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Alzheimer's Disease

alzheimers disease What is dementia?

Dementia is a condition of the brain which causes a gradual loss of mental ability, including problems with memory, understanding, judgment, thinking and language. In addition, other problems commonly develop, such as changes in personality and changes in the way a person interacts with others in social situations.

What are the different causes of dementia?

Dementia can be caused by various diseases or disorders which affect the parts of the brain involved with thought processes. However, most cases are caused by Alzheimer's disease, vascular dementia, or dementia with Lewy bodies (DLB).

Alzheimer's disease

This is the most common type of dementia, causing about half of all cases. It is named after the doctor who first described it. In Alzheimer's disease the brain shrinks (atrophies) and the numbers of nerve fibers in the brain gradually reduce. The amount of some brain chemicals (neurotransmitters) is also reduced - in particular, one called acetylcholine. Alzheimer's disease gradually progresses (worsens) over time as the brain becomes more and more affected.

Vascular (blood vessel) dementia

This causes about a quarter of all cases of dementia. It is due to problems with the small blood vessels in your brain. The most common type is called multi-infarct dementia. In effect, this is like having many tiny strokes, that otherwise go unrecognized, throughout the thinking part of the brain. After each stroke, some more brain tissue is damaged.

Lewy body dementia / dementia with Lewy bodies (DLB)

Lewy bodies are tiny abnormal protein deposits that develop in nerve cells in the brain of people with this condition. It is unclear why the Lewy bodies develop but they interfere with the normal functioning of the brain.

Who gets dementia?

Dementia is a common problem. After the age of 65 about 1 in 12 will develop dementia. Over the age of 85, about 1 in 5 people are living with dementia. Dementia is said to be early-onset (or young-onset) if it comes on before the age of 65.

A lack of physical activity can increase your risk of dementia.

Dementia also seems to run in some families so there may be some genetic factors that can make someone more likely to develop dementia.

What are the main dementia symptoms?
  • Loss of mental ability
  • Changes in mood, behavior and personality
  • Problems carrying out day-to-day activities
How does dementia progress?

The speed in which dementia progresses vary greatly from person to person and the type of dementia. In the later stages of dementia, speech may be lost and severe physical problems may develop, including problems with mobility, incontinence, and general frailty.

How is dementia diagnosed?

People with a high intellect or a demanding job, may notice themselves that their mental ability is starting to fail. In other cases it is usually the patientís relatives, friends or partners who notice the progressive deterioration of mental skills and suggest a visit to your care provider usually a general practioner. The doctor may in turn refer you to a specialist.

Referral to a specialist

Referral for the opinion of a specialist is usually needed to confirm the diagnosis of dementia. This is usually a specialist in the care of elderly people, a neurologist, or a psychiatrist specialized in looking after older people. The specialist may be able to determine the likely cause of dementia and decide if any specific treatment may be helpful.

Can medication help people with dementia?

There is no cure for dementia and no medicine that will reverse dementia. However, there are some medicines that may be used to help in some causes of dementia.

Acetylcholinesterase inhibitors

These include donepezil, rivastigmine and galantamine. They work by increasing the level of acetylcholine. This is a chemical in the brain that is low in people with Alzheimer's disease. These medicines are not a cure for Alzheimer's disease. However, they may help to treat some of the symptoms affecting thinking and memory in about half of people with Alzheimer's disease.

Memantine

This medicine is also licensed for the treatment of Alzheimer's disease in some people. It works by reducing the amount of a brain chemical called glutamate

Other medication
  • An antidepressant may be advised. Depression is common in people with dementia and may be overlooked.
  • Aspirin and other medicines to treat the risk factors for stroke and heart disease may be appropriate for some people - especially those with vascular dementia.
  • Sleeping tablets are sometimes needed if difficulty sleeping is a persistent problem.
  • A tranquillizer or an antipsychotic medicine is sometimes prescribed as a last resort for people with dementia who become easily agitated.
Support and care is the most important part of treatment

Most people with dementia are cared for in the community. Often, the main carer is a family member. It is important that carers get the full support and advice which is locally available.

Can dementia be prevented?

At present, there are no specific medicines or treatments that are definitely known to reduce your chance of developing dementia.

Keeping your brain active may also help to reduce your risk of developing dementia. So, for example, consider reading books, learning a foreign language, playing a musical instrument, taking up a new hobby, etc.

A study published in 2010 showed that a group of medicines used to treat blood pressure, called angiotensin receptor blockers, may help to protect against dementia.


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