Alzheimer's Disease (Senile Dementia)

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Alzheimer's Disease
Body Parts: Head
Medical Subjects: Brain
Overview

What Is Alzheimer's Disease

This is a group of primary brain degeneration diseases with unknown causes. Often onset in old age or pre-old age, slow onset, gradual progress, with dementia as the main performance. The disease started before old age or had a family history of the same disease and developed rapidly. It is generally believed that the prevalence rate will double for every 5 years of age increase. More than half of them are Alzheimer's disease, and women are more common than men.

Cause

What's The Cause Of Alzheimer's Disease

In recent years, there has been an important breakthrough in the study of the etiology of Alzheimer's disease. By using molecular genetics and linkage analysis, it is found that Alzheimer's disease is a familial hereditary disease. In addition, it is found that the risk of Down syndrome is also increasing, and there is a potential familial connection.

Other hypotheses about etiology include:

1. Acceleration of normal aging process, accumulation of neurotoxins such as aluminum or silicon in brain.

2. Progressive failure of the immune system.

3. Decreased detoxification function and chronic virus infection may be related to the occurrence of Alzheimer's disease.

4. Those who are old, widowed, poorly educated, living alone, in economic distress, and living in extreme poverty have more chances of getting sick.

5. Psychosocial factors may be the inducement of this group of diseases.

Symptom

What Are The Symptoms Of Alzheimer's Disease

There are many hidden attacks, and a few patients have symptoms quickly under the condition of physical illness, fracture or mental stimulation. Memory disorder is often the first symptom of this disease, such as losing things frequently, forgetting promised things, repetitive words and so on. After that, the decline of intelligence became more and more serious. After eating, I didn't know how to be hungry. After going out, I couldn't find my own home, couldn't name my family, and even couldn't answer my name, age and whether I was married correctly. Sometimes there are misconstruction and fiction due to memory loss, or because they can't find their own objects, they suspect being stolen by others, or because of strong jealousy, they suspect that their spouse is unfaithful. The delusions of such fragments can fade away with the aggravation of dementia, and the patients' ability of spatial orientation is often damaged in the early stage, so they can't copy simple three-dimensional graphics, which can be detected from neuropsychological tests. Some patients can't use vocabulary correctly, can't know their own image in the mirror, and can still have some primitive reflexes such as loss of speech, agnosia, disuse, lack of self-awareness and strong grip and sucking.

Some patients are mainly emotional disorder in early stage, showing manic or depressive symptoms, and may be misdiagnosed as functional psychosis. With the gradual aggravation of illness, dementia symptoms become more and more obvious before being diagnosed. Patients still have personality changes, lack shame and moral sense, do not pay attention to personal hygiene, can't take care of their own lives, often collect waste paper and sundries as treasures, and in the later stage, they are bedridden all day long, incontinent, slurred speech and disorganized speech. Hallucinations, etc., are often caused by acute mental trauma, changing environment or various physical diseases, such as asymptomatic pneumonia, urinary tract infection, fracture trauma, excessive sedatives, nutrition and electrolyte disorders, etc., if the causes can be removed. If properly handled, the consciousness can be recovered clearly, but there are still different degrees of personality changes and intelligence defects.

 

Detect

How To Check For Alzheimer's Disease

Laboratory examination, as a part of dementia assessment, is an indispensable examination item for determining the causes of dementia and common coexisting diseases among the elderly. Thyroid function examination and serum vitamin B12 level determination are necessary items to determine other special causes of dementia. The following checks should also be made:

1. The whole blood cell count.

2. Determination of blood urea nitrogen, serum electrolyte and blood glucose levels.

3. Liver function examination.

When the characteristics of medical history or clinical situation suggest that the cause of dementia may be infection, inflammatory disease or exposure to toxic substances, the following special laboratory tests should also be carried out, such as syphilis serological test, erythrocyte sedimentation rate, human immunodeficiency virus antibody test or heavy metal screening.

Imaging examination of nervous system plays an important role in the diagnosis of Alzheimer's disease, especially helping to eliminate other causes of dementia. At present, it is suggested that patients should be examined by computerized tomography (CT) or magnetic resonance imaging at least once in the course of dementia. Using positron emission tomography or single photon emission CT for functional imaging examination may be helpful for differential diagnosis of dementia-related diseases. Among them, EEG showed only slow A rhythm in the early stage and diffuse slow wave in the late stage. CT examination can show cortical atrophy and enlargement of the third ventricle.

Prevention

How To Prevent Alzheimer's Disease

The prevention of Alzheimer's disease should start at the age of 40, strengthen at the age of 50, and become regular at the age of 60.

1. To strengthen prevention from internal and external environmental factors such as psychology, personality, diet and nutrition, air quality, etc. Among them, psychological factors are particularly important. Attention should be paid to maintaining a good state of mind and ensuring the balance between mental state and mental state.

2. Think more and take the initiative to do mental activities. Pay attention to adjust mood, cultivate sentiment, enrich cultural life, and constantly absorb spiritual nutrition.

3. Establish a scientific and reasonable lifestyle and develop a good living habit.

4. Pay attention to exercise and persevere, and combine static and dynamic, work and rest, such as playing the piano, drawing, fishing, etc.

5. For postmenopausal women, estrogen and progesterone replacement therapy should be carried out under the guidance of gynecologists in early menopause. Estrogen+progesterone replacement therapy can protect endothelial function, which is better than estrogen alone.

6. Men should increase androgen secretion. Protect endothelial function by regulating endocrine hormone balance.

7. Use antioxidants, such as Ginkgo biloba preparation, vitamin C, E, β-carotene, superoxide dismutase (SOD), etc., to resist the accumulation of oxygen free radicals.

8. Use folic acid, vitamin B6, B12 and other drugs to promote homocysteine metabolism.

9. Use anti-inflammatory agents, such as aspirin and indomethacin.

10. Eat foods rich in L-arginine and less methionine, such as nuts, black sesame seeds, black beans, oats, etc.

The above measures can play a role in preventing and delaying the occurrence and development of Alzheimer's disease, and may have the effect of relieving symptoms for early and middle stage patients.

Treatment

How To Treat Alzheimer's Disease

At present, there is a lack of special etiological treatment measures, and the care and nursing in general life is extremely important. Pay attention to patients' diet, nutrition and daily cleanliness, try to urge patients to take care of their own lives, and encourage patients to participate in appropriate activities to slow down their mental decline. Avoid letting patients engage in dangerous activities alone. Bedridden patients should be prevented from bedsore, infection and fracture.

The drugs used to improve cognitive function and promote brain metabolism are: aminothiophanate-methyl, Y-aminothiophanate, Naofuxin, ribonucleic acid, ergotamine oxide, huperzine and choline precursor dimethylaminoethanol, etc., and calcium antagonists: sibelium, nimodipine, etc. General patients don't need to take antipsychotics. If they have mental excitement or depression, behavior disorder and difficulty in management, they can give a small amount of nerve blockers or anti-anxiety or anti-depression drugs, but they should pay attention to side effects. When symptoms improve, they should stop taking drugs in time.

 

Identify

How To Identify Alzheimer's Disease

1. It is difficult to distinguish Alzheimer's disease from Pick's disease in clinic. The onset age of Alzheimer's disease is usually between 45 and 55 years old, and it is more common in women. It has obvious family genetic tendency, slow onset, early change of personality and apathy, poor initiative, and long memory and computing power, and finally turns into dementia. Head CT showed asymmetric enlargement of ventricles and local brain atrophy, especially frontal lobe, followed by temporal lobe. There is no special treatment.

2. Multiple infarct dementia is a kind of dementia caused by secondary cerebral artery infarction. Most patients have a history of hypertension, arteriosclerosis or stroke, and may have transient ischemic attack, such as transient hemiplegia, aphasia or visual impairment. Memory loss is the first symptom of slow onset, especially near memory impairment, far memory impairment is not obvious, accompanied by emotional instability and emotional fragility, and even tears or excitement for trivial matters. This phenomenon is called "Emotional Incontinence", and the ability to work and live declines, but the personality remains good. Acute onset patients often have a history of stroke or confusion, and when they are conscious, they show the above emotional symptoms and mental decline. Head CT showed multiple scattered low density areas, and the disease was aggravated in a step-like manner, which could be distinguished from AD.

3. Elderly patients with depression often have difficulty in thinking, slow response, low tone and clumsy movements, which are easy to be mixed with early Alzheimer's disease, especially those with depression. However, depression patients can show good memory, attention and calculation ability in a short time through encouragement, and generally have no mental retardation and personality changes.

4. The elderly often appear delirium after physical disease injury or operation, showing memory and orientation disorder, which is similar to dementia, but delirium often occurs suddenly, with fluctuating symptoms and severe night, and the response to environmental stimulation or illusion is rapid and strong, which is obviously different from apathy and idiocy of senile dementia, and can be identified.

5. Other diseases manifested as dementia, such as hypothyroidism, collagen system diseases, pernicious anemia, Parkinson's disease, paralytic dementia, etc., all of which have corresponding physical signs and positive laboratory examination results in early comprehensive medical history, and can find the primary disease, and its symptoms can be improved and recovered after giving corresponding treatment, which can be identified.

Complication

What Are The Complications Of Alzheimer's Disease

1. Behavioral complications include unfriendly, excited, lost and uncooperative.

2. Mental complications include depression, anxiety and paranoid reaction.

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