Dr Alois Alzheimer published a report. In 1907 describing a 51 year old patient who died of progressive dementia. During autopsy microscopic changes in the brain were discovered including abnormal nerve cells, tangled fibres and clusters of nerve endings. The report attracted attention within the medical community, and thereafter progressive dementia in a person younger that 65 was called “Alzheimer’s Disease” Dementia in people older than 65 was thought to be caused by cerebral arteriosclerosis (hardening of the brains arteries) and was labelled “Senile Dementia”. But attitudes began changing in the 1970’s for several reasons. Evidence was accumulating from autopsy studies that Alzheimer’s disease was, in fact, the most common cause of Dementia in older persons. (Harvard Report) Alzheimer’s Disease is a progressive degenerative disease that attacks the brain and results in impaired memory, thinking and behaviour.
Progressive memory loss is one of the common symptoms of Alzheimer’s disease, loss of short-term memory (essential for absorbing information). It can interfere with ability to interact socially and perform ones work. Disorientation becomes more pronounced and extends to places and people. Sense of time becomes distorted. Changes in personality, loss of language skills, poor judgement and planning occurs. Depression is common, because of chemical changes in the brain, and understandable psychological reaction to the loss of mental abilities. There is a loss of interest in previously enjoyable activities.
Early and careful evaluation is very important because many conditions, treatable or reversible, can cause dementia. If an early diagnosis of Alzheimer’s disease is made there are now treatments available that can to delay the effects. There is a percentage of success with the treatment. The family doctor may do part of the evaluation and then recommend a neurologist, geriatrician, or other specialist to complete it.
There is no cure available for Alzheimer’s disease at present. But good planning and medical and social management can ease the burden on the patient and family. Physical exercise and social activity are important as well as proper nutrition. There are new drugs available now that will relieve some of symptoms. The drugs can give a “boost” to failing memory function. While they are of modest symptomatic benefit it may not alter the rate of progression of the disease or have a curative effect. Improvement has been maintained over a significant period of time- anything from 2-3 years plus. This in turn provides welcome relief to families and carers whose role can be emotionally and physically challenging. There is also a new treatment, which works in a very different way to traditional treatment. It states in their literature that memory loss in Alzheimer’s disease is caused by a disturbance of message signals to the brain. This new drug Ebixa works by enabling the messages to get through and therefore causing less disruption. For information contact your G.P.
At least 30,000 to 40,0000 people are currently diagnosed with Alzheimer’s disease in Ireland but there are a significant proportion of people who have it but remain undiagnosed. The “Silent Dementia”. There is a greater need for public awareness so that people can be diagnosed earlier. (Dr. Brian Lawlor, Professor of psychiatry of the Elderly, St. Patrick Hospital, Dublin).
Not everyone with Alzheimer’s Disease exhibits behavioural problems but they are a common feature. Examples:- Stubbornness, resisting care, refusing to give up unsafe activities, incessant pacing, hand-wringing, wandering, obscene or abusive language, hiding things, getting lost, urinating in unsuitable places, wearing too few or too many clothes, eating inappropriate materials, dropping lit cigarettes, throwing money in the fire etc. A particular behaviour can disappear as a patient’s ability deteriorates only to have new problems emerge.
Alzheimer’s Disease is a world health problem with millions of pounds going into research for cause and cure.
Researchers now understand some of the brain alterations in the disease and have worked to develop drugs that will block the destructive process or stimulate the repair of nerve cells.
Loss of independence
Because of the nature of the disease it is necessary to focus on the needs of the family members and other caregivers and not simply on those of the patient. Most diseases leave the patient in the driver’s seat but not so Alzheimer’s Disease. It is different, Alzheimer’s Disease leaves the sufferer increasingly dependent and incapable of decision making which is essential to self-direction. It places heavy responsibilities in the hands of others more profoundly involved in the patient’s daily life.
It is easier for the family to accept cognitive problems than behavioural problems, which may seem deliberately un-cooperative or spiteful. Alzheimer Patients can be over stimulated when more people are in the house, when dinner preparation is underway or when the T.V. is going. Dim light may contribute to misinterpretation of visual information.
At the end of the day behavioural problems worsen. People are tired, their tolerance for stress is lower and a minor problem can generate a major outburst. Ref: Harvard Health letter special report.
Commonwealth Dept. of Health & Family Services (The Carer Experience)
Are there signs to look out for?
Yes, and the early signs are very important to watch out for to enable an early diagnosis: –
Short term memory loss
It is possible that anyone can suffer from forgetfulness at times but an Alzheimer’s Patient forgets more often and cannot recall names, events, can mislay keys, forget where they live etc.
Evidence of Alzheimer’s Disease may first be evident in fine hand movement – illegible handwriting-clumsiness in buttoning clothing. Eventually walking and eating can become obviously affected.
Persons with Alzheimer’s disease may become withdrawn, irritable, have mood swings. Changes in mood and personality are often the most convincing evidence that something is wrong.
Alzheimer’s Disease can show itself as poor performance in an activity the person once did well. Poor judgement and lack of insight can lead to accidental injuries.
Persons with Alzheimer’s disease can get lost in once familiar places. They may not recognise their own home or relatives. They can have problems with days of the week and time. Disorientation becomes more pronounced as the disease progresses. They may insist it’s time to go home just after arriving or may complain of not having been fed as soon as a meal has ended.
The ability to speak and understand words is gradually affected. Searching for words in sentences that make no sense are common.