Alzheimer's

Alzheimer's
International Classification (ICD) G30.9

Basics

Everyone has probably heard of Alzheimer's. But what the disease really means for sufferers and their relatives is unclear to many. Because it is by far more than just forgetting some things. On the contrary, it is a serious disease that does not lead directly to death, but severely restricts the quality of life. And not only for the person affected, but also for the relatives.

Alzheimer's disease, also known as Alzheimer's disease, is a progressive disease in which nerve tissue is increasingly destroyed. Depending on which areas of the brain are destroyed, more or less different brain functions are lost.

How many suffer from Alzheimer's disease

Not everyone who can't remember everything or seems confused is suffering from Alzheimer's disease. However, in the field of dementia diseases, Alzheimer's disease is the most important disease in terms of quantity. Thus, 60 to 80% of all demented persons suffer from Alzheimer's disease. Among 85-year-olds, almost one in three is affected by Alzheimer's disease.

Since women are statistically older than men, they also suffer from Alzheimer's more often. It is generally estimated that the number of Alzheimer's patients will double again by the year 2050 because we are getting older and older.

Causes

In Alzheimer's disease, proteins are deposited in the brain, disrupting the communication between the individual nerve cells. As soon as a nerve cell is no longer used regularly, it shrinks and dies over time.

This destruction of brain matter usually occurs between the sixth and eighth decades of life and then progresses very rapidly. Within four to five years, severe dementia develops, requiring round-the-clock care.

In addition, the messenger substance for the brain, acetylcholine, can no longer be produced in sufficient quantities. This further restricts the communication between the individual brain cells and the cognitive deficits become even more severe.

Familial form in younger sufferers

A particularly severe and aggressive form of the disease is familial Alzheimer's disease. The worst thing about this form is that the disease can break out between the ages of 30 and 60.

In addition, there is a strong psychological burden, because one had to see with parents or grandparents already, how difficult it is to master the life with Alzheimer. Above all, because there are still no satisfactory approaches to treating the disease, those affected often find themselves in a hopeless situation.

Symptoms

The symptoms of Alzheimer's disease can manifest themselves in very different ways. Initially, the most noticeable symptoms are a reduced ability to remember and other memory problems, which are, however, compensated for and concealed for a long time. Only when the disease progresses do the symptoms become so clear that they can no longer be hidden.

For example, during an examination, the orientation in time and place may initially still be in perfect order and the ability to remember may not be noticeably impaired. Nevertheless, other symptoms already point to Alzheimer's disease. The whole thing is also complicated by the fact that there are always better and worse days. Thus, the affected person can still be completely lucid one day, while he is completely confused the next.

Physical limitations due to Alzheimer's disease

  • Headaches
  • Dizziness
  • General decrease in performance

Cognitive impairment due to Alzheimer's

  • Forgetfulness
  • Overview of familiar situations and tasks is lost
  • Arithmetic weakness
  • Reading and writing difficulties
  • Problems with word finding
  • Everyday tasks can no longer be completed
  • Occupational disability
  • Outer personality remains as a facade for a long time

Neuropsychological disorders

  • Problems in speech comprehension
  • Difficulties in the formulation of speech
  • Disturbance of spatial orientation
  • Partially slowed or pathological reflexes
  • Rapid fatigue and frustration
  • Lack of drive
  • Psychomotor restlessness
  • Sleep disturbances or nocturnal restlessness
  • Depression
  • Social withdrawal
  • Aggressiveness

Diagnosis

In the diagnosis, the clinical picture and the probability play a major role. If the symptoms appear and a certain age has been reached, one can most probably assume Alzheimer's disease. Nevertheless, all other causes of the symptoms must first be ruled out before Alzheimer's disease can be assumed. In addition, there are some findings that directly point to the disease.

Changes in imaging techniques

In computer tomography (CT), a reduction in the volume of the cerebral cortex is seen in the advanced stages. Positron emission tomography (PET) shows an altered breakdown of sugar, especially in the frontal and temporal lobes. This is a very important clue to rule out other diseases.

A more detailed examination of the brain and its structures is carried out by magnetic resonance imaging (MRI). This allows a better classification of the individual structures and their changes.

Further diagnostics

In addition, some cerebrospinal fluid can be taken through a puncture on the back and analysed. Special tests show the tau protein, the amyloid precursor protein and other associated proteins.

Clinical examination

Specially designed tests such as the Mini Mental State Examination, the CERAD battery and ADAS-cog are used for clinical examination. In addition, attention is paid to an insidious onset and slow progression at first. In particular, the impairment of cognitive performance, such as language, perception, spatial orientation or the planning of simple courses of action must be closely observed and tested.

Therapy

Even after several years of research, no suitable therapy for Alzheimer's disease has yet been found. There are some drugs, but these are mainly aimed at weakening and alleviating the symptoms, the long-term development of the disease remains unaffected. However, if the therapy is started early enough, the progression can at least be delayed somewhat.

Therapy with drugs

The most promising drug in the treatment of Alzheimer's is probably the acetylcholinesterase inhibitor. This ensures that the still living nerve cells have more signalling substances, as these are not broken down as quickly by the drug. However, despite the great effectiveness of these drugs, it must be said that they can only be used in the early or moderate phase of the disease.

If moderate or severe dementia has already occurred, then the so-called NMDA antagonists, also called memantine, are given to prevent overstimulation of the nerves. Because this would also lead to their death. This can mainly protect the abilities that are necessary for everyday life and improve cognitive performance.

Additional therapeutic measures

In addition to trying to delay the progression of the disease with medication, physiotherapy and hands-on movements can also be helpful in enabling independent living for longer. For example, one should try to use handicraft and artistic skills and promote them, for example, with occupational therapy.

Memory training can also be provided in memory clinics. It is important to consult a professional, because the treatment of Alzheimer's always takes place on a fine line between encouragement and overtaxing.

Help for caregivers

When caring for a person affected by Alzheimer's, it is more than exhausting and energy draining. That's why you should definitely seek help as well. It is also imperative to have a regular day off so that you can recover yourself. Even if you love the person affected, you have to consider your own needs.

Forecast

Since no real therapy is available, the prognosis is also not good. On average, patients live another nine to twelve years from diagnosis. In some exceptional cases, however, patients can survive for up to twenty years.

In general, it can be said that an early onset of the disease also indicates a drastic and rapid course.

Prevent

Since the exact causes of Alzheimer's disease are not yet known, it is not yet possible to give good prophylactic advice against the disease. But the desire for good prophylaxis is becoming more and more pronounced. And there are one or two tips that can at least sometimes be helpful in preventing Alzheimer's disease.

Hormone treatment as protection

Early on, it was found that estrogens provide some protection for the brain and nerves. When women start to menopause, the decrease in these hormones also removes this protection, which is why neurodegenerative diseases are most common after menopause.

It seems that hormone replacement therapies with estrogens may help protect against neurological disease. However, it must be noted that hormone replacement therapy also have many side effects such as thrombosis, strokes and the like.

Many studies without proven effect

In a whole series of studies on the prevention of Alzheimer's disease, it had to be concluded that neither painkillers such as acetylsalicylic acid, nor anti-inflammatory drugs, vitamins or antioxidants can really protect against Alzheimer's disease.

Mental fitness and healthy living offer some protection

However, it has also been shown that keeping yourself mentally fit with anything all the time has some protective effect. So if you are always interested in new things up to a ripe old age and also keep yourself thoroughly occupied with them, you can prevent the development of Alzheimer's or at least slow down its progress.

A healthy lifestyle with a balanced diet without excessive fat and effective treatment of common diseases such as high blood pressure, cardiac arrhythmias and diabetes mellitus can also reduce the risk of Alzheimer's.

Be happy and socially active

There is also strong evidence that happiness and good social standing can protect against Alzheimer's. Thus, one should avoid a lonely and secluded life, but should be socially active even in old age, meet people and keep in touch with others a lot.

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