An Early Diagnosis

11 Feb
Characterized by the slow, progressive and irreversible degeneration of brain cells, Alzheimer’s disease (AD), also known as “pre-senile dementia,” is an illness that affects the elderly and results in the loss of memory, confusion and changes in personality. In the most advanced stages of this illness, patients progressively lose the ability to perform everyday activities and radical language problems as well as behavioral changes; disorientation and hallucination signs start to appear. At some point, patients may also lose the ability to recognize people. Poor or decreased judgment, problems with keeping track of things, and mood swings are also common signs of this disease. This illness not only leads to severe dementia of the most common type, but also to the inevitable death of the patient. Research demonstrates that “Alzheimer’s disease first affects parts of the brain controlling memory and thinking. As it advances, it kills cells elsewhere in the brain. Eventually, if the patient has no other serious illness, the loss of brain function will prove fatal.”

The Alzheimer’s disease has three main stages each of which bears its own symptoms. During the mild or early stage, patients are likely to suffer slight behavioral changes embodied in the asking of repetitive questions, irritability, short-term memory loss, difficulty to learn new things, and loss or misplacement of things among others; this stage usually lasts from 2 to 4 years although this period may vary from patient to patient. During the moderate or middle stage, which may last up to 10 years, patients can have trouble recognizing familiar people or objects, tell stories repeatedly, and need help in carrying out daily activities. Confusion, anxiety and mistrust are also common during this stage and the symptoms progressively get worse with the pass of time. Finally, during the severe or late stage of this disease, which may last from 1 to 3 years, the abilities to walk and perform simple tasks are completely lost, and patients typically lose their appetite, speak in a mumbling way, and display severe sings of disorientation to time and place. Many patients are confined to their beds during this stage, and they typically need assistance 24 hours a day. Despite the most characteristic symptoms of each stage, AD patients are affected differently by senile dementia. No symptoms are likely to develop in two patients in the same way and the degree to which each patient experiences symptoms from each phase and the illness progresses into the different stages may also vary.

AD is named after the German neuropathologist and neuroscientist Alois Alzheimer, who described the signs of this illness by the first time during the early 1900s after discovering fiber tangles and abnormal plaques in the brain tissue of a deceased patient. Some of the risk factors associated with AD relate to age, education, alcohol consumption and injuries in the head. It is believed that genetics may also play a role in the development of AD since certain gene mutations can increase the likelihood of suffering from this illness. Some other causes linked to this disease include diabetes, exposure to some kinds of metals and other environmental factors, high blood pressure and high levels of cholesterol. Reasonable diagnoses to Alzheimer’s are usually preceded by a complete analysis of a patient’s clinical history often backed up by a neuropsychological examination. Different memory tests, brain scans, physical and psychological assessments can also be performed, but no conclusive medical examinations are available to accurately diagnose this disease before the patient’s death. A 100% accurate Alzheimer’s diagnosis requires a thorough check of brain tissue that can only be performed during an autopsy. As a result, an Alzheimer’s diagnosis is primarily based on the presence of characteristic signs and the absence of alternative conclusions that may have been ruled out during the examination period.

One of the most important actions to take during an Alzheimer’s analysis is to interview family, friends or caregivers since patients tend to minimize their symptoms. Although assessment tests may not readily assert on the presence of AD, they may be useful in distinguishing the presence and severity of dementia according to the patient’s cognitive abilities. Over one hundred years since Alzheimer’s disease was first discovered, experts are still struggling to find a cure for it, and although there currently isn’t any, detecting early symptoms of this illness will enable caregivers to be better prepared to cope with the progression of this pathology, provide patients and their families with the opportunity of making decisions about the future while patients still have the ability to do so, and decrease the anxieties caused by unknown health problems. In addition, the chances of benefiting from treatment of the disease when the latter is diagnosed in advance also increase.

Lifestyle modifications, sexual-hormone administration, vaccines, a good level of physical exercise, and a diet low in fat and rich in food supplements are measures that may all prevent and reduce the likelihood of suffering from this disease. In addition, several drug and non-drug treatments are available to help with specific behavioral and cognitive symptoms characteristic of Alzheimer’s. Furthermore, it has been recently asserted that fair amounts of mental stimulation can have a dramatic effect in preventing AD. For this reason, people who are educated and constantly exercise the mind can be better protected against the development of this and other mental diseases.

During recent years there has been a major outgrowth of Alzheimer’s disease, and it is estimated that this pathology currently affects nearly 13.5M people around the world. This number is expected to reach from 36 to 81M by the year 2050; consequently, scientists keep working hard on their quest to find a cure for this illness that represents a significant challenge harming public health. In addition to the great number of people that this malady affects, it represents one of the main leading causes of death in the U.S. and one of the most costly diseases due to the different direct and indirect outlays involved in both the professional or family care that patients suffering from AD require. The average age of AD patients is 65 although some cases of early or late Alzheimer’s can also happen. Nonetheless, the risk of suffering from this illness is directly proportional to the age of the patient. Patients who have been diagnosed with AD can usually live anywhere from 6 to 20 years although the average is 8.

Alzheimer’s-like symptoms?
My grandma is 80 years old today, and although she has not being diagnosed with AD had a sister who did and passed away because of this disease. My grandma recently suffered a heart attack and survived after catheters were inserted in three of her blood vessels, one of which had a 99% obstruction. She was basically at the brink of death although she is strong for her age and has always been a healthy person. Nevertheless, her heart condition, age and the fact that a close relative had Alzheimer’s, all of which represent risk factors, may increase her likelihood of suffering from this disease.

As we grow older, some signs of memory loss are evident, but to which extent are they normal? How can we be sure of the normality of forgetting names, places and things? I do not know where the dividing line is, but my dad is sure that my grandmother has some degree of AD, and as small as it can be it’s still there. My grandma typically confuses her grandchildren’s names. She calls me my cousins’ names and she calls my cousins my name. She has been doing this for a while now although we have never given too much importance to it, as she seems to know who we are and just be confused sometimes with our names. Could this be a sign of normal forgetfulness or is it a sign of AD? She forgets who famous people that she used to know are and confuses them. She has a tendency to repeating the same story several times even during the same day and to the same person. Sometimes she misplaces things although it hasn’t gotten to the point where she puts clothes in the fridge or perishable food in the closet. Could these still be early AD warning signs?

At occasions, she loses track of what she was going to do or say although this is something that happens to everyone; it is therefore hard to determine whether it could be considered a clear AD symptom. Some problems with finding the words to speak are also obvious in her case although it doesn’t seem to be a big deal. She tends to depend a lot on others, as she doesn’t feel like going out unless we do so or doing things that she used to do by herself. She spends lots of hours watching TV, as she can’t find great pleasure in reading, writing or performing other activities to keep herself distracted and busy. She is likely to confuse and forget days, dates and places. For instance, she recently had a doctor’s appoint for a follow-up check and she confused the date and the day of the appointment. She went to the doctor thinking she had an appointment on that day only to discover that it was on the day before and that she had missed it.

She seems to be obsessed by money and how much she spends, and she keeps track of every single penny she pays. Could this be simply a sign of how organized she is? I can’t myself remember what I’ve spent my money on unless I keep a log, so sometimes we think this indication is only normal. She can’t seem to retain new information for long, and she can’t seem to remember new names, faces and processes involving steps for long despite the many times we repeat and explain things to her or the many times she sees people. These and the previous few signs apparently point to the normal course of aging since none of the indicators seem to be severe, but we can’t seem to discard the possibility that maybe she has an extremely mild case of AD that has progressed so slowly that we have become used to atypical changes in her behavior in such a way that the previous noticeable signs now seem to be ordinary and just another part of her aging process.

Even though the lack of harsh symptoms could point to the normality of her forgetfulness and apparent changes in behavior, the frequency of some of these signs is alarming. Does the fact that the signs are not severe mean that she could be suffering from some other related disease or from no disease at all even though these signs are constant and recurrent? She ha snot displayed any to her noticeable changes that could lead us to believe she has this disease, but the few indicators we’ve seen are enough as we know how she used to be and how she is now. The question remains to be answered as no medical assessments regarding AD have been performed on her, but to us who are the people living with her, the uncertainty and concern increases everyday as she seems to have mentally deteriorated a lot in the past few years, and as these signs seem to get worse as days go by.

Although the effects of AD in the brain affecting memory, intelligence, judgment, and speech can’t be reversed, some of the risk factors causing AD can’t be controlled and no cures have yet been found to prevent and stop the progression of this illness, a healthy diet and lifestyle, and a constant stimulation of the brain can have a great impact on reducing the risk of suffering AD later on in our lives. Even though not enough is yet known about this disease and more research is still needed to cover the gray areas, raising our awareness about this disease and becoming active participants in the care of our health. It is also important to mention that AD is not a part of the normal aging of people but rather a fatal disease that severely and progressively damages the brain. Do not take health for granted and do not dismiss potential AD signs that could give you a chance of extending the life of a loved one if detected early.

Image by: Paulus Rusyanto @ Free-Stock Photos

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Posted by on February 11, 2007 in AD, alzheimer's, brain, disease


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