Alzheimer's Disease
--A chronic, progressive, neurologic disorder characterized by degeneration of the neurons in the cerebral cortex and subcortical structures, resulting in irreversible impairment of intellect and memory.
Causes and Incidence
The cause is unknown, although theories involving genetic links, neurotransmitter deficiencies, viruses, aluminum poisoning, autoimmune disease, and viruses have been advanced. Alzheimer's disease is the fourth leading cause of death among the elderly in the United States. Approximately 3% of individuals over 65 years of age show signs of the disease; the proportion climbs to 20% in those over 80 years of age. The incidence is higher in women.
Disease Process
Selective neuronal cells, primarily those involved in the transmission and reception of acetylcholine, degenerate in the cerebral cortex and basal forebrain, resulting in cerebral atrophy of the frontal and temporal lobes, with wide sulci and dilated ventricles. Senile plaques and neurofibrillary tangles are present. The basic pathophysiologic processes accompanying the brain damage are unknown.
Symptoms
Early
Short-term memory loss, impaired insight/judgment, momentary disorientation, emotional lability, anxiety, depression, decline in ability to perform activities of daily living (ADLS)
Midcourse
Apraxia, ataxia, alexia, astereognosis, auditory agnosia, agraphia, prolonged disorientation, progressive memory loss (longand shortterm), aphasia, lack of comprehension, decline in care abilities, insomnia, loss of appetite, repetitive behavior, socially unacceptable behavior, hallucinations, delusions, paranoia
Late
Total dependence in ADLs, bowel and bladder incontinence, loss of speech, loss of individuation, myoclonic jerking, seizure activity, loss of consciousness
Potential Complications
The end stage of Alzheimer's disease invites complications commonly associated with comatose conditions (e.g., skin breakdown, joint contractures, fractures, emaciation, aspiration pneumonia, infections).
Diagnostic Tests
Definitive diagnosis can be made only through autopsy.
Clinical evaluation
Any of the above manifestations after depression, delirium, and other dementia disorders (e.g., head injury, brain tumor, alcoholism, drug toxicity, arteriosclerosis) have been ruled out; family history
Mental status examination
Decreased orientation, impaired memory, impaired insight/ judgment, loss of abstraction/ calculation abilities, altered mood
Computed tomography/magnetic resonance imaging
Brain atrophy; symmetric, bilateral, ventricular enlargement
Electroencephalogram
Slowed brain wave activity, reduced voltage
Treatments
Surgery
None
Drugs
Medications for treating specific symptoms or behavioral manifestations (i.e., antidepressants, stimulants, antipsychotics, sedatives); experimental drugs include cholinergic, dopamine, and serotonin precursors; neuropeptides; and transcerebral dilators
General
Structured, supportive, familiar environment; orientation and cueing program for daily tasks; safety program; family support and counseling; respite care; institutionalization when home care is no longer possible.
Causes and Incidence
The cause is unknown, although theories involving genetic links, neurotransmitter deficiencies, viruses, aluminum poisoning, autoimmune disease, and viruses have been advanced. Alzheimer's disease is the fourth leading cause of death among the elderly in the United States. Approximately 3% of individuals over 65 years of age show signs of the disease; the proportion climbs to 20% in those over 80 years of age. The incidence is higher in women.
Disease Process
Selective neuronal cells, primarily those involved in the transmission and reception of acetylcholine, degenerate in the cerebral cortex and basal forebrain, resulting in cerebral atrophy of the frontal and temporal lobes, with wide sulci and dilated ventricles. Senile plaques and neurofibrillary tangles are present. The basic pathophysiologic processes accompanying the brain damage are unknown.
Symptoms
Early
Short-term memory loss, impaired insight/judgment, momentary disorientation, emotional lability, anxiety, depression, decline in ability to perform activities of daily living (ADLS)
Midcourse
Apraxia, ataxia, alexia, astereognosis, auditory agnosia, agraphia, prolonged disorientation, progressive memory loss (longand shortterm), aphasia, lack of comprehension, decline in care abilities, insomnia, loss of appetite, repetitive behavior, socially unacceptable behavior, hallucinations, delusions, paranoia
Late
Total dependence in ADLs, bowel and bladder incontinence, loss of speech, loss of individuation, myoclonic jerking, seizure activity, loss of consciousness
Potential Complications
The end stage of Alzheimer's disease invites complications commonly associated with comatose conditions (e.g., skin breakdown, joint contractures, fractures, emaciation, aspiration pneumonia, infections).
Diagnostic Tests
Definitive diagnosis can be made only through autopsy.
Clinical evaluation
Any of the above manifestations after depression, delirium, and other dementia disorders (e.g., head injury, brain tumor, alcoholism, drug toxicity, arteriosclerosis) have been ruled out; family history
Mental status examination
Decreased orientation, impaired memory, impaired insight/ judgment, loss of abstraction/ calculation abilities, altered mood
Computed tomography/magnetic resonance imaging
Brain atrophy; symmetric, bilateral, ventricular enlargement
Electroencephalogram
Slowed brain wave activity, reduced voltage
Treatments
Surgery
None
Drugs
Medications for treating specific symptoms or behavioral manifestations (i.e., antidepressants, stimulants, antipsychotics, sedatives); experimental drugs include cholinergic, dopamine, and serotonin precursors; neuropeptides; and transcerebral dilators
General
Structured, supportive, familiar environment; orientation and cueing program for daily tasks; safety program; family support and counseling; respite care; institutionalization when home care is no longer possible.
2 comments:
It is a very painful disease and the gradual deterioration of the patient is hard to see and go through it as much for the family members.There are not too many remedies either.
Alzheimer disease symptoms can be prevented with some anti depressants. Alzheimer disease is the most common form of dementia. Patients with Alzheimer disease should use coconut oil.
Post a Comment