Alzheimer's disease is the most common and well-known form of dementia. But how can you distinguish Alzheimer’s disease from other forms of dementia? How can you recognise initial symptoms? Information provided by Senior Home Plus
What is Alzheimer's disease?
Diagnosed for the first time over a century ago, way back in 1906, by neurologist Alois Alzheimer, this neurodegenerative disease is characterised primarily by the gradual loss of memory and cognitive functions. It manifests in the form of behavioural disorders of varying severity, depending on disease progression.
Two physiological changes in the brain, namely the formation of senile plaques and neurofibrillary tangles are the hallmarks of Alzheimer’s disease. Although certain risk factors have been identified, the precise cause of these disease-related mechanisms has not been fully elucidated to date. Senile plaques mainly comprise an amyloid peptide, which is normally present in the body. However, in a brain affected by Alzheimer’s disease, this peptide accumulates and clumps together to form senile plaques, which constantly increase. Neurofibrillary tangles are twisted fibrils located within the neurons.
How to recognise the symptoms of Alzheimer's disease?
Memory disorders are usually the first symptoms of this condition. It is important to note that it does not affect all types of memory and differs from simple forgetfulness or memory loss that can occur with advancing age. Although both short-term memory and explicit memory are affected, implicit memory remains intact. Short-term memory, also known as the "working memory", allows us to remember short-term information such as addresses or telephone numbers, and involves the prefrontal cortex. Everyone forgets appointments or events at one time or another. However, a patient presenting Alzheimer’s disease systematically forgets recent events and will never recall them.
Long-term memory includes both implicit and explicit memory. Implicit memory combines our unconscious processes and motor skills, such as riding a bike, for instance. Explicit memory comprises episodic or autobiographical memory and the memory that defines our general culture or semantic memory. Therefore, Alzheimer's patients experience a gradual loss of memory when it comes to recent events. They also tend to search for words, confuse words, basically forget abstract concepts and use general phrases as opposed to precise expressions. They also tend to lose items on a regular basis. An individual with Alzheimer’s disease will also have difficulty using standard utensils. As a general rule, this leads to an inability to perform activities of daily living and to a gradual loss of independence. Furthermore, cognitive disorders can cause disrupted behaviour patterns such as agitation, aggression or disinhibition, for example. Dementia is also accompanied by sudden memory loss as well as symptoms of stroke, a change in gait, early loss of bladder or bowel control and sudden outbursts of laughter or tearful episodes.
What is dementia?
Dementia is characterised by a gradual decline in mental capacity. It is progressive and, unfortunately, irreversible. Alzheimer's disease is the most common form of dementia. It mainly affects individuals over the age of 65, and is more prevalent over the age of 80. In some cases, it can occur before the age of 60. These are the early stages of the disease, which often have a dramatic effect on the individual’s friends and family. Dementia affects a person's intellectual and social capacity, and everyday living becomes difficult. It can also affect memory and judgment, and may cause disorientation. Personality changes can occur. It should be noted that elderly individuals often tend to develop a specific type of dementia known as "senile dementia". It affects all of the individual’s mental faculties and alters their emotions and activity. However, this does not necessarily mean that they have Alzheimer's disease.
What is the correct diagnosis of Alzheimer’s disease?
Certain behavioural tendencies in a loved one should draw our attention such as recurring memory loss, speech problems, disorientation in space or time or a frequent loss of objects. Medical advice should be sought immediately in this instance. The doctor may recommend additional tests or refer you to a specialist for a specific diagnosis. Despite the apparent symptoms, only a medical professional is capable of diagnosing Alzheimer's disease based on specific examinations such as a CT scan and various cognitive tests.
What causes Alzheimer's disease?
According to the various studies carried out to date, Alzheimer's disease is more likely to be due to a combination of various environmental, factual and genetic factors rather than one specific cause per se.
Hereditary forms of the disease are very rare, occurring in less than 1% of cases, and mostly during Alzheimer's disease of early onset. Three different genes have been highlighted thus far in relation to these hereditary forms. One anomaly in one of these three genes in one parent or the other is sufficient to trigger disease onset, with a tendency for the condition to develop before the age of 65. However, even if an individual carries one of these genes, this does not necessarily mean that they will go on to develop the condition despite being predisposed to it, i.e. the risk factor is higher in some people than in others.
Other risk factors
Studies of Alzheimer's disease around the world have highlighted seven risk factors potentially responsible for nearly 50% of all cases of Alzheimer's disease. These range from low educational ability, smoking, a sedentary lifestyle, depression, high blood pressure (hypertension) and, to a lesser extent, obesity and diabetes.
Furthermore, a recent study has shown that living in areas with a high level of airborne pollution also increases the risk of developing Alzheimer's disease and other forms of dementia.
According to many doctors, a Mediterranean diet rich in fish, fruit and vegetables appears to considerably reduce the risk of developing Alzheimer's disease and is also very beneficial for the heart.
Indeed, a diet rich in fatty fish and antioxidants found primarily in fruit and vegetables can be very effective in combating free radicals responsible for neuron death.
Among the numerous studies conducted on this subject, some researchers were able to prove a 32% reduction in the risk of developing dementia, taking all causes into account, in trial subjects with a high genetic predisposition to Alzheimer's disease who adopted a "favourable" lifestyle compared to those with an "unfavourable" lifestyle.
The brain could therefore be protected from Alzheimer's disease by directly targeting these risk factors. In other words, a healthy lifestyle, regular mental and physical activity and a balanced diet are vital.
What are the symptoms of Alzheimer's disease ?
A distinction is essentially made between:
Memory loss in terms of recent events,
Loss of reference points in terms of time,
Loss of reference points in terms of spatial cognition,
Difficulty in recognising objects,
Speech disorders,
Aggression and restlessness.
These symptoms are usually referred to by the medical profession as "the four A's": Amnesia, Aphasia, Agnosia and Apraxia.
The 4 A's in Alzheimer's Disease
Amnesia:
Memory problems are often the first symptoms of Alzheimer’s disease. They are mainly related to the inability to learn new information. The individual in question fails to recall the events they are actually experiencing.
Our advice: At this stage of the disease, it is advisable to stimulate the individual’s memory function through various activities and aids to off-set memory-related issues.
Aphasia:
Speech disorders arise and hamper communication. The individual has a tendency to search for words and to use one expression instead of another. They may sometimes remain silent and make no attempt to communicate.
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Our advice: Suggest activities to stimulate speech such as word games and crossword puzzles, etc. You can also use cards, picture books and short stories to work on their vocabulary and narrative skills, etc.
Apraxia:
Clumsy movements are accompanied by loss of sensation in individuals with apraxia. As the disease advances they will find it difficult and then impossible to feed themselves unaided or to look after themselves. Assistance with activities of daily living will then be required.
Our advice: Use what is known as physical prompts by placing a fork in the individual’s hand, for instance, rather than asking them to eat.
Agnosia:
The patient no longer recognises friends and family. They are in a state of deep mental confusion and may show indifference, silence or aggression. They will inevitably be confined to bed in the long term.
Our advice: Individuals with Alzheimer's disease often experience visual agnosia. They are unable to identify faces or objects in their immediate vicinity. However, this inability can be offset by the other senses such as touch and hearing. Touching an object can help a patient, and hearing a familiar voice can help them recognise a loved one.
Despite advances in research and medicinal products at the clinical trial stage, current treatments are unable to provide a cure. Several symptoms can nevertheless be targeted by alleviating the effects and slowing down disease progression.
What are the different stages of Alzheimer's disease?
The mild stage
At this stage, memory problems are almost undetectable. They often go unnoticed because friends and family are likely to attribute them to the ageing process.
The short-term memory is primarily affected. The individual in question will gradually find it difficult to perform routine daily tasks and express themselves. They will also encounter difficulties with spatial orientation.
The patient will tend to jot down everything they do for fear of forgetting essential things or their schedules and appointments.
Any new situation creates a sensation of instability, either because they are unfamiliar or the individual has forgotten them, etc.
The intermediate or moderate stage
Judgement starts to be impaired. Memories become increasingly inaccurate and moods can change over the course of one day.
They have difficulties in recognising objects and loved ones and often forget first names. These problems impact their daily life and their relationships with family and friends. They need help and support.
They may ask the same questions over and over, without registering the answers, not out of disregard or distraction but simply because they have forgotten them. Family and friends should demonstrate understanding and compassion as opposed to annoyance, which would only exacerbate the situation further.
If individuals with Alzheimer’s disease have to go out, they may get lost as they really do not know where they are going. Worse still, they no longer remember their own home address. Make sure they always have their address and an emergency contact number with them. They should never go out without this information.
In the early onset of this stage, memory workshops offered by day care centres are both vital and beneficial. It is also a good idea for your loved one to move to a nursing home to ensure their safety.
The critical or terminal stage
By now a total introvert, the individual is withdrawn. They are all alone because they no longer recognise those around them.
They can no longer wash themselves, get dressed or to go to the bathroom unaided because they have forgotten what to do.
The danger arises when such extensive memory loss affects their diet. They need constant attention and monitoring day and night to prevent them from running away, falling, which can prove fatal, malnutrition and dehydration.
Our elderly care advisors can help you to move your loved one to the right memory care that suits your budget, is convenient in terms of geographical location and which provides optimal care for individuals with Alzheimer's disease. There is no charge for our service. Call our advisors today at 343 309 5289.
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