Alzheimers

     Alzheimer’s disease is a common neurodegenerative disorder. Originally described in the early 1900s, it is characterized by impairment of short-term memory. Short-term memory is its commonest presenting symptom with preservation of sustained attention and remote memory. It is often necessary to obtain a history from family members and significant others in order to obtain an accurate picture, especially in the early stages of mild Alzheimer’s. The patient often tries to excuse these early symptoms or just to try to explain them away.

     The cognitive deficits associated with Alzheimer’s progress to include other domains to make the diagnosis; for example, involving difficulties with language, visual spatial dysfunction, and difficulties with executive function. Behavioral difficulties, such as depression, are often commonly seen in the early stages. And more difficult behavior features, such as agitation and paranoia, may present themselves later.

      It is becoming clear that it is the overproduction and toxicity of a protein called beta amyloid 42 that is responsible for Alzheimer’s disease. Most of the current investigational research is aimed at reducing the amyloid protein. There are ongoing studies including vaccine studies that are focusing on using antibodies that will target small pieces of this amyloid protein.

     For those who are not able to have the opportunity of such research studies, there are treatments available today for patients with Alzheimer’s.

     The most prominent treatment is the use of cholinesterase inhibitors in the mild to moderate patients. As patients progress, the addition of an antagonist of the NMDA receptors called memantine may be added. Further research is ongoing to find new and more effective therapies for the control of Alzheimer’s.
If the behavior features progress, phamaco therapies for the control of agitation and paranoia will have to be considered and instituted.

     Often times, it’s also important to address not only the care of the patient with Alzheimer’s but also to give some assistance to the caretakers of this individual afflicted by this disorder. If you do have a concern about yourself or a friend or loved one, please consult your Physician or Allied Health Care professional to obtain the appropriate assessments which can include not only the formal cognitive testing but there are various tests to rule out other differential diagnoses of dementia, such as addressing thyroid, calcium, B12, and neuroinfectious ideologies. Other tests that need to be consideration, when appropriate, include neuroimaging and electrophysiology studies to address the patient’s neurologic status.

      Another part of treatment is the non-pharmacologic. It is important to maintain appropriate exercise, both for the brain as well as for the body of these individuals. It’s also important to focus on other medical conditions that may exist and control them as best as possible, such as hypertension and diabetes, and also, if there is an increased BMI, to address issues of appropriate diet. Supplements may also prove beneficial in an effort to preserve memory function. Whenever any medication is added to a patient with Alzheimer’s, as with any other medical condition, it is important to review additional medicines and supplements with your Physician and Allied Health Care professional.

    While many people suffer from this condition each year, there are simple steps that you can take to improve your quality of life. More information regarding these steps is outlined in Dr. Winner's "The 7 Steps to a Healthy Brain".