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Written by Professor Marion McMurdo, honorary consultant in medicine for the elderly
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What is Alzheimer's disease?
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| Deteriorating memory can be the first sign of a treatable
disease. Don't accept the diagnosis of Alzheimer's disease before it
has been properly diagnosed by a physician. |
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Alzheimer's disease is the most common type of
dementia, affecting over half of all
dementia sufferers.
Alzheimer's disease is caused by a loss of brain cells,
probably related to an imbalance in the chemical messengers (neurotransmitters)
in the brain.
How are people affected?
Over time, their mental abilities deteriorate, gradually
progressing through forgetting important matters, getting confused about where
they are and what day it is, to becoming lethargic and withdrawn and starting
to neglect personal hygiene.
The sufferer may tend to dwell in the past and mistake friends
and neighbours for long-departed family members. Conversation may become
repetitive and the personality may alter as people develop odd or
uncharacteristic behaviours.
In the later stages of the illness, sufferers lose insight and
may not be aware of their plight, which makes the disease particularly hard for
carers to bear.
How does Alzheimer's disease progress?
Alzheimer's disease tends to progress, deteriorate and lead
to death within 7 to 10 years. However, the progress of the illness varies a
lot between individuals. For some, the illness may progress slowly over many
years, whereas for others it may progress rapidly.
Get a proper diagnosis
A number of other treatable medical conditions can mimic
Alzheimer's disease. These include
thyroid problems, infections, vitamin
deficiencies,
depression and anxiety. It is vital
that any elderly person who is concerned about whether they may be getting
Alzheimer's disease sees their family doctor and receives a full medical
assessment. This may involve seeing a hospital specialist.
Never assume that an old person who becomes forgetful will have
Alzheimer's disease. For the majority of old people, forgetfulness is
simply a nuisance, and most will not develop Alzheimer's
disease.
Other treatable medical conditions must be excluded before a
diagnosis of Alzheimer's disease is made.
What about treatment?
Treatment is aimed at supporting patients and carers by
providing information about the illness and highlighting potential sources of
assistance.
Depression, poor sleep, agitation and behavioural disturbance
can all be helped by medicines.
Support for the carer may also involve respite care to give them
a break from their often demanding routine. This may involve the patient going
to a day centre, or day hospital. Later, it may be helpful for the patient to
go into a nursing home for two weeks intermittently to allow the carer to
recharge their batteries. Joining a carer support group can also be very
helpful.
Considerable research work has been devoted to Alzheimer's
disease in recent years. Although a cure is still a long way off, treatments
like
donepezil (Aricept),
galantamine (Reminyl)
and
rivastigmine (Exelon)
are now available and have modest beneficial effects for some
patients. These medicines act on the chemical messengers (neurotransmitters) in
the brain, and should be prescribed and monitored by a specialist.
There is also modest evidence that the food supplement gingko
biloba can be helpful in improving mental function in Alzheimer's
disease.
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Last updated 16.02.2005
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