A B C D E F G H I J K L M N O P R S T U V W

ALZHEIMER'S DISEASE

What is Alzheimer's Disease?

Alzheimer’s disease is the commonest type of dementia and is the name given when other types have been excluded. Dementia means a loss of intellectual abilities. It affects about 5% of people over 65 and 20% of those over 80. The commonest and earliest signs may be the loss of memory, particularly for recent events or messages. People may dismiss this as just due to age, but they may also find it increasingly difficult to learn new skills, such as getting used to a new car or handling a new gadget in the home. They may give up activities they have always enjoyed. They may become uncharacteristically placid or disagreeable and may get up in the night thinking it is morning. Speech may become disjointed or repetitive and spatial skills such as finding things that have been put away may become difficult. Eventually almost every brain function may be impaired, causing physical frailty and loss of bladder or bowel control. Although at first, the patient may be aware that something is going wrong, later on they are usually unconcerned or oblivious.

How does Alzheimer's Disease occur?

Brain cells degenerate at a faster then usual rate, leaving behind damaged areas known as tangles and plaques. Dementia can also be caused by little strokes, an under active thyroid gland, deficiency of vitamin B12, alcohol and Huntington’s disease. Accordingly, it is important that those conditions which are treatable must be excluded. Depression, which is certainly treatable, can make someone appear demented and may mimic Alzheimer’s disease.

Why does Alzheimer's Disease occur?

The cause is not known, but research within some families has suggested that a genetic factor may predispose to the disease. Brain trauma in early life may also be a factor. Most cases however are sporadic, with no family tendency or other cause identified.

What does treatment/management of Alzheimer's Disease involve?

Early detection is important in order to exclude other causes of dementia or other treatable illness. Blood tests are useful for identifying some of the other conditions causing dementia. Brain scans, either computerized x-ray (CT scan) or magnetic (MRI) will be carried out. This will usually demonstrate the loss of brain tissue characteristic of Alzheimer’s disease, and will help to exclude other important structural causes of dementia such as repeated minor strokes and brain tumours. A scan using a short-lived radio-active chemical may be done to show how different parts of the brain are working. Some measurement of intellectual function is made, using a variety of tests. This is useful as a baseline for identifying a treatment response. Explanation to the patient and relatives combined with assessment of the home situation allows planning of management.

Although most patients will be dealt with by their own family doctors, dementia clinics or community services may be valuable for support and management. Two drug treatments are available for Alzheimer’s disease. In trials, these drugs have shown benefit, but side effects also occur and the benefit may be marginal. It is recommended that an experienced doctor manages the treatment as it is important that the right drug is used at the right stage for the right patient. As the disease progresses beyond a certain point, the treatment is usually stopped. Many other treatments such as vitamins, anti-inflammatory drugs and herbal remedies are also used in practice, often without good clinical evidence of benefit. Treatments for symptoms such as agitation and depression may also be needed. Sleeping pills may make confusion worse but other ways of promoting sleep may be tried by the doctor.

What to watch out for after treatment for Alzheimer's Disease?

It is important to monitor the good and bad effects of treatment and to try to help with problems as they arise.

What would happen if Alzheimer's Disease was not treated?

The condition is invariably progressive, but the rate of worsening and the changes in behaviour may vary considerably. The disease is usually fatal after a number of years. During this time, affected people lose weight and become prone to fall and to other diseases such as chest infections.

What is involved for family and friends of Alzheimer's Disease sufferers?

Respite for carers can be helpful and support throughout the illness is vital.