Alzimers: a disease that kills mind


'Suffering is always hard to quantify especially when the pain is caused by as cruel a disease as Alzheimer’s. Most illnesses attack the body; Alzheimer’s destroys the mind and in the process, annihilates the very self.'




 Anagha Telang





Alzheimer's, or Alzheimer's disease (AD) is a chronic neuro-degenerative disease that usually starts slowly and worsens over time.  It is the cause of 60–70% of cases of dementia. In 2015, there were approximately 29.8 million people worldwide with AD. It most often begins in people over 65 years of age, although 4% to 5% of cases are early-onset Alzheimer's which begin before this. It affects about 6% of people 65 years and older. In 2015, dementia resulted in about 1.9 million deaths.  It was first described by, and later named after, German psychiatrist and pathologist Alois Alzheimer in 1906. In developed countries, AD is one of the most financially costly diseases.


Signs & Symptoms:

The disease is divided into four main stages:

  • Pre-dementia- The first symptoms are often mistakenly attributed to ageing or stress. These early symptoms can affect the most complex activities of daily living. The most noticeable deficit is short term memory loss, which shows up as difficulty in remembering recently learned facts and inability to acquire new information.

  • Early- In people with AD, the increasing impairment of learning and memory eventually leads to a definitive diagnosis. In a small percentage, difficulties with language, executive functions, perception (agnosia), or execution of movements (apraxia) are more prominent than memory problems. AD does not affect all memory capacities equally. Older memories of the person's life (episodic memory), facts learned (semantic memory), and implicit memory (the memory of the body on how to do things, such as using a fork to eat or how to drink from a glass) are affected to a lesser degree than new facts or memories. Language problems are mainly characterised by a shrinking vocabulary and decreased word fluency, leading to a general impoverishment of oral and written language. 

  • Moderate- Progressive deterioration eventually hinders independence, with subjects being unable to perform most common activities of daily living. Speech difficulties become evident due to an inability to recall vocabulary, which leads to frequent incorrect word substitutions (paraphasias). Reading and writing skills are also progressively lost. Complex motor sequences become less coordinated as time passes and AD progresses, so the risk of falling increases. During this phase, memory problems worsen, and the person may fail to recognise close relatives. Long-term memory, which was previously intact, becomes impaired. Behavioral and neuropsychiatric changes become more prevalent. Common manifestations are wandering, irritability and labile affect, leading to crying, outbursts of unpremeditated aggression, or resistance to care giving.

  • Advanced- During the final stages, the patient is completely dependent upon caregivers. Language is reduced to simple phrases or even single words, eventually leading to complete loss of speech. People with Alzheimer's disease will ultimately not be able to perform even the simplest tasks independently; muscle mass and mobility deteriorates to the point where they are bedridden and unable to feed themselves. The cause of death is usually an external factor, such as infection of pressure ulcers or pneumonia, not the disease itself.



Causes of the disease

The cause for most Alzheimer's cases is still mostly unknown except for 1% to 5% of cases where genetic differences have been identified. Several competing hypotheses exist trying to explain the cause of the disease.

  • Genetic
  • Cholinergic hypothesis
  • Amyloid hypothesis
  • Tau hypothesis



Prevention

  • Medication
  • People who engage in intellectual activities such as reading, playing board games, completing crossword puzzles, playing musical instruments or regular social interaction show a reduced risk for Alzheimer's disease
  • People who maintain a healthy, Japanese, or Mediterranean diet have a reduced risk of AD



Cure

There is no cure for Alzheimer's disease; available treatments offer relatively small symptomatic benefit but remain palliative in nature. But following steps may help in proper mangement and controlling AD. 

  • Medications
  • Psycho-social intervention
  • Care giving



World Alzheimer's Day

September 21st every year is World Alzheimer’s Day around the world. This is an international campaign aimed at raising awareness and challenges the common stigma that surrounds Alzheimer related dementia.

Alzheimer’s is a progressive disease that impairs memory and other mental functions. It is the most common form of dementia that generalizes memory loss and loss of other essential cognitive abilities that are serious enough to interfere with an individual’s daily life.

September 21st 2018 marks the 7th world Alzheimer’s month since the campaign was launched in 2012. From previous studies, an average of 2 out of 3 people globally has little or no understanding of Alzheimer’s disease and associated dementia in their countries.

Since its inception, the impact of World Alzheimer’s Month is increasing. However, the stigmatisation and lack of information surrounding dementia remains to be a global problem that calls for global action. Most people often think that this disease is a normal part of ageing.

Though this may not be true, a greatest risk factor for Alzheimer’s disease is increasing age. This is evident by majority of Alzheimer’s patients being 65 years or older. This doesn’t completely classify the disease as an elderly disease. This is because there are approximately 200,000 Americans under 65 suffering from disease.

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