Alzheimer’s: causes, symptoms, therapies

Neurodegenerative disease that affects in old age: one of the first symptoms is lack of memory.

What is it

Alzheimer’s is a degenerative brain disease characterized by a progressive decline in cognitive functions and memory in particular that involves increasing difficulty in carrying out common daily activities, up to the complete loss of personal autonomy.

Causes

The exact causes that trigger and sustain degeneration are not known despite the significant amount of studies carried out in over a century since its discovery.

Many of the hypotheses advanced (viral, toxic, autoimmune), in fact, have not yet been confirmed and only the idea of a possible genetic origin seems to resist.

To corroborate it there would be the tendency of the disease to occur more easily in individuals of the same family and its association with specific gene variants (of chromosomes 14, 19 and 21).

It is known, however, that the symptoms are due to a widespread destruction of neurons, mainly caused by amyloid beta, a protein that, deposited between neurons, acts as a sort of glue, incorporating “neurofibrillary” plaques and tangles and a strong decrease in the brain of acetylcholine a neurotransmitter fundamental for communication between neurons, and therefore for memory and any other intellectual faculty.

Symptoms

The onset of the disease is usually insidious also because the first symptoms are mild and difficult to distinguish from the common carelessness and difficulties of a healthy person who is simply aging.

Memory problems, for example, are the most characteristic of Alzheimer’s and often the first to appear, but within certain limits they can be considered “normal” in the elderly or be due to other types of more or less serious problems that can be treated with appropriate therapies.

However, since only a thorough examination and any other tests can remove the doubt between normal and pathological aging and possibly rule out problems of a nature other than Alzheimer’s, it is important to understand when it is appropriate to go to the doctor.

According to the US Alzheimer’s Association, there are ten symptoms to watch out for:

Symptom Demonstration
Anterograde amnesia Forgetfulness and memory disorders especially for the most recent events
Apraxia Difficulty performing familiar tasks such as tying shoes or buttoning that are not due to physical disabilities
Agnosia Difficulty recognizing everyday objects and their functions
Anomie Difficulty in naming common things that are recognized
Spatial disorientation Confusing familiar places
Temporal disorientation Getting the month, season or year wrong
Acalculia Difficulty in performing relatively simple logical or mathematical operations that may involve, for example, having to count and recount money
Losing items Tendency to continually lose things by forgetting them in the strangest places (keys in the refrigerator, linen in the kitchen)
Mood or personality changes Tendency to become confused, suspicious, depressed, fearful, anxious, upset
Apathy Loss of initiative and interest in oneself, others and the environment in general

When to go to the doctor

Each of these symptoms, taken individually, does not necessarily indicate the existence of dementia and the appearance should therefore not frighten, but rather sound like an alarm bell to go to the doctor, especially if there are precedents in the family of degenerative brain diseases or if we are not experiencing a moment of stress or particular fatigue, they are particularly frequent or disturbing, They tend to persist or worsen, adding up as new ones appear.

Diagnosis

Even when the pathological character of the disorders and some behaviors is recognized, reaching a safe diagnosis is not easy even for the doctor.

First of all, it is necessary to exclude all other pathologies that may have a similar symptomatology: the certainty of the diagnosis of Alzheimer’s disease can only be obtained by detecting the typical signs of the pathology, amyloid plaques and neurofibrillary skeins, in the brain tissue and therefore only with biopsy or post-mortem autopsy.

However, a possible or probable diagnosis can also be made through the history of the patient and family, the analysis of symptoms and the use of other laboratory and instrumental tests: blood and cerebrospinal fluid tests to check for the possibility of anemia, biochemical deficits or brain infections; electroencephalogram; CT or MRI to observe possible anatomical changes (cortical atrophy or expanded ventricles).

The cornerstone, however, remains the neuropsychological and cognitive evaluation through a series of tests oriented to the evaluation of different functions: short-term memory (of digits, words, sentences), long-term memory (voluntary and incidental), attentional, verbal, perceptual and praxic functions, and general cognitive functions. Among these, one of the best known and used is the Mini Mental State Examination.

The presence of spatiotemporal disorientation, memory deficits, acalculia, anomie or agnosia (especially for animated objects) makes the clinical picture compatible with the diagnosis of Alzheimer’s dementia.

Course

Unfortunately, at present there are no treatments that can stop and heal the brain degeneration underlying Alzheimer’s dementia.

However, symptomatic treatment and continuous assistance with targeted rehabilitation slows down its progression while maintaining a good quality of life for as long as possible, especially if implemented early on the appearance of the first symptoms.

The course is slowly progressive up to a stage in which the severity of the dementia picture increases the likelihood of contracting other organic diseases and greatly reduces life expectancy, about 5-10 years after the onset of the disease.

Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.

The blog covers a wide range of topics related to health and wellness, with articles organized into several categories.

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