Alzheimer’s Disease

What is Alzheimer’s disease?

Alzheimer’s disease is an irreversible progressive brain condition commonly affecting the elderly. It is characterized by the continuous death of brain cells (neurons) and the development of abnormal brain deposits called plaques and tangles. The loss of connections between neurons results in memory loss, cognitive problems, and changes in behavior.

What are the symptoms of Alzheimer’s disease?

Alzheimer’s disease is the most common cause of dementia. The symptoms of the disease differ from person to person from mild memory loss to inability to carry out simple daily tasks.

• Forgetting recent events or conversations
• Repeating statements or questions
• Losing objects or placing them in unusual locations
• Disorientation, getting lost in familiar places
• Forgetting names of objects and people

• Difficulty concentrating and thinking
• Difficulty planning
• Inability to grasp abstract concepts such as numbers
• Inability to multitask
• Poor judgment and decision-making

• Experiencing anxiety, low mood or depression
• Becoming paranoid, aggressive or demanding
• Having hallucinations (hearing or seeing things that are not there)
• Having delusions (believing things that are not true)

Who are at risk for Alzheimer’s disease?

The exact cause of Alzheimer’s disease is not yet fully understood. It affects adults older than 60 years old. However, early-onset Alzheimer’s disease has also been detected in younger patients with genetic abnormalities. Currently, the disease is attributed to several factors such as:

• Aging
• Female gender – slightly higher incidence among women
• Family history of Alzheimer’s disease
• Genetic mutation – apolipoprotein E (ApoE) gene, Down’s syndrome
• Vascular ailments – heart disease, hypertension, stroke
• Metabolic diseases – obesity, diabetes, high cholesterol
• Traumatic brain injury
• Smoking
• Alcohol intake
• Environmental pollutants – secondhand smoke, toxic metals, pesticides, industrial chemicals
• Decrease in social and mentally-stimulating activities
• Poor sleep patterns – difficulty falling or staying asleep

How is Alzheimer’s disease diagnosed?

There is no single diagnostic examination for the condition. The disease is frequently misattributed to normal aging and the patient often goes undiagnosed until he or she shows significant impairment. While memory loss does not necessarily equate to dementia, it is best to consult a physician, especially if forgetfulness becomes more often and other symptoms affect daily living.

The diagnosis of Alzheimer’s disease entails interviewing the patient as well as family members or caregivers for memory, language, and behavioral changes. The following examinations may be performed:

• Memory or cognitive tests
• Neurological examination for senses, balance, and reflexes
• Blood and urine tests
• Computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET) scans – to detect loss of brain mass and to rule out other causes such as hemorrhage, tumor, hydrocephalus or stroke

How is Alzheimer’s disease managed?

As of the moment, there is no cure for Alzheimer’s disease. Patients are given medications and other supportive therapies to manage symptoms, delay the decline in cognition and behavior, and aid in daily living.

Medications for cognitive symptoms:

• Cholinesterase inhibitors – such as donepezil, rivastigmine, and galantamine which improve neural communication and slow disease progression
• N-Methyl-D-aspartate (NMDA) receptor antagonist – memantine, a drug that decreases abnormal brain activity
• Combination drugs – donepezil plus memantine

Medications for behavioral and emotional changes:

• Anti-anxiety drugs
• Anti-depressants
• Anti-psychotic agents

• Changes in the home – for safety and ease of movement, reminders for daily tasks
• Cognitive stimulation therapy – reading, writing, dancing, puzzles, card games, etc.
• Assisted daily living, caregivers
• Occupational therapy
• Hospice or palliative care for severe cases

• Vitamin E
• Omega-3

What is the prognosis of a patient with Alzheimer’s disease?

Alzheimer’s disease is pervasive and life-limiting - affecting the quality of life of patients and their caregivers alike.

Although there is no cure, patients can live for several years and be kept comfortable with appropriate medications and assistance.

Patients with early-stage disease will typically have short-term memory loss and mild cognitive difficulties (e.g., taking longer in performing daily tasks, difficulty handling money, getting lost, etc.). Those with moderate Alzheimer’s disease will exhibit greater memory loss, language problems, impaired judgment, and changes in consciousness (hallucinations and delusions).

In the late stages of the disease, patients will become bedridden and unable to communicate. Patients will lose essential brain functions such as those for swallowing, balance, movement, and bowel and bladder control. Thus, extra care of these patients should be taken to avoid:

• Dehydration and malnutrition
• Pneumonia
• Aspiration (inhaling food or liquids into the lungs)
• Urinary tract infection
• Bedsores and skin infections
• Falls and fractures

How can Alzheimer’s disease be prevented?

• Keep mentally and physically active
• Maintain a healthy weight
• Quit smoking
• Avoid alcoholic beverages
• Get adequate sleep
• Eat fruits, vegetables, and foods low in saturated fat
• Follow the doctor’s advice in managing diabetes, hypertension, etc.

For more information on Alzheimer’s disease, consult your physician.