Cognitive disorders
- are the mental disorders categorised by impaired coordinative abilities and daily functioning.
- Anything memory.
- Brain is either damaged or injured.
- Neuro degeneration due to age.
Two types of cognitive disorder.
- Dementia.
- Amnestic disorder.
What is Alzheimer’s Disease
Alzheimer’s disease is a gradually progressive form of dementia occurring in middle age or later categorised by loss of short term memory.
Detoriation in behaviour and slowness of thought. It is most common type of dementia.
Around 50 to 70% cases of dementia are diagnosed as Alzheimer’s disease. It is believe that Alzheimer disease results from an increase in the production or accumulation of a specific protein called the beta amyloid protein in the brain that leads to nerve cell death.
Generally it is diagnosed in people over 65 years of age although the less prevalent early on set of Alzheimer can occur much earlier.
Alzheimer Disease is the most common cause of dementia among people age 60 and older. For every five year age group beyond 45 the percentage of people with Alzheimer’s disease doubles.
50 to 70% dementia are Alzheimer’s disease patients.
What are the Causes of Alzheimer’s Disease ?
- Genetic Factors
- Environmental Factors
- Lifestyle Factors
- Cholinergic effect have also been proposed.
- Occur by building proteins in the brain. The build up manifest in two ways.
- Plaque : deposits of proteins beta amyloid accumulate in the spaces between nerve cells.
- Tangles.
Major Risk Factors
- History of stroke.
- History Of neuro psychiatry.
- Chain smoking
- Alcohol.
- Diabetes.
- Ldl.
- Oxidative stress.
- Hypertension.
Anatomical Changes
Neuropathology
Plague are dance mostly insoluble deposits of amyloid beta peptide and cellular material outside and around neurones.
Tangles (neurofibrillary angles) are aggregates of the micro tubule associated protein and accumulate inside the cell themselves.
Although many older individual developed some played and tangles as consequences of aging.
Stages of Alzheimer diseases.
Early stage or Mild Stage.
- This is considered as a mild or early stage and the duration period is 2 to 4 years.
- Frequent recent memory loss.
- Asking Questing Repeatedly, unable to express thing, cannot express with language.
- Using daily objects become difficult, which causes irritation and depression.
2. The Moderates Stage.
- This is considered as a middle moderate stage and the duration is 2 to 10 years.
- Ramping speech.
- Unusual reasoning confusion about certain events time and place.
- Nearly 80% of the patients exhibit emotional and behaviour problems.
- Slowness rigidity tremors.
- Need reminders and assistance with activities of daily life.
- Increased memory loss and confusion.
- Inability to learn new things.
- Problem coping with new situation.
- Delusions.
- In moderate ad damage occurs in the area of brain that controls language.
- Sensory processing and contrast thought.
3. Severe State
- Duration is 1 – 3 years.
- Confused about past and present.
- Loss of recognition of familiar people places and verbal loss.
- Problem Swallowing and illness.
- Extreme problem with mood behaviour problems hallucinations.
- Patient need total support and care.
Alzheimer’s Facts
Although a lot of people already have an understanding about Alzheimer’s Disease, its helpful to know all the hidden facts about it. Listed below are some details about the condition :
- Alzheimer’s disease is a chronic i.e a long lasting or ongoing condition. It is not a typical sign of aging.
- Alzheimer’s disease and dementia are both different things or conditions, where Alzheimer’s disease is a type of Dementia.
- Any Person can be a victim of Alzheimer’s disease, But there is certainty of some people being at high risk. This includes over the age of 62 – 65 and also those who have family history of Alzheimer’s disease.
- the symptoms of Alzheimer’s disease come in gradually, and there is a degenerative effect on the brain cells, causing slow decline.
- There is no cure or treatment for Alzheimer’s disease yet, but some treatment may help in slowing the process of the disease which may eventually help in quality of life.
- There is no certain outcome for people living with Alzheimer’s disease . Some may be living a long life at a severe stage and others may be taken back at an early age.
- Each Persons journey in Alzheimer’s disease is totally different.
Clinical Symptoms
1- Cognitive
- Memory Loss (poor recall and losing items)
- Aphasia (anomia)
- Apraxia
- Disorientation (impaired perception of time and unable to recognise familiar people and incidents).
- Impaired executive function.
2- Noncognitive
- Depression , psychotic symptoms (hallucination and delusions).
- Behavioral disturbances (physical and verbal aggression, motor- hyperactivity, uncooperative, wandering, repetitive mannerisms and activities, and combativeness.
3- Functional
- Cannot perform Self care activities (dressing, bathing, toileting and eating).
Diagnosing Alzheimer’s Disease
Physicians today can use a number of tools to diagnose Alzheimer disease.
- Information of Patient history from friends and family.
- Physical and neurological exams and lap test.
- Neuro physiological test.
- Imaging tools such as CT scan or magnetic resonance imaging MRI.
- Biopsy or Autopsy of brain can confirm diagnosis.
Management of Alzheimer Disease
- No specific treatment is known or discovered for Alzheimer disease yet .
- The primary goal of treatment in Alzheimer disease is to symptomatically trade cognitive difficulties and preserve patient functioning as long as possible.
- Secondary goal includes treating the psychiatric and behavioural condition that occur as a result of the disease.
Pharmacological Treatment
- For cognitive symptoms.
- Cholinesterase inhibitors : this drug postpones the worsening of symptoms 6 to 12 years. Some examples are Rivastigmine daily 1.5mg BD , 3-6- mg twice, Galantamine daily 4m BD, 8-12mg twice.
- Cholinergic drugs : Eg Acetyl Choline
- Anti- glutamatergic Therapy : Memantine
2. Non Cognitive Symptoms
- Anti Depressant Drugs : Paroxetine, Sertraline : Fluoxetine 10-40mg/day
- Anti-Psychotic drugs , olanzapine, Risperidone : Haloperidol 1-3mg/day
- Anti- convulsant Agent , Valproic acid , such as carbamazepine 200-600mg/day.
Non pharmacological therapy.
- Sleep disturbance is wandering urinating, incontinence agitation and aggregation should be managed with behavioural intervention whenever possible.
- On initial diagnosis the patient and caregiver must be educated on the course of illness, available treatment, legal decision changes in the lifestyle that will be necessary with disease progression, and other quality of life issues.
Other Alzheimer’s Disease Treatment
In addition with the medications and therapies, a change in the lifestyle can also help you manage your condition. Try some other strategies or methods to add quality of life to yourself or your loved ones.
- You may Simplify your Tasks.
- Get enough of rest every day
- Create a claiming environment
- Limit confusion
- Use relaxation techniques such as listening to slow and relaxing music or meditation and doing yoga.
How to Prevent Alzheimer’s Disease
As there is no cure for Alzheimer’s disease there are no preventive measures but still you may have a few changes in your life to lead a healthy life and add quality to it.
- Try quit smoking : If you are a smoker, try quitting it, if not quitting try to smoke the minimum as it will benefit your health and your life.
- Exercise Regularly : A little bit of exercise everyday can have a very good effect on your body and your mind, exercises daily will help all your body parts be in motion and be active.
- Keep Your Brain Busy : An empty brain can lead to many different conditions and you don’t want any more to happen, try keeping yourself busy with small tasks.
- Eat Well and Healthy : Eating healthy and a balanced diet is the least you can do to keep your body and brain healthy.
- Stay away from loneliness : meet friends, go for outings, focus on your hobbies and try not to be alone for most of the time.
