Alzheimer's disease is
a chronic neurodegenerative disease that usually has a subtle beginning and
worsens progressively. It is mostly characterized by memory loss and cognitive
disorders. This is the most common form of dementia- more than 70% of the cases
with dementia, can be attributed to Alzheimer. It affects 5.4 million Americans,
from which 5,2 million are over the age 65.
Causes
Alzheimer's disease is related with deficiency of neurotransmitters within the central neuros system. The neurotransmitters are chemical substances that transport the neuronal signals from one neuron to the other. When there are not enough neurotransmitters the processes in the nervous system are seriously disturbed. Acetylcholine is the main mediator which quantity is decreased in the evolution of Alzheimer. Other substances such as GABA, glutamate and aspartate may also be involved.
Alzheimer's disease is related with deficiency of neurotransmitters within the central neuros system. The neurotransmitters are chemical substances that transport the neuronal signals from one neuron to the other. When there are not enough neurotransmitters the processes in the nervous system are seriously disturbed. Acetylcholine is the main mediator which quantity is decreased in the evolution of Alzheimer. Other substances such as GABA, glutamate and aspartate may also be involved.
The exact etiology of
the disease is so far unclear. There are several hypotheses:
• Amyloid hypothesis- it claims that the accumulation of Beta-amyloid into the interneuron space is the reason for the neuronal degeneration. Beta-amyloid is a fragment of a larger protein situated in the neuronal membrane, called Amyloid precursor protein. It is assumed that incorrectly folded Beta-amyloid accumulates, forms plaques that disturb the calcium balance in neurons and induce apoptosis (cell death). In vitro studies have proven its neurotoxicity.
• According to another hypothesis, hyper phosphorylation of a protein, called Tau protein is the main cause for Alzheimer. Tau protein binds to the microtubules of the cell skeleton and takes part in the neuronal transport. Hyper phosphorylation of tau protein makes it bind to microtubules much more than normal. This leads to the formation of neurofibrillary tangles, which disrupt the cell metabolism. Amyloid plaques and neurofibrillary tangles are clearly visible by microscopic examination of the brain tissue of Alzheimer's patients.
• The role of heavy metals, and certain viruses such as Herpes simplex virus type I is also discussed in the development of Alzheimer.
• Amyloid hypothesis- it claims that the accumulation of Beta-amyloid into the interneuron space is the reason for the neuronal degeneration. Beta-amyloid is a fragment of a larger protein situated in the neuronal membrane, called Amyloid precursor protein. It is assumed that incorrectly folded Beta-amyloid accumulates, forms plaques that disturb the calcium balance in neurons and induce apoptosis (cell death). In vitro studies have proven its neurotoxicity.
• According to another hypothesis, hyper phosphorylation of a protein, called Tau protein is the main cause for Alzheimer. Tau protein binds to the microtubules of the cell skeleton and takes part in the neuronal transport. Hyper phosphorylation of tau protein makes it bind to microtubules much more than normal. This leads to the formation of neurofibrillary tangles, which disrupt the cell metabolism. Amyloid plaques and neurofibrillary tangles are clearly visible by microscopic examination of the brain tissue of Alzheimer's patients.
• The role of heavy metals, and certain viruses such as Herpes simplex virus type I is also discussed in the development of Alzheimer.
• The oxidative stress
is also a factor for Alzheimer's disease progression. It is proved that long
term use of vit.E, which is a powerful antioxidant, slows down the progression
of the condition.
Risk factors
• Age over 65 years
• Family history of Alzheimer- the role of the genetic factors is undoubtable. The disease can start earlier in patients with family history of Alzheimer
• Female sex
• Diabetes
• High cholesterol
• Atherosclerosis
• Education and occupation- people with higher educational degree and those who are engaged with intellectual work are less threatened by Alzheimer
• Age over 65 years
• Family history of Alzheimer- the role of the genetic factors is undoubtable. The disease can start earlier in patients with family history of Alzheimer
• Female sex
• Diabetes
• High cholesterol
• Atherosclerosis
• Education and occupation- people with higher educational degree and those who are engaged with intellectual work are less threatened by Alzheimer
Symptoms
Alzheimer disease has three stages: mild, moderate and severe and each one is characterized by different symptoms.
► Mild Alzheimer- usually lasts from 2 to 4 years. Many of the symptoms are not specific and could be attributed to other conditions
• Short term memory loss- impossibility to remember things that just happened
• Language problems- difficult expression of thoughts
• Difficulty to understand others
• Coordination problems using familiar objects
• Driving problems such as getting lost on familiar itineraries
• Mood changes
• Lack of motivation
• Decreased interest in everyday activities like reading or watching TV
• Social isolation
► Moderate Alzheimer- the memory loss becomes more noticeable and begins to trouble the life of the patient. Usually lasts 2-10 years. The patient may or may not be aware of his condition. Realizing his lack of control over the situation, may throw the patient into deep depression. Typical symptoms include:
• Forgetting details about his own life like when or where he was born
• Forgetting where he lives.
• Hardly recognizing friends and relatives
• Use of wrong words or messy speech
• Impossibility to solve simple problems
• Getting angry, upset or paranoid very fast- for example the patient may think that the ones that take care of him, are trying to hurt him
• Getting lost in familiar places or being unable to remember why or how he got there
• Not dressing in accordance with the weather
• Having sleeping troubles
► Severe Alzheimer- the last stage of the disease lasts between 1 and 3 years. One by one body functions are declining, ultimately leading to death. Patients may experience some of the enumerated symptoms:
• Impossibility to remember, express himself or learn new information
• Unable to differentiate past, present and future
• Can't move on its own
• Urinary and fecal incontinence
• Hallucinations
• Extreme mood changes
Alzheimer disease has three stages: mild, moderate and severe and each one is characterized by different symptoms.
► Mild Alzheimer- usually lasts from 2 to 4 years. Many of the symptoms are not specific and could be attributed to other conditions
• Short term memory loss- impossibility to remember things that just happened
• Language problems- difficult expression of thoughts
• Difficulty to understand others
• Coordination problems using familiar objects
• Driving problems such as getting lost on familiar itineraries
• Mood changes
• Lack of motivation
• Decreased interest in everyday activities like reading or watching TV
• Social isolation
► Moderate Alzheimer- the memory loss becomes more noticeable and begins to trouble the life of the patient. Usually lasts 2-10 years. The patient may or may not be aware of his condition. Realizing his lack of control over the situation, may throw the patient into deep depression. Typical symptoms include:
• Forgetting details about his own life like when or where he was born
• Forgetting where he lives.
• Hardly recognizing friends and relatives
• Use of wrong words or messy speech
• Impossibility to solve simple problems
• Getting angry, upset or paranoid very fast- for example the patient may think that the ones that take care of him, are trying to hurt him
• Getting lost in familiar places or being unable to remember why or how he got there
• Not dressing in accordance with the weather
• Having sleeping troubles
► Severe Alzheimer- the last stage of the disease lasts between 1 and 3 years. One by one body functions are declining, ultimately leading to death. Patients may experience some of the enumerated symptoms:
• Impossibility to remember, express himself or learn new information
• Unable to differentiate past, present and future
• Can't move on its own
• Urinary and fecal incontinence
• Hallucinations
• Extreme mood changes
Treatment
There is no cure for Alzheimer. Efforts are directed at slowing down the progression of the disease. Symptomatic treatment is the only option available. It includes:
• Inhibitors of the enzymes that destroy the acetylcholine, such as galantamine
• Drugs that improve the processes of education and memorization like pyracetam
• Drugs and supplements that improve the blood supply of the brain like Gingko biloba
• Antidepressants, such as Zoloft and Prozac
• Anxiolytics like for example Xanax
• Vitamin E and other supplements such as omega 3-fatty acids, coenzyme Q10, calcium that are considered to have neuroprotective effect. Except for vit. E, for the moment there are no enough data to confirm their efficacy.
• Alternative medicine, such as art or music therapy, could be beneficial for improving cognitive functions and depression as well as for stimulating the brain functions in patients with Alzheimer.
There is no cure for Alzheimer. Efforts are directed at slowing down the progression of the disease. Symptomatic treatment is the only option available. It includes:
• Inhibitors of the enzymes that destroy the acetylcholine, such as galantamine
• Drugs that improve the processes of education and memorization like pyracetam
• Drugs and supplements that improve the blood supply of the brain like Gingko biloba
• Antidepressants, such as Zoloft and Prozac
• Anxiolytics like for example Xanax
• Vitamin E and other supplements such as omega 3-fatty acids, coenzyme Q10, calcium that are considered to have neuroprotective effect. Except for vit. E, for the moment there are no enough data to confirm their efficacy.
• Alternative medicine, such as art or music therapy, could be beneficial for improving cognitive functions and depression as well as for stimulating the brain functions in patients with Alzheimer.
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