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Alzheimer's disease: symptoms and signs, stages, treatment and drugs

This disease, like many in neurology ( Parkinson , Binswanger, Van Bogart, Creutzfeldt-Jakob, Wernicke), is named after its “discoverer”. Of course, in this case we are talking not so much about the discoverer as the first doctor who systematized and pointed out to the rest of the medical community one of the types of dementia. This is a German psychiatrist and neurologist, Alois Alzheimer's.

Since 1907, they first described the special cases of senile dementia, which later became known as "Alzheimer's disease." In the 20th century, especially at the end, this disease became widely known, especially in intellectual circles.

And often, in the form of self-irony, the person said to himself: “Yes, as long as you manage to run away from Alzheimer's.” Things reached the point that the name of the disease began to be written with a small letter. But today we will return this real name to this disease, and out of respect for Alois Alzheimer, we will call the disease discovered by him as it should be, with a capital letter.

Content

Alzheimer's Disease - what is it?

Alzheimer's disease

Alzheimer's disease is a type of dementia, or acquired dementia. In order to immediately put an end to possible questions, let's say that there are three degrees of congenital dementia, which is called oligophrenia (dementia).

The names of these stages are well known to everyone, as they are often used in everyday life as “soft” curses: debility, imbecility and idiocy.

Idiocy is the most severe form in which the patient needs careful care all his life, is not able to control natural functions, and often cannot eat without help.

Debility is the easiest stage in which a person can graduate from a special school, acquire social and labor skills, get a job and even support a family if he is well adapted to the conditions of a stable social environment.

Alzheimer's disease (BA) is one of the most common forms of acquired dementia. And if oligophrenia is a consequence of the underdevelopment of the functions of the central nervous system, then the essence of Alzheimer's disease lies in their breakdown.

In everyday life, you can find terms such as senile dementia, senile dementia, senile dementia or senile marasmus, which designate the extreme form of disintegration of the personality.

  • Alzheimer's dementia exists in two versions: the usual one, which begins after reaching the age of 65, and the early form, which is much less common.

In total in the world (according to data for 2006) about 25 million cases of BA were recorded, but given the low level of development of psychiatry and neurology in developing countries, the number of cases can be increased to 40 million. This means that the average risk of getting sick is 1: 180.

This is a fairly high figure. Given the development of medicine and the increase in the number of older people, especially in developed countries, the number of patients will only grow, and, according to some estimates, by the year 2050 the number of patients may be about 100 million people worldwide.

The causes of Alzheimer's disease, despite the very large number of studies, 80% remain unclear. One thing has been clarified: in the early onset of the disease, heredity plays a significant role.

Three genes have been discovered that are responsible for the development of family and early forms, and in the event of a defect, the risk of getting sick with early form of dementia is almost 100%.

Unfortunately, the majority of cases that occur at a later age do not yet have a well-established reason, although there are many theories. Of great importance are the risk factors that can increase the incidence of this disease.

About risk factors

Alzheimer's Disease photo 2

Alzheimer's Disease photo 2

As always, there are factors that cannot be changed (modified), and there are factors that are subject to change, if desired, by the patient and certain applied efforts. The permanent, non-modifiable BA factors include:

  • Elderly age over 65 years. This is the main risk factor, and suggests that apart from age, nothing more was found;
  • The presence of sick relatives (parents, sisters or brothers). As stated above, there are gene mutations that make higher familial cases than the average in a population;
  • Genetic anomalies are found in the allele pair E4 of the APOE gene. The only proven reason so far. Therefore, it is not even a risk factor, but a “sentence”. Even if this defect is found in a child, this guarantees him the disease in the future.

In addition to these factors, there are modifiable risk factors. They can be changed by the patient and even cease to exist. These include:

  • Mild memory impairment (cognitive impairment) that occurs at a young age. In case their therapy is carried out, progression is stopped, this risk factor decreases;
  • Diseases of the cardiovascular system and the endocrine system, which is manifested by chronic hypoxia of the brain (atherosclerosis, diabetes mellitus, strokes, hypercholesterolemia, increased blood pressure);
  • Bad habits (mostly smoking);
  • An interesting factor is the relationship between the level of education of the patient and the frequency of development of the disease. The more educated a person is, the more “trained” his brain is, the less chance he has of having dementia in old age. Apparently, the matter is in a large number of inter-neural connections and the great perfection of the neural network of an educated person who is used to solving various tasks;
  • Chronic effects of traumatic brain injuries and permanent injuries. It is known that with frequent blows to the head, the risk of not only dementia increases, but also other post-traumatic diseases (for example, the development of post-traumatic parkinsonism in the well-known boxer Mohammed Ali).

Symptoms and signs of Alzheimer's disease, photo

signs of Alzheimer's disease

photo 3

The symptoms of Alzheimer's disease are very diverse, since this is a matter of higher nervous activity. We will try to talk about the most common symptoms, with a gradual increase in their severity.

It all starts with the fact that the patient, being in full mind, informs relatives or colleagues that he has memory problems: names, dates, geography. He often remembers where his glasses and keys are, but all this does not interfere with work or family matters. And, if the patient would not say, no one would notice anything.

When mild symptoms and signs of Alzheimer's disease begin to appear, relatives, colleagues, and testing already reveal abnormalities. Most often they consist in the following violations:

  • Difficult word selection, denoting objects. The patient often shows his hand;
  • Names are forgotten, information is remembered and reproduced in chunks, with a significant semantic part falling out;
  • Reduced ability to plan, to organize;
  • There may be a loss of interest from work or from favorite activities, “cooling down” to friends;
  • Constantly lost things that all the time before were "at hand";

Alzheimer's disease progression

At the stage of mild cognitive impairment, progression of symptoms of Alzheimer's disease occurs:

  • Patients are lost in previously known places, for example, in familiar quarters, or at a metro station, but they still remember where they live and can tell the exact address of their place of residence;
  • Patients have difficulty writing, counting, unable to conduct financial activities and pay for purchases;
  • Patients forget their biography, confuse dates;
  • Insomnia disorders appear, the day is confused with the night.

With the progression of Alzheimer's disease, the symptoms become more pronounced - the patient does not remember the current date and time of the year, does not remember who he is by profession, is not able to dress properly for the weather and for the season. Only important details are remembered. While a person is still able to serve himself, sometimes there may be problems in using the toilet.

Gradually lost contact with friends and acquaintances who live in the distance. There is an emotional “burnout” and flattening of feelings.

Then the patient may begin to confuse the names of loved ones, wear shoes on the wrong foot. Appears untidiness, suspicion, pettiness, a tendency to seduction. There are crazy ideas, stereotypical obsessive movements. Insomnia increases, eating behavior changes (gluttony). It is at this stage that older people are left unattended.

At the more severe stage of Alzheimer's disease, contact with the patient is difficult, the patient is untidy with urine and feces, loses the ability to move actively, and express his thoughts. Need help when walking and even sitting, when eating.

Stages of Alzheimer's Disease

Symptoms of Alzheimer's disease in stages

photo 5

As with any chronic, progressive disease, BA has its own frequency. There are many classifications, but the most convenient is the following, which reflects the stages of Alzheimer's disease, which are understandable for a person without medical education:

  • Predeference. Sometimes it develops 5-8 years before the onset of the disease, it is confused with "aging" and the general deterioration of memory. Does not interfere with work;
  • Early dementia (not early Alzheimer's disease by age of occurrence, but by the progression of symptoms). The boundary between pre-dementia and early stage is the fact that at the stage of early dementia the symptoms of the disease begin to attract the attention of others, difficulties arise at work;
  • Moderate stage. Classical symptoms - a violation of speech, gait. Labor activity or very difficult, more often impossible. The patient mostly serves himself;
  • Severe dementia. The patient needs constant care, contact with him in everyday life is either difficult or impossible. The further development of Alzheimer's disease leads to the fact that a person goes to bed, reflexes of oral automatism come to life, intercurrent diseases arise: infected bedsores, intestinal paresis, and fatal hypostatic pneumonia.

The convenience of this classification is that it does not consider the individual symptoms and signs of Alzheimer's disease, but is based on the reaction of others, inability to work and the constant need for care and care.

How many live in Alzheimer's disease

With very good care, patients live quite a long time, the average life expectancy may be indistinguishable from the average in the population. The fact is that the average life expectancy for this disease, after diagnosis, is 7-10 years.

Therefore, the patient’s life expectancy, if the disease began at 65 years, can be 75 years or more. By the way, this period is 4 years longer than the average life in Russia, so the patient dies earlier from inadequate care and exacerbation of concomitant chronic diseases.

Alzheimer's disease treatment - drugs and techniques

Alzheimer's Disease Treatment - Drugs Treatment of Alzheimer's disease, the symptoms and signs of which we have examined, is currently impossible. There are groups of drugs that can only slow the progression of the disease and improve the quality of life of the patient. These tools include:

  1. Anticholinesterase drugs (rivastigmine, galantamine). Characteristic representative - "Ekselon", "Donepezil". Increasing the concentration of acetylcholine slows down the progression, and the formation of a pathological amyloid protein, which is formed in the brain of Alzheimer's patients;
  2. Glutamate NMDA receptor blockers. This is “Akatinol Memantine”, which slows down the atrophy of gray matter;
  3. Antidepressants (fluoxetine "Prozac", sertraline, lorazepam);

It is necessary to slow down Alzheimer's disease: the treatment, the drugs are good, but the psychosocial management of patients is also very important. These include:

  • Supportive psychotherapy aimed at relieving depressive background;
  • Therapy experienced positive memories;
  • SIT-sensory - integrative therapy. Patients perform exercises that stimulate the visual, auditory, tactile zones of the cortex, that is, sensations;
  • Art therapy, animal therapy (patients are engaged in simple forms of art: modeling, drawing, communicate with animals).

Of course, complex therapy, medications that provide comfort to the patient, and then care, which soon becomes almost permanent, is very expensive. In developed countries, each case of this disease puts a serious burden on the state budget, because the patient is already aged, and soon loses the ability to work.

Therefore, the causes and treatment of Alzheimer's disease is information that can help relatives and friends to quickly detect the signs of this disease and draw the attention of doctors to it.

The sooner treatment is started, the longer the time to the disabling stage of the disease.

Interesting

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