Alzheimer's Disease (Alzheimer's Dementia)

Poor nutrition and vitamin deficiency in childhoodExposure to electromagnetic fieldsExcess metal in the blood, especially zinc, copper, aluminum, and ironCertain viral infectionsDiabetesHigh Cholesterol SymptomsSymptoms of Alzheimer's disease come on gradually. They begin as mild memory lapses but progress to profound loss of memory and function. Alzheimer's disease is divided into three stages: early, intermediate, and severe. Symptoms include: Increasing trouble remembering things, such as How to get to familiar placesNames of friends and family membersWhere common objects are keptSimple mathHow to perform tasks (eg cooking, dressing, bathing)Trouble concentrating on tasksTrouble completing sentences due to lost or forgotten words (progresses to a complete inability to speak)Difficulty with daily life tasks such as bill paying and housekeepingInability to remember the date, time of day, seasonMood swingsWithdrawal, loss of interest in usual activitiesSlow, shuffling walkPoor coordinationSlowness and then loss of purposeful movement DiagnosisThere are no tests to definitively diagnose Alzheimer's disease. The doctor will ask about your symptoms and medical history and do a physical exam. The doctor will ask many questions to rule out other causes.

Tests to rule out other medical conditions may include: Neurological examPsychological and mental status testingCT scana type of x-ray that uses a computer to make pictures of the brain MRI scana test that uses magnetic waves to make pictures of the brain Electroencephalogram (EEG)a test that measures electrical currents in the brain Blood tests and urine testsLumbar punctureto test for levels of certain brain proteins that increase with Alzheimers disease and to rule out other disorders TreatmentThere are no treatments to cure Alzheimer's disease and no certain ways to slow its progression. Four medications have received US Food and Drug Administration approval for the treatment of some symptoms of Alzheimer's dementia. Various drugs are being studied to see if they can manage the symptoms or slow its course. Medications for Symptoms and Disease Progression Medications being used and studied include: Cholinesterase inhibitors (donepezil, rivastigmine, galantamine)NMDA receptor antagonist (memantine)Antioxidants (vitamin E)EstrogenAnti-inflammatory agentsGinkgo biloba (herbal supplement) Lifestyle Management Managing the disease includes:

Creating an environment in which you can receive the care you needOptimizing your quality of lifeKeeping yourself safeHelping yourself learn to deal with the frustration of your uncontrollable behaviorProviding a calm, quiet, predictable environmentProviding appropriate eyewear and hearing aids, easy-to-read clocks and calendarsPlaying quiet musicLight, appropriate exercise to reduce agitation and relieve depressionEncouraging family and close friends to visit frequently Psychiatric Medications Medications to treat the psychiatric symptoms that may occur with Alzheimers disease include: Antidepressantsto treat depression Anxiolyticsto treat anxietyAntipsychoticsto treat severe confusion, paranoia, and hallucinations Caregiver SupportCaring for a person with Alzheimer's disease is extremely difficult and exhausting. The primary caregiver needs emotional support, as well as regular respite. PreventionThere are no guidelines for preventing Alzheimer's disease because the cause is unknown. RESOURCES: Alzheimer's Associationhttp://www.alz.org/ Alzheimer's Disease Education and Referral Centerhttp://www.alzheimers.org/ CANADIAN RESOURCES: Alzheimer Societyhttp://www.alzheimer.ca/ BC Health Guide

http://www.bchealthguide.org/ References: Alzheimers disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Accessed February 23, 2008. American Academy of Neurology website. Available at: http://www.aan.com/professionals/. Accessed October 12, 2005. Goetz CG. Textbook of Clinical Neurology. Philadelphia, PA: WB Saunders Company; 1999. Green RC, Cupples LA, Go R, et al. Risk of dementia among white and African-American relatives of patients with Alzheimer disease. JAMA. 2002;287:329-336. Kasper DL, Braunwald E, Fauci AS, et al. Harrison's Principles of Internal Medicine. 16th ed. New York, NY: The McGraw-Hill Companies; 2005. Rakel RE, Bope ET. Conn's Current Therapy. 53rd ed. Philadelphia, PA: WB Saunders Company; 2001. Rowland LP, Merritt HH. Alzheimer's disease and related dementias. Merritt's Neurology. Philadelphia, PA: Lippincott Williams and Wilkins; 2000: chap 106. Last reviewed February 2008 by J. Thomas Megerian, MD, PhD, FAAPPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.