ability to be aware of the actions and words of other people.
From time to time, the patient has a sudden outbreak of aggression. But most often his state is apathetic, detached. He cannot do without outside help in performing various daily tasks.
In the last stage of Alzheimer's disease, a person shows signs of physical exhaustion. He is losing muscle mass and has difficulty moving, so he also needs outside help. Gradually, the situation is aggravated by the inability of the patient to independently eat.
Death in asthma may occur due to the negative impact of external factors. These may be the development of pneumonia or ulcers. Alzheimer's disease, as such, never leads to the death of a patient.
The first warning signs indicating the development of Alzheimer's disease cannot be ignored. First of all, a survey is conducted, which helps to identify the prerequisites for the development of this pathology and to detect its initial symptoms.
In addition, the patient must pass clinical tests, undergo CT or MRI of the brain, cardiogram, thyroid research, and encephalography. Also, a special procedure can be prescribed by a doctor - a PET scan of the brain.
The diagnosis is made on the basis of the analysis of the patient's life, family history, the results obtained during the instrumental diagnostic procedures. It is also important to eliminate the possible impact of comorbidities.
Based on comprehensive examinations and a thorough analysis, a specialist can tell exactly whether Alzheimer's disease actually occurs. However, sometimes to confirm the correctness of the diagnosis requires an additional biopsy of brain tissue.
Can Alzheimer's Cure Be Cured?
The treatment of asthma consists in slowing down or stopping the progression of the pathological process, and stopping associated symptoms. If therapy is started in time, it is possible to significantly prevent the loss of cognitive functions in a patient.
Modern medicine does not yet have medical products that can completely cure a dangerous disease. However, there are tools that can significantly facilitate the life of the patient.
Pharmacotherapy is carried out to restore the memory and thinking of a patient with BA. In addition, efforts are directed at stopping such emotional disorders as depression, excessive excitability, hallucinations. To this end, resort to the use of:
- Cholinesterase inhibitors. This is the basis of drug therapy for Alzheimer's disease. The pathological process develops against the background of an acute deficiency of acetylcholine, which is responsible for memorizing facts and events. Drugs prevent the destruction of this amino acid and contribute to its accumulation in the body. The initial and middle stages of the disease are treated mainly with drugs such as Rivastigmine and Galantamine. In severe situations, donepezil is prescribed.If the dosage prescribed by the doctor is observed, therapy in patients with BA proceeds easily.
- Memantine Alzheimer's disease causes excessive accumulation of glutamate in the body. This substance leads to the destruction of the cells of the cerebral cortex. The drug reduces the destructive effects of glutamate and, on the contrary, prolongs the period during which the patient is able to self-service. As a rule, medication is prescribed to patients with moderate and severe Alzheimer's disease.
- Psychotropic drugs. They are necessary for patients with depression and sleep disorders. Neuroleptics or tranquilizers can also be prescribed to alleviate or eliminate symptoms. However, these funds are not prescribed in the absence of depression or insomnia in patients.
- Tranquilizers. They help relieve psycho-emotional stress, stop depression and improve sleep. At the same time, there is no effect on functional memory and thinking. Preparations in parallel have a relaxation and anticonvulsant effect. Since tranquilizers have a lot of side effects, they should be appointed exclusively by a specialist.
- Neuroleptics. The expediency of using this group of drugs is due to the development of psychopathic states. But their appointment can lead to increased dementia.
- Antidepressants. They are necessary to rid the patient of depression and apathy.
- Antioxidants that have a positive effect on blood microcirculation and hemodynamics. They also contribute to an increase in the period during which the patient is capable of self-care.
Pharmacotherapy is necessarily complemented by social medical techniques:
Only with an integrated approach using the above techniques can the progression of pathology be significantly slowed down. In some cases, doctors can restore the skills and abilities previously lost by the patient, albeit partially. Art therapy, music therapy, pet therapy, etc. also have a good effect on the health of patients.
If the symptoms of Alzheimer's disease have just begun to appear, as well as to prevent the development of pathology, patients are advised to resort to a special Mediterranean diet. It involves the enrichment of the daily diet with fresh vegetables and fruits, various kinds of cereals, red wine (in reasonable quantities) and fish dishes. Of great importance is the use of large quantities of products enriched with vitamins B3 and B12, ascorbic and folic acids.
Under the strictest prohibition is smoking and the use of spirits. It is better to give preference to citrus fruits and seafood enriched with vitamin B9.
It is very important to control the amount of fluid consumed. Its volume should be not less than 1.5 liters per day.
Excellent help to improve brain activity in Alzheimer's disease bee products. A day is recommended to take at least 3 spoons of honey.
Caring for a sick person
The patient, who has been diagnosed with a severe stage of the disease, needs the help of relatives and friends, since his ability to self-care is lost. To help the patient, you must follow these simple rules regarding his care:
- Develop a daily regimen that will greatly facilitate patient orientation in time. Try to base it on those activities that most of all occupied the patient before identifying dementia.
- Try to use as many bright, multi-colored pointers as possible, which will help a person with BA to navigate in time and space. Hang on the door of the house pictures rich in color, with instructions and clear names of certain objects. On the wall in the patient's room you can put a large poster with the developed mode of the day. Well influence on the emotional state and cognitive functions of the patient pictures of relatives and people close to him.
- To give the patient the feeling that he is capable of doing something on his own, provide him with simple tasks. For each task completed successfully, be sure to praise him.
- Avoid discussion in the presence of the patient, his condition and illness, as such. This way you can cause him serious psycho-emotional harm, and undermine his self-esteem.
- Communication with the patient should be warm, relaxed. Underline the sincerity of your words with gestures, touches, facial expressions.
- Do not conflict with the patient - in his aggressive behavior is not his fault, he is influenced by the existing disease.
In addition, certain precautions must be taken in providing patient care. They are to:
- remove all potentially dangerous items from the sight of the patient;
- keys to the apartment, material values and documents should be kept in an inaccessible place (better - locked up);
- provide the patient with free movement around the house (remove high projections, cover the floor with carpets so that it is not slippery, etc.);
- ensure that the patient is not hungry or, on the contrary, avoids overeating;
- remove from the room of a person with BA all small items that he can swallow;
- during water procedures, remove all mirrors from the bathroom, and in no case wash the patient under the shower;
- watch the patient's behavior carefully while walking, since many people with Alzheimer's disease have an unreasonable desire for vagrancy on the street;
- for patient's safety, indicate the address and contact telephone number on a piece of paper, and put this information in the ward’s pocket;
- walks should be carried out in quiet places, because loud or harsh sounds can frighten or disorient the patient;
- Do not allow a sharp change in the situation - patients with asthma react very strongly to this;
- do not allow the ward to contact with strong irritants - too bright light or loud sound, etc.
If the patient is too restless, consult a doctor to prescribe the necessary treatment.
Early dementia creates serious difficulties in terms of diagnosis, so the diagnosis is often made even when serious cognitive disorders become well marked. Gradually, minor deviations accrue, as a result of which the patient loses the ability to fully think, memorize, etc.
Alas, the prognosis for Alzheimer's disease is very disappointing. Due to the propensity of pathology to progression, the mortality rate in people with a similar diagnosis is almost 100%. As a rule, after diagnosis, patients can live for about 7 years, but this is only an approximate forecast. And only in 3% of cases the patient lives 14 years. In 70% of cases, the death is caused by the disease itself, but it is not uncommon that patients die from pneumonia or dehydration.
Many people familiar with the signs of Alzheimer's disease, and who have found disturbing symptoms in themselves or their relatives, are trying to prevent their worsening by all available means. First of all, it should be remembered that it is necessary to make sure that the unpleasant symptoms associated with this disorder. In addition, there is no specific prevention of Alzheimer's disease.
Nevertheless, there are allegations that if you immediately begin to develop and improve cognitive functions, it will help save the situation. So, you can play chess, learn poems or songs, learn to play musical instruments, etc.: There are really many options.
In parallel, there is a perception that only a diet with the complete exclusion of harmful products can stop the progression of pathology. Perhaps both points of view have a right to exist, and partly correct. Therefore, it is better to approach the issue of Alzheimer's disease prevention in a comprehensive manner, and adopt both methods described above.
What really requires careful attention from a person who is afraid of developing Alzheimer's disease is the risk of developing vascular diseases. It is on their prevention that all forces must be thrown. The fact is that hypercholesterolemia, hypertension, diabetes mellitus and other pathologies not only increase the risk of developing Alzheimer's disease, but also significantly aggravate its course, becoming frequent causes of death for the patient.