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Alzheimer's disease

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VOL: 101, ISSUE: 46, PAGE NO: 23



- Alzheimer's is a disorder of the brain that affects a person's ability to carry out normal daily activities.

- It involves the part of the brain that controls thought, memory and language. The structure of the brain changes as the cerebral cortex atrophies and shrinks. Levels of brain chemicals that carry messages between nerve cells fall. Beta-amyloid protein plaques and neurofibrillary tangles build up in brain tissue.

- Most cases of Alzheimer's occur in older people. Its incidence in people below the age of 65 is one in 1,000. Over the age of 65 the likelihood of developing the disease doubles every five years (Alzheimer's Association, 2005).

- Scientists do not yet fully understand what causes the disease. Several factors can affect people in different ways:

- Age;

- Genetics - there is a clear genetic link in a small number of families where early-onset Alzheimer's develops (before 65), although it is not inevitable;

- Down's syndrome - 15 per cent of people with Alzheimer's have Down's syndrome;

- Environment, education and diet - though none of the theories involving these has yet been supported.

- Alzheimer's develops slowly. In the early stage people may have trouble remembering recent events, activities, or the names of familiar people or things.

- As the disease progresses memory loss begins to interfere with daily activities - people in the middle stages may forget how to do simple daily tasks, such as bathing or cooking, and lose the ability to think clearly. They will have trouble recognising familiar people and places and begin to have problems speaking, understanding, reading or writing.

- In the later stages, people with Alzheimer's may become anxious or aggressive and be difficult to control, wandering away from home and becoming a danger to themselves. Eventually, they will require total care.

- The definitive test for Alzheimer's is an autopsy to see whether there are plaques and tangles in brain tissue.

- A diagnosis of 'possible' Alzheimer's is usually made while the person is alive by:

- Asking questions about the person's general health, past medical problems and ability to carry out daily activities;

- Tests of memory, problem-solving ability, attention span and use of language;

- Blood, urine, or spinal fluid tests and brain scans.

- There is no cure. Treatment is based on symptom reduction.

- Certain medicines can be useful in early-onset Alzheimer's, including donepezil, rivastigmine and galantamine. They must be reviewed every six months.

- Medication can help to reduce behaviour problems.

- Alternative therapies such as music therapy and reminiscence therapy can be beneficial.

- Patients should be encouraged to use the brain, and the environment should be as stimulating as possible without being overwhelming.

- Research is ongoing into the treatment and causes of Alzheimer's. Various theories are under investigation, including:

- The beneficial effect of a diet high in saturated fats and low in carbohydrates;

- Whether smoking increases the chances of developing the disease;

- Whether brain stem cell therapy is viable;

- Whether vaccination to prevent the development of plaques in the brain is viable.

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