Alzheimer's disease is an incurable neurodegenerative disease, affecting mainly people of old age.
It develops because of the destruction of nerve cells that transmit impulses between brain structures. As a consequence, a rapid and irreversible deterioration of memory occurs. A person suffering from this disease subsequently loses the ability to self-service. That is, 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 widespread in developed countries.
In ancient Greece, doctors and philosophers explained the decline in a person's mental activity by the natural aging process of the body. And only in 1901 the German psychiatrist Alois Alzheimer noted and recorded a separate disease, which was later named after him.
In 1907, when the patient August Deter, whom Alzheimer observed, died, he published the results of his research. Over the next 5 years, 11 more cases of symptoms, previously mentioned by a German doctor, have been described in the medical literature. 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 Volume 8 of his textbook on psychiatry was published, Alzheimer's disease was ranked as a subtype of cyanide 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 aged 45-65 years. That is, in relatively young people, doctors showed signs of presenile dementia.
However, everything changed in 1977, when the conference participants on this disease came to the conclusion that the pathological and the clinical features of presenile and senile dementia are not too different from each other. Although they did not exclude the possibility of the presence of etiological differences between these states.
Over time, the diagnosis of "Alzheimer's disease" began to be set regardless of the patient's age. Thus, the term was formally adopted into the medical nomenclature. And today it is a disease that is diagnosed in patients of different age categories, and manifests itself in a number of characteristic neuropathological symptoms.
Causes and risk factors
Factors predisposing to the development of Alzheimer's disease can be ones that can not be influenced, and those that can be changed. The first include:
- age of the patient (over 65 years);
- genetic predisposition;
- anomalies in the genetic code. In particular, if failures in the allelic unit E4 of the APOE gene were detected, then this is no longer a risk factor, but a factual statement of fact. If such a violation was found in a child, 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 classified as:
- Cognitive disorders (moderate memory impairment) in young people. If the anomaly is timely treated, and its progression has been successfully stopped, the risk of developing Alzheimer's disease in the future is significantly reduced.
- 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, it concerns smoking.
- Permanent head injuries or severe complications of CCT, which led to irreversible or chronic pathological processes in the brain.
It is interesting. Scientists have established a close relationship between the intellectual development of man and the risk of developing asthma. In highly educated people, pathology occurs much less frequently. This is due to the great improvement in neural networks of the brain, who are accustomed to solve complex problems.
The true causes of the development of Alzheimer's disease to date remain unsettled. However, the researchers took a big step toward solving such a difficult secret, finding the genes that are responsible for a person's predisposition to dementia. The scientifically proven fact is that a large number of destroyed brain cells leads to a significant decrease in a person's mental abilities.
The first signs of Alzheimer's disease
Symptoms of Alzheimer's disease, which is at the initial stage of development, are quite smeared, so distinguish them from signs of cardiovascular or other neurological diseases is extremely problematic on its own. Initially, a sick person shows unusual strangeness of behavior, which is often ignored by others. But it is precisely these deviations that speak of the initial stage of pathology-pre-conditions. It is characterized by symptoms in the form of:
- decrease in attention concentration, absent-mindedness and confusion of the patient when there is a need to perform a task that requires attention and active thinking;
- memory impairment, including difficulties with memories of what was the day before yesterday, yesterday or half a day ago;
- the inability to remember new information or events (important and not very);
- difficulties with concentrating on the performance of assigned tasks;
- forgetfulness, manifested in everyday life. Thus, patients suffering from pre-conditions often forget to conduct hygienic procedures, clean up or perform another simple action. Problems with self-care is one of the most troubling symptoms of the onset of Alzheimer's disease.
The confusion of thoughts, the inability to collect them "into a pile," frequent "hang-ups," or the constant retardation of thoughts when talking to people is also one of the symptoms of pre-dementia. This should especially alert the loved ones, if earlier the person was an interesting interlocutor, and could support any conversation.
Similar symptoms can be noticed about 8 years before the development of the disease as such. This clinical picture is called "mild cognitive impairment," and can signal the development of other neurological pathologies, as well as diseases that damage blood vessels and the human brain.
People in a family history of whom there were no such disorders, and who previously had no health problems cardiovascular system, can independently note the occurrence of a disturbing symptomatology. If earlier the decision of certain tasks or memorization of various information was given easily, it is not difficult to note the deterioration of these processes. At the same time, the patient himself is able to notice them much earlier than people around him who can completely write off such deviations in the process of aging of a sick person.
Symptoms and stages of Alzheimer's disease
During its development pathology is 4 stages. Each of them differs from the previous intensity of the 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 a specific reaction of the organism to a stressful situation. When carrying out neurocognitive testing, deviations in brain function are detected even 8 years before the onset of active disease progression.
These symptoms can occur when performing even the easiest tasks. For example, patients experience a significant deterioration in memory, so they can not remember basic information or tell about events that occurred in the recent past.
In addition, at an early stage of Alzheimer's disease, the patient may develop abnormalities in the form of:
- the impossibility of focusing on the implementation of specific actions;
- deterioration of cognitive flexibility;
- violations of abstract thinking;
- reduce semantic memory, etc.
At the stage of proctomy, apathy is often manifested, which is one of the most persistent symptoms of the early stage of Alzheimer's disease. The stage of "soft cognitive impairment" is also called the stage of "soft cognitive decline". However, today scientific disputes are being held about whether to leave such a designation of symptoms behind the initial phase of the pathological process, or to separate it into a separate diagnostic unit.
The gradual worsening of memory and the progression of agnosia are symptoms, which sooner or later the diagnosis of "Alzheimer's disease" will be confirmed. In some patients, the main signs of the disease are not memory problems, but speech disorders, inability to perform certain actions, motor disruptions occur.
The pathological process has different effects on all aspects of human memory. But:
- memories of old events, which are part of the 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 affected by the disorder. But this can not be said about recent events or new information. In this case, the difficulties with memorization are manifested as vividly as possible.
Aphasia is expressed in a significant reduction in the vocabulary of a person and a decrease in the fluency of his speech. As a consequence, 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 normally operating elementary concepts in speech communication. But during the execution of tasks that require the connection of fine motor skills of the hands, his movements become awkward. This indicates a lack of 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 situations where special cognitive efforts are necessary, the patient needs outside help or control in almost all cases.
The patient's condition is rapidly deteriorating, against which his ability to perform certain actions is significantly reduced. The patient develops paraphasia - a deviation characterized by the selection of incorrect words in return for phrases appropriate to a particular situation. Gradually, the patient loses his writing and reading skills.
Most everyday tasks become a serious obstacle for a person - he simply can not cope with them because of a lack of coordination of movements. Problems with memory are aggravated, the patient may not even recognize his nearest relatives and people he knows.
There is a violation of long-term memory, which previously was not subjected to negative changes. Because of this, the deviations in the patient's behavior become more and more obvious.
The patient begins to suffer from neuropsychological disorders, manifested in:
- propensity to vagrancy;
- emotional lability, when anger is replaced by an upbeat mood, and laughter - crying and depressed state;
- evening exacerbations;
- causeless attacks of aggression, etc.
In 30% of patients, various symptoms of delirium are clearly manifested. Sometimes urine incontinence can develop on the background of mental disorders. Since such manifestations can lead to stress development in the next of kin of the patient, the latter, when such deviations occur, it is better to place in a 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, the vocabulary is reduced. At first the patient manages with sparse phrases, then - in separate words. As a consequence, he completely loses his oral skills. However, despite this, patients remain able to recognize the actions and words of other people.
From time to time, the patient has sudden outbreaks of aggression. But most often his condition is apathetic, detached. He can not do without outside help in the performance of various daily tasks.
At the last stage of Alzheimer's disease, a person is showing signs of physical exhaustion. He loses muscle mass and struggles to move, so he also needs help from the outside. Gradually, the situation is aggravated by the inability of the patient to eat alone.
The lethal outcome of asthma can occur due to the negative impact of external factors. These can be the development of pneumonia or ulcers. Alzheimer's disease, as such, never leads to the death of the patient.
It is impossible to ignore the first alarming signs, indicating the development of Alzheimer's disease. First of all, a questionnaire 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 necessarily pass clinical tests, pass CT or MRI of the brain, cardiogram, thyroid examinations, encephalography. Also, a doctor can be assigned a special procedure - PET scan of the brain.
The diagnosis is made based on the analysis of the patient's life, family history, the results obtained in the course of instrumental diagnostic procedures. It is also important to exclude the possible impact of concomitant diseases.
Based on complex surveys and careful analysis, a specialist can tell exactly whether Alzheimer's is actually occurring. However, sometimes an additional biopsy of the brain tissue is required to confirm the diagnosis.
Is it possible to cure Alzheimer's disease?
Treatment of asthma is to inhibit or stop the progression of the pathological process, and to stop the concomitant symptoms. If the therapy is started on time, you can significantly prevent the loss of cognitive functions in the patient.
Modern medicine does not yet have medical drugs that can completely cure a dangerous disease. However, there are tools that can greatly facilitate the life of the patient.
Methods of treatment
Pharmacotherapy is performed to restore the memory and thinking of the patient with asthma. In addition, efforts are directed at arresting 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, conducted with Alzheimer's disease. The pathological process develops against the background of acute deficiency of acetylcholine, responsible for memorizing facts and events. Drugs interfere with the destruction of this amino acid and contribute to its accumulation in the body. The initial and middle stage of the disease is treated, mainly, with drugs such as rivastigmine and galantamine. In severe situations, prescribe Donepezil. If the dosage prescribed by the doctor is observed, the therapy in patients with asthma is easy.
- Memantine. In Alzheimer's disease, there is an excessive accumulation of glutamate in the body. This substance leads to the destruction of cells of the cortex of the brain. The drug reduces the damaging effect of glutamate and, on the contrary, prolongs the period during which the patient is able to self-service. Typically, the drug is prescribed for patients with moderate to severe Alzheimer's disease.
- Psychotropic drugs. They are necessary for patients with a depressed state and a sleep disorder. To alleviate or remove symptoms, neuroleptics or tranquilizers may also be prescribed. However, these drugs are not prescribed in the absence of a depressive state or insomnia in patients.
- Tranquilizers. They help to remove psychoemotional stress, to stop depression and to establish a dream. At the same time, there is no impact 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 conditions. But their purpose can lead to activation of the manifestation of dementia.
- Antidepressants. They are necessary to relieve the patient of depression and apathy.
- Antioxidants, which have a positive effect on blood microcirculation and hemodynamics. They also contribute to increasing the period during which the patient is able to self-service.
Pharmacotherapy is necessarily complemented by social treatment methods:
Only with a comprehensive approach using the above methods can significantly slow the progression of pathology. In some cases, doctors manage to restore previously lost skills and abilities, even if partially. Also, art therapy, music therapy, pet therapy, etc., also have a positive effect on the health of patients.
If the symptoms of Alzheimer's are only beginning to manifest, and also in order to prevent the development of pathology, patients are recommended to resort to adherence to a special Mediterranean diet. It involves enriching the daily diet with fresh vegetables and fruits, different kinds of cereals, red wine (in reasonable quantities) and fish dishes. Of great importance is the use of a large number of products enriched with vitamins B3 and B12, ascorbic and folic acid.
Under the strictest prohibition is smoking and drinking strong 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 used. Its volume should be at least 1.5 liters per day.
Excellent help to improve brain activity in Alzheimer's disease products of beekeeping. On the day it is recommended to take at least 3 spoonfuls of honey.
Care for a sick person
The patient, who was diagnosed with a serious stage of the disease, needs help from relatives and friends, since the ability to self-service is lost. To help the patient, it is necessary to observe such simple rules concerning the care of him:
- Develop a regime of the day, which will greatly facilitate the patient's orientation in time. Try to base it on those activities that most occupied the patient before revealing his dementia.
- Try to use as many bright, colorful indicators that will help a person with AD navigate in time and space. Hang on the door of the house pictures saturated with rich colors, 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 affect the emotional state and cognitive functions of the patient's photos of relatives and friends of his people.
- To give the patient the feeling that he is able to do something on his own, provide him with simple tasks. For each task performed successfully, be sure to praise it.
- Avoid discussions in the presence of the patient's condition and illness, as such. This you can cause him serious psycho-emotional harm, and undermine the sense of his own dignity.
- Communication with the patient should be warm, laid-back. Emphasize the sincerity of your words with gestures, touches, facial expressions.
- Do not conflict with the patient - his aggressive behavior is not his fault, it affects the existing disease.
In addition, it is necessary to adhere to certain precautions when providing care for the patient. They consist in:
- remove all potentially dangerous items from the patient's field of vision;
- keys to the apartment, material values and documents should be kept inaccessible place (better - under lock and key);
- to provide the patient with free movement around the house (remove high protrusions, cover the floor with carpets, so that it is not slippery, etc.);
- To ensure that the patient is not hungry or, on the contrary, avoiding 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 do not wash the patient under the shower;
- carefully follow the patient's behavior during walks, as many people with Alzheimer's disease on the street have an unreasonable craving for vagrancy;
- for the sake of patient's safety, indicate on the piece of paper the address and contact phone, and place this information in the ward's pocket;
- walks should be carried out in quiet places, since loud or sharp sounds can frighten, or disorient the patient;
- Do not allow a sharp change in the situation - patients with asthma react very sharply to this;
- Do not allow the patient to come into contact with strong irritants - too bright light or loud sound, etc.
If the patient is too restless, consult a doctor for the necessary treatment.
Early dementia creates serious difficulties in terms of diagnosis, so the diagnosis is often made already when serious cognitive disorders become well marked. Gradually, minor deviations increase, so that the patient loses his ability to fully think, remember, and so on.
Alas, the prognosis for Alzheimer's disease is very disappointing. In view of the propensity of pathology to progression, the mortality rate in people with a similar diagnosis is almost 100%. As a rule, after the diagnosis, patients manage to live 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, death is caused by the disease itself, but situations where patients die from pneumonia or dehydration are also not uncommon.
Many people who are familiar with the signs of Alzheimer's disease, and who have found alarming symptoms in their or their relatives, try by all available means to prevent their aggravation. First of all, it should be remembered that it is necessary to make sure that unpleasant symptoms are 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, this will help save the situation. So, you can study chess, learn poems or songs, learn to play musical instruments, etc.: there really are many options.
In parallel, there is an opinion that only compliance with a diet with the complete exception of harmful products can stop the progression of pathology. Perhaps both points of view have a right to exist, and are partly correct. Therefore, it is better to approach the prevention of Alzheimer's disease in a comprehensive way, and to adopt both methods described above.
That's what really requires careful attention from a person who is afraid of the development of Alzheimer's disease, so this is the risk of developing vascular diseases. It is on their prevention that all forces must be thrown out. The fact is that hypercholesterolemia, hypertension, diabetes mellitus and other pathologies not only increase the risk of developing Alzheimer's, but also significantly aggravate its course, becoming frequent causes of death of the patient.
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