alzheimer's disease
Alzheimer’s disease is a progressive neurologic disorder that causes the brain to shrink (atrophy) and brain cells to die. Alzheimer’s disease is the most common cause of dementia — a continuous decline in thinking, behavioral and social skills that affects a person’s ability to function independently.
The early signs of the disease include forgetting recent events or conversations. As the disease progresses, a person with Alzheimer’s disease will develop severe memory impairment and lose the ability to carry out everyday tasks.
When to see a doctor
A number of conditions, including treatable conditions, can result in memory loss or other dementia symptoms. If you are concerned about your memory or other thinking skills, talk to your doctor for a thorough assessment and diagnosis.
If you are concerned about thinking skills you observe in a family member or friend, talk about your concerns and ask about going together to a doctor’s appointment
Symptoms
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Memory loss is the key symptom of Alzheimer’s disease. Early signs include difficulty remembering recent events or conversations. As the disease progresses, memory impairments worsen and other symptoms develop.
At first, a person with Alzheimer’s disease may be aware of having difficulty remembering things and organizing thoughts. A family member or friend may be more likely to notice how the symptoms worsen.
Brain changes associated with Alzheimer’s disease lead to growing trouble with:
Memory
Everyone has occasional memory lapses, but the memory loss associated with Alzheimer’s disease persists and worsens, affecting the ability to function at work or at home.
People with Alzheimer’s may:
- Repeat statements and questions over and over
- Forget conversations, appointments or events, and not remember them later
- Routinely misplace possessions, often putting them in illogical locations
- Get lost in familiar places
- Eventually forget the names of family members and everyday objects
- Have trouble finding the right words to identify objects, express thoughts or take part in conversations
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Planning and performing familiar tasks
Once-routine activities that require sequential steps, such as planning and cooking a meal or playing a favorite game, become a struggle as the disease progresses. Eventually, people with advanced Alzheimer’s often forget how to perform basic tasks such as dressing and bathing.
Changes In Personality And Behavior
Brain changes that occur in Alzheimer’s disease can affect moods and behaviors. Problems may include the following:
- Depression
- Apathy
- Social withdrawal
- Mood swings
- Distrust in others
- Irritability and aggressiveness
- Changes in sleeping habits
- Wandering
- Loss of inhibitions
- Delusions, such as believing something has been stolen
Thinking and reasoning
Alzheimer’s disease causes difficulty concentrating and thinking, especially about abstract concepts such as numbers.
Multitasking is especially difficult, and it may be challenging to manage finances, balance checkbooks and pay bills on time. Eventually, a person with Alzheimer’s may be unable to recognize and deal with numbers.
Making judgments and decisions
Alzheimer’s causes a decline in the ability to make reasonable decisions and judgments in everyday situations. For example, a person may make poor or uncharacteristic choices in social interactions or wear clothes that are inappropriate for the weather. It may be more difficult to respond effectively to everyday problems, such as food burning on the stove or unexpected driving situations.
Preserved skills
Many important skills are preserved for longer periods even while symptoms worsen. Preserved skills may include reading or listening to books, telling stories and reminiscing, singing, listening to music, dancing, drawing, or doing crafts.
These skills may be preserved longer because they are controlled by parts of the brain affected later in the course of the disease.
A diagnostic work-up would likely include the following tests:
Management of alzheimer's disease
Physical and neurological exam
Your doctor will perform a physical exam and likely assess overall neurological health by testing the following:
- Reflexes
- Muscle tone and strength
- Ability to get up from a chair and walk across the room
- Sense of sight and hearing
- Coordination
- Balance
Lab tests
Blood tests may help your doctor rule out other potential causes of memory loss and confusion, such as a thyroid disorder or vitamin deficiencies.
Mental status and neuropsychological testing
Your doctor may give you a brief mental status test to assess memory and other thinking skills. Longer forms of neuropsychological testing may provide additional details about mental function compared with people of a similar age and education level. These tests can help establish a diagnosis and serve as a starting point to track the progression of symptoms in the future.
Brain imaging
Images of the brain are now used chiefly to pinpoint visible abnormalities related to conditions other than Alzheimer’s disease — such as strokes, trauma or tumors — that may cause cognitive change.
Imaging of brain structures include the following:
Magnetic resonance imaging (MRI).
They may show brain shrinkage of brain regions associated with Alzheimer’s disease, MRI scans also rule out other conditions. An MRI is generally preferred to a CT scan for the evaluation of dementia.
PET SCAN
- Positron emission tomography (PET SCAN) Imaging of disease processes can be performed with positron emission tomography (PET). During a PET scan, a low-level radioactive tracer is injected into the blood to reveal a particular feature in the brain. PET imaging may include the following:
- Fluorodeoxyglucose (FDG) PETscans show areas of the brain in which nutrients are poorly metabolized. Identifying patterns of degeneration — areas of low metabolism — can help distinguish between Alzheimer’s disease and other types of dementia.
- Amyloid PET imagingcan measure the burden of amyloid deposits in the brain. This imaging is primarily used in research but may be used if a person has unusual or very early onset of dementia symptoms.
- Tau PET imaging,which measures the burden of neurofibrillary tangles in the brain, is generally used in the research setting.
In special circumstances, such as rapidly progressive dementia, dementia with atypical features or early-onset dementia, other tests may be used to measure abnormal beta-amyloid and tau in the cerebrospinal fluid.
TREATMENT
In Alzhiemers D Medications may temporarily improve or slow progression of symptoms. These treatments can sometimes help people with Alzheimer’s disease maximize function and maintain independence for a time.
Different programs and services can help support people with Alzheimer’s disease and their caregivers.
There is no treatment that cures Alzheimer’s disease or alters the disease process in the brain.
In advanced stages of the disease, complications from severe loss of brain function — such as dehydration, malnutrition or infection.
