| What is Alzheimer's disease ? |
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What is Alzheimer's Disease ? |
Alois Alzheimer, Eminent German Neurologist
and Psychiatrist described the symptoms of Aguste D as a disease in 1906,
which was named after him. Great strides have been made in the early diagnosis
and treatment of this mind crippling illness. In a totally bleak scenario,
where nothing could have been done, four drugs are available now to manage
some of the distressing symptoms and help the affected person lead a better
life. It is estimated that there are nearly 22 million people suffering
from this dreadful condition out which, over 3 million are estimated to
be in India. By 2030 this number is expected to double. Are we capable
managing this large number of elderly people with dementia? With dwindling
family support, care of these frail, confused elderly will fall on the
community. This is going to be even more difficult in countries like India,
where there is gross ignorance coupled with total lack of services for
providing a reasonable quality life for the victims and their families
in distress.
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Alzheimer's Disease is the most common cause of dementia |
Typically Alzheimer's Disease begins with lapses
of memory, difficulty in finding the right words for everyday objects or
swinging mood. Mild symptoms may be a natural effect of ageing, but in Alzheimer's
Disease a pattern of problems emerges over six months or more. As it progresses
the person may: |
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Routinely forget recent events, appointments,
names and faces and have difficulty in understanding what is being said,
become confused when handling money, driving a car or using a washing machine. |
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Undergo personality changes, appearing no longer to care
about those around them, and becoming irritable or apathetic, suffer mood
swings and burst into tears for no apparent reason, or become convinced
that someone is trying to harm them |
In advanced cases people may also: |
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Adopt unsettling behaviour, like getting up in the middle
of the night, or wandering off from their home and becoming lost. |
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Lose their inhibitions and sense of suitable behaviour,
undressing in public or making inappropriate sexual advances. |
Alzheimer's is a physical disease which attacks
brain cells (where we store memory), brain nerves and transmitters (which
carry instructions around the brain). Production of a chemical messenger
acetylcholine is disrupted, nerve ends are attacked and cells die. The brain
shrinks as gaps develop in the temporal lobe and hippo campus important
for receiving and storing new information. The ability to remember, speak,
think and make decisions is disrupted. After death, tangles and plaques
made from protein fragments, dying cells and nerve ends are discovered in
the brain. This confirms the diagnosis. |
What Causes Alzheimer's Disease? |
The short answer is we don't know. It may be a combination
of factors, some we are born with, some in our environment and some which
happen to us. Things that cause Alzheimer's Disease more likely are called
risk factors. They include: |
The greatest risk factor is increasing age |
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Below the age of 65 dementia affects one person
in 1,000 |
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Over the age of 65 it affects four to five in 100 |
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By the age of 80 it affects one person in five |
Although the risk continues to rise, a majority
of 90 years old are still unaffected. |
A Family Condition: Some people are born
at risk because of the genes they inherit |
Early onset: Alzheimer's Disease in younger
people often progresses more rapidly. A number of rare genetic faults make
the disease more likely at a young age. |
Brain Damage: People who have had a severe
head injury with loss of consciousness are at increased risk of dementia.
This is also true of boxers who have become punch-drunk. |
Down's syndrome: Because of their chromosomal
defect, people with down's syndrome are more likely to develop Alzheimer's
Disease. As more people with, Down's syndrome survive in to their 50's and
60s, more will develop the disease. |
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A possible association has been discovered with
the cold sore virus, herpes simplex, but the link is complicated and seems
also to include genetic factors. |
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Some toxic chemicals put people at risk of Parkinson's Disease.
This has led to a search for a chemical link to Alzheimer's. |
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There is no evidence of risk from aluminium saucepans or
from drinking tea, which has traces of aluminium. |
How is Alzheimer's
Disease Diagnosed? It is important not to become over concerned
at minor mental slips, but early and accurate diagnosis is important to
clarify whether a treatable condition is causing symptoms, and to provide
the best possible care |
A health professional records
the pattern of symptoms, and uses simple tests to see what someone remembers
and if they can hold simple information in the memory. These can be repeated
after a few months to measure change. Where dementia is suspected brain
scans can show chemical activity and whether areas of the brain are shrinking.
Diagnosis can be 80 to 90 per cent accurate in life but can only be confirmed
after death. |
Is treatment possible?
There is no cure for Alzheimer's Disease but prospects for management have
improved. New drugs are being developed which seek to slow down the rate
of mental decline. These are promising in the early stages of the disease,
although it is unclear for how long they can help and they are not yet widely
available. In April 1997, donepezil (Aricept) became the first drug to be
licensed for Alzheimer'' in Britain. |
Affected people should live
as normal a life for as long as they can. Memory aids and familiar routines
are helpful. As the disease progresses, people need more support and may
be need close supervision and eventually nursing care. In India Rivastigmine
(Exelon) is being marketed by Novartis since 1999. |
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