Causes, signs and symptoms of Alzheimer's disease, stages and prevention
Alzheimer's is an incurable neurodegenerative disease that affects the brain. The destruction of the nerve cells responsible for the transmission of impulses between the brain structures causes irreversible memory impairment. A person with Alzheimer's disease is deprived of basic skills and loses the ability to self-care.
It is Alzheimer's disease that is recognized as the most common form of dementia (dementia) that develops in old age. Statistics say that Alzheimer's disease accounts for about 35-45% of cases of senile dementia. Pathology is gradually acquiring the character of an epidemic in developed countries.
- Signs and symptoms
- The reasons
- How to cure Alzheimer's disease?
Alzheimer's signs and symptoms
Severe symptoms of Alzheimer's disease develop gradually.
In most cases, memory impairment becomes the first sign of dementia, but it is far from the only one:
- Memory impairment: the patient does not assimilate new information, repeats during a conversation, is forced to use diaries, organizers and notepads to remember;
- Inability to cope with everyday affairs: a person loses the skills of interacting with household appliances, is not able to perform elementary arithmetic operations (addition, subtraction);
- Difficulties with spatial and temporal orientation: the patient does not recognize his location, is unable to name the current season, day of the week, month, time of day;
- Visual impairment: the patient is unable to calculate the distance from himself to the object, is constantly exposed to the threat of injury when hit or falling, sees a "stranger", looking in the mirror;
Lack of memory of the actions performed: the patient constantly loses things, does not remember where the necessary items are. Related to this are the accusations of theft and deception that Alzheimer's patients often make against their environment;
- Difficulties in communication: a person is not able to find the right words, confuses the names of things (for example, replaces the word "felt-tip pen" with the phrase "subject for drawing"), forgets about the topic of the conversation in its midst;
- Refusal of hobbies: the patient loses interest in the occupations that once carried him away, completely refuses them;
- Mood swings: the patient shows hypertrophied distrust, becomes confused, shows indifference or excitement, becomes depressed, ignoring what is happening around;
- Disregard for personal hygiene: A person completely ignores the need to brush their teeth, take a bath, and perform other hygiene procedures. If no one takes care of him, he takes on a sloppy look;
- Inability to choose and make decisions, loss of financial skills.
The development of the symptoms listed above can take several years - it is difficult to determine the exact sequence of their appearance. Initially, the patient and his entourage take alarming signs for fatigue, age-related memory impairment, but the signals of the disease become pronounced. As a result, a person who develops Alzheimer's disease becomes unable to take care of himself. It cannot be left unchecked for a long time, since "forgetfulness" and other disorders pose a threat to life and health - say, the patient leaves the gas stove on.
Causes of Alzheimer's Disease
Modern medicine attributes to Alzheimer's disease a multifactorial nature, the main reason is heredity. There are also other risk factors, which are subdivided into uncorrected, conditionally corrected and corrected.
This group includes genetic or acquired characteristics of the patient's body, as well as a number of life events:
- Age over 65 years (research results in this area show that of all people celebrating their 90th birthday, 42% have signs of dementia);
- Belonging to the female sex (women are more likely to face the disease, which has not yet been fully explained by medicine);
- Transfer of severe depression, deep psychological shock;
- Receiving traumatic brain injury (this category also includes injuries acquired in infancy or during childbirth);
- Lack of full-fledged intellectual activity (the entire life period is considered);
Low level of education (graduation from a university is a positive factor).
Conditionally correctable factors
This group includes various disorders that can lead to oxygen starvation of brain cells:
- Diseases of the cardiovascular and respiratory system, causing general oxygen deficiency;
- High concentration of lipids in the blood;
- Atherosclerosis of the vessels of the neck and head;
- High blood pressure;
- Diseases associated with excessive concentration of glucose in the blood (for example, diabetes mellitus).
Timely treatment allows you to eliminate the factors of this group, "pushing" the body to develop Alzheimer's disease.
This group includes threats that a person can cope with on their own, only by making changes in their lifestyle and closely taking care of their health:
- Lack of physical activity;
- Excess weight;
- Lack of intellectual activity;
- Addiction to alcoholic beverages, smoking;
- Excessive love for caffeine-containing drinks.
Alzheimer's disease stages
Studies have shown that degenerative processes occur in the human brain long before the onset of distinguishable symptoms of Alzheimer's disease - an average of 15-20 years. This factor creates difficulties in accurately determining the clinical onset of the pathological process and complicates the early diagnosis of dementia.
Until a few years ago, medicine only considered the stages marked by the obvious symptoms of Alzheimer's disease. However, an early start of treatment can significantly slow down the destructive process and suspend the formation of a pronounced clinical picture of pathology.
As a result, the number of stages of Alzheimer's disease increased to 7 due to the early stages:
- The first stage: there is no memory impairment, no signs of pathology. Examination of the patient shows no abnormalities typical of dementia.
- The second stage: the deterioration of mental processes is insignificant, only the patient himself sees alarming signals. Physiological memory impairment (caused by aging of the body) should not be confused with early symptoms of pathology.
The third stage: memory impairment becomes moderate, the problem is noted by other people. A person does not remember the location of things, makes mistakes with the names of those around him, picks up words for a long time when communicating, gets distracted. During the examination, the doctor discovers memory impairments, but still cannot make the final verdict - Alzheimer's disease.
- Fourth stage: memory impairment is obvious. The patient confuses the names of relatives and friends, does not remember events from his life, does not cope with arithmetic calculations (say, is not capable of counting down from 10 to 1). A person develops stiffness, a desire for solitude, and difficulties in choosing.
- Fifth stage: the patient forgets his own place of residence, cannot give his phone number, does not determine the season, day of the week and date, does not dress for the weather. Recognition of relatives is preserved, as well as the memory of bright moments from one's own life. The ability to independently go to the toilet and take food is also preserved.
Sixth stage: memory impairment progresses, the patient does not remember the names of relatives and friends (although he recognizes them visually), a significant interval of his biography "disappears" from his life, sleep disorders appear (night wakefulness, daytime sleep), urinary incontinence, problems with stool. The patient is no longer capable of independent (separate) living, loses the skills of choosing clothes. A person develops distrust of others, complains about deception, theft, hallucinations are not excluded.
- Seventh stage: the patient is unable to move around, sit without help, loses speaking skills (or reproduces individual phrases, words), the ability to swallow food (refusal of food and water is possible). Such a patient cannot be left without supervision - he needs support when going to the toilet, dressing, feeding. This stage is the most severe, there is a danger of infection with infections, the threat of pneumonia, pyelonephritis.
The allocation of stages is conditional, since different patients have different manifestations of Alzheimer's disease, and the rate of its development differs.
Diagnosing Alzheimer's Disease
If signs of Alzheimer's disease are found, you should immediately visit a neurologist. Before visiting a doctor, the patient must psychologically prepare for a variety of mandatory questions. The survey allows the specialist to understand the nature of the complaints, the peculiarities of the development of violations, the presence of risk factors and make a preliminary verdict. The results of a thorough examination and questioning help to exclude an alternative diagnosis.
Neuropsychological testing is an obligatory part of the examination of a patient who has symptoms of Alzheimer's disease.
Their implementation allows you to detect a violation of a number of cognitive functions:
Intelligence testing allows you to check the patient's ability to analyze information, to separate the secondary from the main, the particular from the general, and to understand the differences and similarities. Also, the possibility of building logical chains by the patient is checked.
Perception testing is useful in the absence of pronounced symptoms of pathology, it allows you to detect it at the initial stages. Dementia is suspected when a person is unable to name the four items on the paper.
Memory testing involves testing the ability to memorize words, gestures, and drawn elements. Most often, a test of "auditory" memory is carried out, according to the results of which the ability to fix sentences and words in memory is assessed.
Combined testing is a simultaneous study of the level of intelligence and the state of memory. The advantage of this technique is the ability to distinguish an initially poor memory from manifestations of Alzheimer's disease.
Depression testing. The rapid test can refute the suspicion of latent depression, the symptoms of which in some cases are mistaken by the victims for the symptoms of dementia.
A blood test is done to detect risk factors that contribute to the development of Alzheimer's disease. The study allows you to evaluate the indicators of glucose, lipids, cholesterol. Also, at the stage of the absence of pronounced manifestations of pathology, the study of cerebrospinal fluid makes a valuable contribution to diagnosis. This procedure allows to identify specific markers of the degenerative process.
There are the following neuroimaging techniques:
- PET-CT (contrast positron emission tomography) can detect traces of amyloid formations in the brain, assess metabolic activity, check blood flow and the location of specific receptors in the brain tissue. The technique is an effective tool for early diagnosis, it allows you to detect a pathological process in the absence of pronounced symptoms. Its use is not available if the patient has high blood sugar, there are other contraindications to PET-CT;
- MRI (magnetic resonance imaging) allows you to examine the brain tissue in great detail, to refute other violations. The procedure provides information about the structure of the brain tissue, its deep layers and functioning;
CT (computed tomography) is performed in the absence of severe symptoms, is a tool for differential diagnosis (the results confirm or exclude other diseases with similar symptoms);
- EEG (electroencephalography) checks the activity of brain cells. The technique is not used to diagnose pathology at the initial stage, but it effectively refutes other diseases;
- SPECT (single photon emission tomography) can detect abnormalities that are specific to Alzheimer's disease. The study examines certain functions of the brain and assesses the blood flow in it.
How to cure Alzheimer's disease?
Treatment for Alzheimer's disease is aimed at slowing the progression of the pathology, reducing or eliminating the symptoms present. Starting treatment on time increases the chances of saving the brain's cognitive capabilities.
At the moment, medicine does not have drugs that ensure the complete recovery of the patient. Only means are offered, the use of which alleviates human suffering.
Treatment of Alzheimer's disease with medications aims to restore the patient's intelligence and memory.
There is also a fight against the typical symptoms of pathology - with a depressive state, excitability, the appearance of hallucinations:
- Cholinesterase inhibitors are the basis on which drug therapy is built. Pathology is caused by a deficiency in the body of a substance that controls the ability to remember - acetylcholine. The drugs slow down the breakdown of this amino acid and lead to its accumulation. The development of the disease at the initial and middle stages is effectively stopped by rivastigmine, galantamine. Donepezil is indicated for severe cases. Subject to the dosage prescribed by the doctor, most patients easily tolerate therapy;
- Memantine is another drug that is actively used in the treatment of Alzheimer's disease. Pathology leads to a high concentration of glutamate, which leads to damage to the cerebral cortex. The drug allows to reduce the intensity of the destructive effects of glutamate and increases the period during which the patient is able to serve himself. Basically, the medicine is used in the diagnosis of moderate and severe stages, the decision can only be made by a doctor;
- Psychotropic drugs are prescribed to a patient if he has such common manifestations of the disease as depression and sleep problems. Antipsychotics and tranquilizers help to alleviate or remove symptoms. Funds are not prescribed if the above signs of Alzheimer's disease are absent or practically do not appear;
- Tranquilizers can relieve or alleviate emotional stress without affecting the thought process and memory functionality. Also, the drugs have a relaxing effect and are anticonvulsants. Reception involves strict adherence to medical recommendations, since there are side effects;
- Antipsychotics are prescribed for psychopathic conditions, but they can activate the manifestations of dementia;
- Antidepressants are needed to relieve the patient of chronic anxiety or apathy;
- Antioxidants have a positive effect on hemodynamics and microcirculation. With their help, the period during which the patient can serve himself is increased.
On the subject: Treatment methods for Alzheimer's disease
Drug treatment is necessarily complemented by psychosocial, the following techniques are practiced:
An integrated approach based on the above methods provides a reduction in the intensity of manifestations of Alzheimer's disease and an improvement in the patient's condition. In some situations, it is even possible to partially restore the abilities lost as a result of the development of pathology and restore a person's ability to at least partial self-service. Art therapy, music therapy, therapeutic contact with animals (pet therapy) and many other practices are used.
Diet for a person affected by Alzheimer's is almost as important as pharmaceutical drugs. The correct choice of menu components allows you to activate memory, increase the ability to concentrate, and has a positive effect on brain activity.
Good nutrition, the basics of which are suggested below, can also be considered a tool for preventing dementia:
- Antioxidants are included in the diet in the form of corn, celery, spinach, honey is also useful. A strong effect (antioxidant, immunostimulating, anti-inflammatory) has curcumin, which is extracted from the Indian spice turmeric;
- Omega-3s are the most effective lipids for restoring hematopoiesis. Also, these substances have a positive effect on the state of memory and suspend the destruction of intelligence. You can get valuable elements from olive oil, walnuts, seafood. It will be useful to periodically maintain a Mediterranean diet based on seafood;
- Amino acids help restore brain function and improve the condition of nerve cells. A regular supply of tryptophan and phenylalanine is especially important. Their suppliers are fresh fruits and vegetables, nuts, herbs and dairy products;
- Foods designed to help normalize bowel function are also very important. The menu should definitely include lean meat, eggs, liver and cereals.
There are also foods that it is desirable to completely eliminate from the diet of a person suffering from Alzheimer's disease, or at least reduce their number.
The patient is contraindicated:
- Fat meat;
- Hot spices and sauces.
In general, it is necessary to constantly monitor the level of carbohydrates and fats in foods that are added to the diet.
A good drinking regime also plays a role. Lack of fluid negatively affects the state of the brain. A person with Alzheimer's should consume at least 2 liters of clean water a day. It is advisable to add green tea to the diet, freshly squeezed juices are useful.
Portions for the patient are best kept small and the feeding process should be unhurried. If the disease is severe, it may be difficult to swallow. Therefore, the best form for food is mushy.
Stem cell therapy
Stem cells are the next step in the fight against Alzheimer's disease. Pathology is associated with the accelerated death of nerve cells, eventually leading to the destruction of the brain. The essence of the technology is to use healthy cells instead of those affected by dementia. New cells entering the brain tissue produce an element that stimulates the recovery process. The result is the restoration of nerve cells, "restart" of brain activity and elimination of the symptoms of the disease.
The main goal of such treatment is to improve the patient's quality of life, normalize mental function. In fact, a person turns into a big child, his condition is obviously improving. Stem cell treatment also increases life expectancy.
Autologous stem cells used in the fight against Alzheimer's disease are material taken from the patient himself or from a donor (close relative). A small amount of bone marrow is taken by the puncture method - 100-150 ml. The introduction is repeated two to four times, depending on the patient's condition, the interval can be up to 3 months.
The negative side of the stem cell-based technique is the high probability of complications, including the formation of malignant tumors.
Is there a vaccine?
Curing Alzheimer's sufferers completely is a challenge many scientists are struggling to achieve. For the first time, scientists from the United States became interested in the invention of the "vaccine". The technique proposed by them is based on the destruction of pathological formations by stimulating immune processes. Specialists from Sweden are also working on a system to effectively eliminate the abnormal protein. Developments have already made it possible to slow down the development of the disease, but still have not led to a cure.
The proposed vaccine, the fruit of innovative technological developments, includes small amino acid elements in the form of a carrier molecule. Molecular mimicry allows for an immune response from the body. The sensational drug has already been subjected to the first stage of research, the high tolerance of the drug was noted.
More than 200 victims of Alzheimer's disease have already participated in the research. The final stage of the trials is planned for 2016; patients with the initial stage will become its participants.
On the subject: List of essential foods and remedies for Alzheimer's disease
Prevention of Alzheimer's Disease
Of course, the main factor of dementia - heredity - cannot be eliminated, and nothing can be done with age. However, everyone can still reduce the threat.
The steps to prevent Alzheimer's are very simple. You just need to take into account the following rules:
- Indicators of blood sugar, blood pressure. The parameters are kept under control, stabilized by drugs if necessary;
- Long walks. It is desirable that prolonged exposure to the air be of daily nature;
- Training for mental development. Solving math problems (without using a calculator) and puzzles, solving (composing) crosswords and other logical exercises. It is also useful to actively participate in social activities, take on social functions;
- Strengthening memory. Learning foreign languages, learning poems, memorizing fragments of stories. Application of special techniques (for example, coming up with associations) instead of using a weekly journal and a notebook;
- Correct daily routine. The alternation of rest and work, the absence of overwork;
- Healthy sleep. Sleep should be 7-8 hours. This provides a decrease in the concentration of beta-amyloid protein formed in nerve cells. The concentration of this protein in brain tissues increases the threat of the development of pathology;
- Moderate physical activity. Swimming pool, long walks, simple (but regular) gymnastics. Walking with alternating slow and fast paces is shown in particular. Physical activity has a positive effect on blood circulation and stimulates brain activity.
There are risk factors that need to be eliminated as part of the prevention of Alzheimer's disease:
- Cigarettes and alcoholic beverages consumed in large quantities;
- Unhealthy foods that include excessive amounts of animal fats, "wrong" carbohydrates (baked goods, sweets). Lack of vitamins in the daily diet;
- Regular neglect of 8-hour sleep;
- Stressful situations;
- Excess weight;
- Long-term stay in a room that is not ventilated.
All of the above rules can be considered only conditional prevention of Alzheimer's disease. There is still no guaranteed prevention.
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Even correct and timely treatment does not deprive Alzheimer's disease of the status of a deadly pathology. According to statistics, patients with this form of dementia live no more than 8-10 years from the date of diagnosis. The nature of the manifestations of the disease is different, long-term stabilization and slow development are possible. According to the doctors, it is not the pathology itself that leads to death, but the diseases that arise against its background: infections, pneumonia.
Correct treatment and proper care will prolong the life of someone with Alzheimer's. Perhaps a vaccine will still be invented.
Author of the article: Sokov Andrey Vladimirovich | Neurologist
Education: In 2005 completed an internship at the IM Sechenov First Moscow State Medical University and received a diploma in Neurology. In 2009, completed postgraduate studies in the specialty "Nervous diseases".