Alzheimer's disease is the most common form of dementia, but it is important to note that not all dementia is Alzheimer's disease. Alzheimer's disease is usually diagnosed in people who are 65 years or older. There are some cases, although they are much more rare, of early onset Alzheimer's.
Alzheimer's disease has four stages. There is pre-Alzheimer's with symptoms that include difficulty remember recently learned facts, difficulty planning, abstract thinking and completing the most complex activities of daily living. Early dementia is the second stage of Alzheimer's disease. Early dementia symptoms include increased memory loss and a shrinking vocabulary. The third stage of Alzheimer's is moderate dementia. In this third stage, people suffering from Alzheimer's begin to show signs of significant long-term memory loss, wondering behaviors, irritability and aggression. It is usually in the third stage that most families decide their loved should move to a long-term care facility that specializes in Alzheimer's patients. The fourth and final stage is advanced dementia. In the fourth stage the body begins to fail and ultimately the failure of the body leads to death.
There is no cure for Alzheimer's at this time, but there are some promising medications and therapies that seem to slow the progression of Alzheimer's disease in some patients. Typically people suffering from Alzheimer's disease end up in a specialized facility with highly trained employees who understand how to work with Alzheimer's patients.
The most well-known and recognized symptom of Alzheimer's is memory loss. Memory loss is slight at first and usually attributed to aging, but as the disease progresses the memory loss becomes extreme, effecting long-term memory. Moderate dementia is where symptoms that include wondering and sundowning begin. Sundowning occurs in about 45% of people suffering with Alzheimer's. Characteristics of sundowning include demanding behavior, mood swings, disorientation and hallucinations that typically begin in the late afternoon or evening. Symptoms of advanced dementia include loss of speech, inability to participate in activities of daily living without assistance. These activities include toileting, bathing and eating.
The true cause of Alzheimer's disease is still up for debate. Currently there are three hypotheses. The oldest hypothesis proposes that the cause of Alzheimer's is the disruption of the neurotransmitters affecting the peripheral and central nervous systems. This hypothesis is the cholinergic hypothesis.
Amyloid hypothesis centers on the build up of amyloid beta deposits. The build up these deposits seems to disrupt the function of the brain causing the Alzheimer's disease.
The last of the three hypotheses is the tau hypothesis. The postulate proposes that abnormalities in tau proteins begin the progression of the disease. The abnormalities cause the dysfunction of neuron transport systems.
Observation of the patient, patient history, family history and an absence of other medical conditions is often how diagnosis of Alzheimer's disease comes about. Patients with possible Alzheimer's disease have CT and PET scans and MRI's to rule out other conditions. Further more cognitive testing that will look at memory issues and other abilities.
At this time there is no cure for Alzheimer's disease. People suffering from the disease must settle for management of the disease. Treatment to manage Alzheimer's disease is both behavioral and pharmacological. Medications work to slow the progression of the disease and to help alleviate some of the symptoms, such as memory loss, that people with the disease suffer from.
Medications that show the most promise work by slowing the destruction of acetylcholine (ACh) in the brain. The inactivity of cholinergic neurons causes the destruction of ACh. These Cholinesterase inhibitor medications reduce the rapid loss of ACh, helping to slow the progress of Alzheimer's disease. Behavioral intervetion, cognitive therapies and psychosocial interventions are done in conjunction with medication. These therapies can help with some problem behaviors like incontience, but usually do not improve overall functioning of the person suffering from Alzheimer's disease.
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