Alzheimer's Disease

Symptoms of alzheimer disease are as follows:

1. Replicate comments, sentences, and questions over and again
2. Unable to remember conversations, appointments, or events
3. Misplace possessions on a routine basis, often keeping them in new and illogical places
4. Get lost in familiar places
5. Ultimately unable to remember the names of family members and day-to-day objects.
6. Difficulty concentrating and thinking
7. Inability to make reasonable decisions and judgments in everyday situations. 
8. People often forget how to perform basic tasks such as dressing and bathing.
9. Depression
10. Apathy
11. Social withdrawal
12. Mood swings
13. Distrust in others
14. Irritability and aggressiveness
15. Changes in sleeping habits
16. Wandering
17. Loss of inhibitions
18. Delusions

The exact causes responsible for causing Alzheimer's disease aren't known, but brain proteins fail to function in a normal manner leading to disruption of the work of neurons and initiating a chain of toxic reactions resulting in damage to neurons and eventually death of these cells. Doctors trying to determine the cause of this condition are engrossed in the role of two proteins:

1. Plaques

   Beta-amyloid is a segment of a bigger protein. When these parts adjoin together, they harm neurons, disrupting cell-to-cell communication. These parts form larger deposits called amyloid plaques, which also comprise other cellular debris.
   

2. Tangles

   In Alzheimer's disease, proteins alter the shape and accordingly organize themselves into various structures known as neurofibrillary tangles, which often disrupt the transport system and are toxic to cells.

An important aspect of diagnosing this condition includes being able to narrate entire symptoms and their impact on daily life. In addition, a diagnosis of Alzheimer's disease is based on tests that the doctor recommends to evaluate skills related to memory and thinking.

Laboratory and imaging tests can help rule out other potential causes or help the doctor better identify the disease-causing symptoms.

Physical and Neurological Exam

The doctor performs a physical examination and also carries out an entire neurological examination by testing the following:

• Reflexes
• Muscle tone and muscle strength
• Ability to stand from a chair and walk a few steps
• Sense of sight and hearing
• Coordination
• Balance

Lab Tests

Blood tests help rule out various other potential causes of memory loss and confusion.

Mental Status and Neuropsychological Testing

The doctor conducts a mental status test to assess memory and other thinking skills. Longer and more detailed forms of neuropsychological testing provide accessory details about patients' mental function with people of a similar age. These tests help establish a diagnosis and act as a reference point to trace the advancement or deterioration of symptoms with time.

Brain Imaging

Images of the brain are commonly used to highlight visible abnormalities related to conditions other than Alzheimer's, such as stroke, tumours, or trauma causing cognitive change. New imaging applications help doctors ascertain particular brain changes due to Alzheimer's. Imaging of brain structures comprises the following:

1. Magnetic Resonance Imaging (MRI)

   Magnetic resonance imaging (MRI) uses radio waves and a strong magnetic field to create brain images in detail. In addition to depicting shrinkage of brain areas associated with Alzheimer's, MRI scans also help rule out several other conditions.

2. Computerized Tomography (CT)

   A Computerized tomography (CT) scan gives cross-sectional images of the brain. It's generally performed to rule out conditions like tumours, strokes and head injuries.
   

Imaging can be done with Positron Emission Tomography (PET), during which a low-level radioactive tracer is administered into the blood to disclose a specific feature in the brain. It includes the following:

• Fluorodeoxyglucose (FDG): Scans show brain areas where nutrients are not properly metabolized. Identifying patterns of degeneration and areas of poor metabolism can help compare Alzheimer's disease to other forms of dementia.
  
• Amyloid PET Imaging: Amyloid PET imaging can calculate the number of amyloid deposits in the brain.
  
• Tau PET Imaging: Tau PET imaging which measures the number of neurofibrillary tangles in the brain, can also be used to find abnormal beta-amyloid and tau in the cerebrospinal fluid.

There's no specific alzheimer treatment, however, certain medications slow its progression, mainly in the early stages. Other medications help with mood changes and other behaviour issues.

1. Aducanumab-avwa (Aduhelm)

   This human monoclonal antibody focuses on the fundamental pathophysiology of the disease by decreasing amyloid-beta plaques in the area of the brain.

2. Donepezil (Aricept), Galantamine and Rivastigmine (Exelon)

   These medications improve the working of the brain during the early stages of the disease and delay the rate of worsening symptoms.

3. Memantine (Namenda)

   This drug helps brain cells avoid excessive brain chemical glutamate, which Alzheimer's-damaged cells make too much of. This drug protects against neural damage and has fewer side effects than other drugs.
   

4. Memantine-Donepezil (Namzaric)

   This medication is a combination of donepezil and memantine and is meant for patients with moderate to severe Alzheimer's.

5. Tacrine (Cognex)

   This was the first drug the FDA approved for treating Alzheimer's disease. It acts by slowing the breakdown of acetylcholine, which helps nerve cells in the brain send messages to each other.

1. Age
2. Family history
3. Down syndrome
4. Sex: Females more prone than males
5. Mild cognitive impairment
6. Head trauma
7. Air pollution
8. Excessive alcohol consumption
9. Poor sleep patterns
10. Lack of exercise and obesity
11. High blood pressure

As Alzheimer's disease progresses to its final stages, brain changes involve several physical functions like swallowing, balance, and bowel and bladder control. These effects can increase susceptibility to other health issues like:

1. Consuming food or liquid into the lungs (aspiration)
2. Flu, pneumonia and other infections
3. Falls
4. Fractures
5. Bedsores
6. Malnutrition or dehydration
7. Constipation or diarrhoea

Alzheimer's disease is not a preventable condition. But certain lifestyle-related risk factors for Alzheimer's can be modified accordingly. Research studies indicate that changes in diet and exercise lower the risk of developing Alzheimer's disease and other disorders responsible for causing dementia. These modifications are as follows:

1. Regular exercise
2. Consuming a healthy diet focusing on oils and foods low in saturated fat
3. Following treatment protocols to manage high blood pressure, diabetes, and high cholesterol

Alzheimer's disease usually worsens over some time and is ultimately lethal. On average, persons with Alzheimer's disease survive for four to eight years after the confirmation of diagnosis. Some patients survive as long as 20 years after diagnosis. The course of the disease varies from person to person.

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