Alzheimers Disease

Introduction
Alzheimers disease is a type of dementia that gradually destroys brain cells, affecting a persons
memory and their ability to learn, make judgments, communicate and carry out basic daily
activities. Alzheimers disease is characterized by a gradual decline that generally progresses
through three stages: early, middle and late stage disease. These three stages are distinguished by
their general features, which tend to progress gradually throughout the course of the disease.
Alzheimers disease is not inevitable in people with Down syndrome. While all people with
Down syndrome are at risk, many adults with Down syndrome will not manifest the changes of
Alzheimers disease in their lifetime. Although risk increases with each decade of life, at no point
does it come close to reaching 100%. This is why it is especially important to be careful and
thoughtful about assigning this diagnosis before looking at all other possible causes for why
changes are taking place with aging. Estimates show that Alzheimers disease affects about 30%
of people with Down syndrome in their 50s. By their 60s, this number comes closer to 50%.
BODY

Causes
In Alzheimers disease, brain cells start to deteriorate. The body attempts to stop this process by
producing a protein called amyloid. However, amyloid deposits build up in the brain, leading to
further deterioration. These deposits of amyloid are referred to as "plaques" and cause the brain cells
to shrivel up and form "tangles", which in turn lead to changes in the brain structure and cause the
brain cells to die. The formation of plaques and tangles also prevents the production of some important
brain chemicals, called neurotransmitters. Over time the loss of brain cells causes the brain to shrink.
There is no known cause for Alzheimer's disease but some researchers now believe that a combination
of environmental and genetic risk factors triggers an abnormal biological process in the brain that,
over decades, results in Alzheimer-type dementia. Identified risk factors for developing the condition
include:

Increasing age

Down's syndrome

History of a head injury

Risk factors for blood vessel disease such as smoking

Family history of Alzheimer's disease

Obesity

High blood pressure

High cholesterol

Insulin resistance.

There is some evidence of a slightly higher prevalence of Alzheimer's disease in females than males,
but this may be a reflection of their longer life expectancy.
Research studies have indicated that that the following factors may play an important role in the
development of the condition:
Genetic factors, such as the presence of, or changes to, certain genes.
Environmental factors, such as long term exposure to some environmental solvents eg: pesticides,
glues and paints.
The role of autoimmune factors and certain viruses are also being studied.

Signs and symptoms

The degenerative changes that occur with Alzheimer's disease affect the areas of the brain that control
thought, memory and language resulting in gradual signs and symptoms related to a persons
behaviour and mental function. Often, physical functions such as bowel and bladder control are also
affected.
With Alzheimers disease there is great individual variability as to the nature of symptoms experienced
and the speed at which deterioration occurs. The types of behaviour change and the length of time
symptoms are present are different for each person. The symptoms of Alzheimer's disease typically
develop quite slowly. The time between the onset of the disease and death can range from five to 20
years.

Ang tatlo ka diagram ka symptoms

Remedy for Alzheimers disease

New Alzheimers disease research from China indicates that melatonin
supplements can prevent the development and slow the onset of dementia.
Melatonin protects neurons from protein toxicity and prevents protein
formations such as fibrils in the brain. Melatonin is a hormone found in
plants, animals and microbes. It decreases with age within patients with
Alzheimers.
Alzheimers researchers in the U.K. claim that sensitivity to gluten, a protein found in
wheat, barley and rye, can trigger a number of neurological conditions, including

dementia. (As you have noticed, protein is a common theme in this battle for the brain.)
Writing in the Journal of Neurology, Neurosurgery, and Psychiatry, Dr. Marios
Hadjivassilou stated, Gluten sensitivity can be primarily, and at times exclusively,
a neurological disease.

Diagnosis
There is a no single test to diagnose Alzheimers disease. Diagnosis involves a full assessment of
medical and psychiatric history to rule out other possible causes. Therefore a variety of tests are
required to obtain a conclusive diagnosis, which may include:

A neurological and physical examination

Blood and urine tests

Brain scans

Mental status assessment to determine the level of mental deterioration

Caregiver interview to determine the level of dependency

Scans to check brain structure and function may be recommended. The different types of scans used
may include CT scanning (computerised tomography) and MRI (magnetic resonance imaging).
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Treatment
As there is no known cure for Alzheimers disease, treatment focuses on managing symptoms and
supporting the person and their family. This may include:

Treating medical conditions that may contribute to confusion or physical decline eg: lung
disease or anaemia.

Encouraging stimulating activities in order to encourage the person to continue their normal
activities as much as possible.

Providing memory aids and memory triggers such as calendars and written reminders.

Encouraging social interaction to help prevent feelings of loneliness and depression.

Contacting support groups that may be able to offer family/caregivers assistance.

Encouraging regular routine to reduce confusion.

Not smoking.

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Medications
Medications such as sleeping tablets and tranquillisers may help to control symptoms such as
sleeplessness and agitation. However they often cause increased confusion, so their use should be
limited.
A group of medications called cholinesterase inhibitors have shown some effectiveness in slowing the
progression of the condition in some people. These medications help prevent the breakdown of
acetylcholine, a neurotransmitter responsible for memory. Cholinesterase inhibitor medications that
are available in New Zealand include donepezil (Donepezil-Rex), rivastigmine (Exelon) and
galantamine (Reminyl).
More recently, another drug - memantine (Ebixa) - has become available in New Zealand. Memantine
works in a different way to the cholinesterase inhibitors, aiming to prevents the entry of an excess
amount of calcium into brain cells. Higher than normal levels of calcium in the brain cells causes
damange to them and also prevents them from receiving signals from other brain cells.
Currently, donepezil is the only drug that is government-subsidised for the treatment of Alzheimer's
disease.
Research continues into the development of other medications for the treatment of Alzheimer's
disease. Medications being investigated include those that prevent the build up of amyloid deposits in
the brain, as well as looking at the use of some anti-inflammatory and hormone medications. Research
also continues into the use of alternative therapies such as anti-oxidants like Vitamin E, selenium and
some herbal extracts (ginko baloba in particular).

Prevention / risk reduction

There are no proven ways to prevent the development of Alzheimer's disease. However, there is
epidemiological evidence to suggest that leading a healthy lifestyle can reduce the risk of Alzheimer's
disease. Regular physical activity and exercise may have a general protective effect on brain health
and may slow progression of Alzheimer's disease. Although there are no specific dietary
specifications for Alzheimer's, a Mediterranean-style diet (ie, plant foods such as vegetables, fruits,
beans, whole grains, nuts, olives and olive oil, along with some cheeses, yoghurt, fish, poultry and
eggs) may reduce the risk of Alzheimer's disease, and has the added benefit of lowering cardiovascular
disease and diabetes risk. For more diet information, refer to the Healthy Heart Diet.