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Introduction:
Alzheimer’s disease is a brain disorder named for German physician Alois
Alzheimer. It is a neurodegenerative disease that is generally found in people over
the age of 60. Approximately 24 million people worldwide suffering due to Alzheimer’s.
Alzheimer's disease does not discriminate between rich and poor, engineer and doctor, teacher and head of State. Says K. Jacob Roy, National Chairman, Alzheimer’s and Related Disorders Society of India (ARDSI): “The only known risk factor is age. As a person grows older, he is at greater risk of developing Alzheimer’s. After 60, the risk is one in 20, but after 80 it is one in five.” No one knows why it happens, but it occurs when cells in the brain start dying. It is degenerative and leads to progressive mental deterioration.
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Basics of
Alzheimer's disease
Dr. Alois Alzheimer, a German psychiatrist, identified
in 1901 the first case of what became known as Alzheimer's disease in a 50 year-old patient
Auguste D and followed her to her death in 1906. The term Alzheimer's disease was formally adopted in
medical nomenclature to describe individuals of all ages with the characteristic common
symptom pattern, disease course, and neuropathology.
Just like the rest of our bodies, our brains change as we age.
But when serious memory loss, confusion and other major changes in the way our minds work are not a normal part of aging. They may be a sign that
brain cells are failing. The brain has 100 billion nerve cells (neurons). Each nerve cell communicates with many others to form networks.
Nerve cell networks have special jobs. Some are involved in thinking,
learning and remembering. Others help us see, hear and smell. Still others tell our muscles when to move. In Alzheimer’s disease, parts of the cell’s factory stop running well.
Alzheimer's disease attacks nerve cells in several regions of the brain.
Cerebral Cortex: Involved in conscious thought and language.
Basal forebrain: Has large numbers of neurons containing
acetylcholine, a chemical important in memory and learning.
Hippocampus: Essential to memory storage.
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What is
Alzheimer's disease?
Alzheimer's disease is a
kind of mental disorder and is characterized by gross diffuse atrophy of the brain and loss of neurons, neuronal processes and
synapses in the cerebral cortex and certain subcortical regions. In
Alzheimer's disease usually short-term memory loss and visual-spatial
confusion are visible in the initial stage. As the disease progresses
patients will not be able to perform even simple tasks independently and will require constant supervision.
They will slowly lose the ability to walk and eat without assistance. Language becomes severely
disorganized and then lose the ability to swallow food and fluid and ultimately lead to death.
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Risk factors and causes of
Alzheimer's disease
In a report, Mathew Varghese MD, Professor of Psychiatry,
NIMHANS, says mental disorders in the elderly in India are a major public health issue for these major reasons: poor public awareness of these disorders; rapidly changing traditional family and social support systems; and few health services that are geared to cater to the special needs of the elders.
Some known risk factors are:
1. Advancing age 2. ApoE epsilon 4 genotype 3. Environmental exposure to aluminum
4. Head injury
5. Cardiovascular disease, diabetes, hypertension, high
cholesterol and strokes 6. Smoking
7. Environmental pollution.
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Sign and Symptoms
The first identified symptoms of Alzheimer's disease are usually short-term memory loss and visual-spatial confusion. These initial symptoms
progress from seemingly simple and often fluctuating forgetfulness and difficulty orienting oneself
such as in a traffic lane while driving and difficulty navigating through
familiar areas such as one's neighborhood, loss of other familiar and well-known skills as well as recognition of objects and persons
There are few warning signs as:
* Difficulty in doing familiar tasks: inability to perform simple, tasks such as unlocking a door or making tea.
* Slipping job performance: forgetting appointments or meetings.
* Language difficulties: difficulty with words and in naming objects such as pen or spectacles.
* Confusion of place and time: difficulty in remembering the time of day, or even recognising their neighbourhood.
* Lack of judgment: touching a hot object, being insensible to traffic while crossing the road
etc.
* Lack of initiative: becoming passive and needing constant prompting.
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Treatment Options
There is no cure for Alzheimer's
disease found at present. Currently available medications offer relatively small symptomatic benefit for some patients but do
not slow disease progression.
A large number of potential treatments for Alzheimer's disease are currently
under investigation, including four compounds being studied in phase 3 clinical
trials. Xaliproden had been shown to reduce neurodegeneration in animal
studies. Tramiprosate (3APS or Alzhemed) is a GAG-mimetic molecule that is
believed to act by binding to soluble amyloid beta to prevent the accu
mulation of the toxic plaques. Tarenflurbil (MPC-7869, formerly R-flubiprofen) is a gamma
secretase modulator sometimes called a selective amyloid beta 42 lowering agent.
Leuprolide has been studied for Alzheimer’s to work by reducing luteinizing hormone levels
which may be causing damage in the brain as one ages.
Alternative treatments for Alzheimer's include a range of herbal compounds and dietary supplements.
Prevention methods
There
is no cure for Alzheimer's disease but adopting some preventive methods
reduces the risk of Alzheimer’s disease:
1. Intellectual work as playing chess, doing crosswords etc.
2. Regular physical exercise lowers the risk.
3. A social interaction reduces the risk of Alzheimer’s disease. A
lonely individual is likely to develop the type of dementia linked to Alzheimer’s disease in
his or her late life.
4. A vegetarian diet rich of fruits and vegetables and low in saturated
fat, supplemented with B vitamins , folic acid, Omega-3 fatty acids,
fruit and vegetable juice.
5. High doses of the antioxidant Vitamin E (in combination with vitamin C)
reduces Alzheimer's risk.
6. Minimize consumption of alcohol.
7. Cholesterol-lowering drugs (statins) reduce Alzheimer's risk in observational studies.
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