Alzheimer’s Disease: Understanding Alzheimer’s when dementia isn’t just about memory.

Alzheimer's Disease: Understanding Alzheimer's when dementia isn't just about memory.

Get to know Alzheimer’s disease
Alzheimer’s is one of the diseases caused by the deterioration of the functioning or structure of brain tissue, which is often found in the elderly. It’s not a natural deterioration, because the elderly don’t have to have Alzheimer’s at all. But it is a degenerative type of protein called beta-amyloid, an insoluble type. When it comes to brain cells, it can cause dementia cells and atrophy. This can also damage communication between brain cells by decreasing acetylcholine. This is a neurotransmitter that directly affects memory.

The accumulation of beta-amyloid results in a gradual decrease in brain performance. It starts with the hippocampus that plays an important role in remembering new information. When this part of the brain cells is destroyed, Patients will begin to have memory problems, especially short-term memory. Then the damage is spread to other parts of the brain and affects learning, feelings, thoughts, language, and behavior.

Alzheimer’s and dementia.
Alzheimer’s disease and dementia syndrome are different. Understanding the differences will help patients and relatives better understand the doctor’s diagnosis. However, dementia means abnormal syndrome as a result of multiple brain degeneration. This is found in the elderly. It can be divided into 2 types:

Curable dementia
It found about 20% of all dementia patients It is often caused by physical diseases such as cerebral palsy, cerebral hemorrhage, some brain tumors, vitamin B12 deficiency, and thyroid hormone deficiency.

Incurable dementia
It found up to 80% of dementia patients, and it causes form Alzheimer’s disease is 50 percent. The rest are five to six alzheimer’s-like dementia-like diseases. As a result, Alzheimer’s is the most common cause of dementia.

Age
Age is classified as a risk factor that increases the likelihood of Alzheimer’s disease. The older you get, the more likely you are to develop the disease. Current statistics show that 65-year-olds experience about 5 percent of Alzheimer’s patients. About 15 percent of people with Alzheimer’s were found to be in the 75s. And groups of seniors aged 85 and over up to 40 percent of Alzheimer’s patients were found. As a result, the number of Alzheimer’s patients is likely to continue to increase as people live longer. Alzheimer’s disease can also be hereditary. But it’s a minority, that’s only about 5 percent. The patient begins to experience symptoms from the age of 50 to 60 years old.

When do I need to see a doctor?
When a memory problem occurs or forgetfulness, This results in difficulty managing everyday life. For example, slow down. Make mistakes more often. Or forgetfulness. This results in problems managing daily life on their own. For example, need helpers to pay. Need an assistant to prepare regular medicines, etc.

Alzheimer’s isn’t just forgotten.
The first major symptom of Alzheimer’s patients is short-term memory loss. This is a symptom that is similar to natural amnesia in the elderly. But over time, 80-90 percent of patients will also have behavioral or psychiatric symptoms. This behavioral condition makes it more difficult to care for patients. Especially those with aggressive symptoms.

Common symptoms of Alzheimer’s disease can be roughly divided into 3 phases:
First phase: The patient has a regressive memory that they can feel, like to ask repeatedly about the same thing. Confused direction Starting to get stressed, easily upset, and depressed. But they can also communicate and do their daily routines. It is a phase in which those around the patient can still take care of them.

Medium-term: The patient has more obvious symptoms. The memory gets worse. Walk out of the house without a destination. The behavior has changed a lot. For example, from being calm, it becomes irritated, aggressive, rude. Or, from a hot-tempered person, it turns out to be quiet. And over time, Patients will begin to have difficulty using daily life. For example, can’t make coffee. Can’t use tv remote or mobile phone Think something wrong. Not living in real the world. For example, i think someone’s going to kill me for stealing things, thinking that your spouse is cheating. These are all difficult symptoms to care for and socialize.

End phase: The patient’s symptoms worsen. Less responsive to the surroundings, Health deteriorated like a patient stuck in a bed. Eat less. Less movement or no movement at all, can’t help themself. Dementia is widespread, much less speaking. Weakened immunity, which often leads to infection and eventually death. The total duration from the first diagnosis to death is approximately 8-10 years.

Risk factors for Alzheimer’s disease
Age increases as the most important risk factor, with the fact that after the age of 65, the patient is twice the risk of developing the disease in every 5 years.

Genetics, for example, has many direct relatives in families with this disease, some genes such as ApoE4, etc.

Down’s syndrome, This group of patients is considered to be at risk of developing the disease. It is also found that patients with certain protein accumulation disorders can also cause Alzheimer’s disease.

Head injury, Several epidemiological studies have been reported, People with Alzheimer’s disease and other causes of dementia have a history of having more head injuries than people without dementia. However, some studies have not found that getting head injuries before is a risk factor for dementia.

Alzheimer’s disease has been found to be caused by vascular disease. It is also commonly found in cerebral vascular disease.

Therefore, the risk factor for stroke may also be a risk factor for Alzheimer’s disease. as follows:

  1. Overweight
  2. Lack of exercise
  3. Smoking
  4. High blood pressure
  5. Hyperlipidemia
  6. Diabetes

Prevention of Alzheimer’s Disease
The exact cause of Alzheimer’s disease is not yet known. Prevention of the disease reduces the risk factors that may cause the disease as follows:

  1. Eat 5 groups of nutrition, avoid foods high in saturated fats and cholesterol.
  2. Maintain weight not exceeding the standard.
  3. Do not smoke and avoid the smoking area.
  4. Regular exercise
  5. Be careful about brain accidents. To fall apart
  6. Take care of your health, annual health check-up periodically, monitors the existing diseases. If you have an illness, see your doctor early.

In addition, brain training, such as numeracy, read books, play games, try using new equipment, Frequent meetings with others, Having a social relationship, such as going to a party, attending an elderly club. It may help prevent dementia and also help older people live a happy and happy life.

Alzheimer’s Care
There is currently no evidence of a cure for the disease. Therefore, it focuses on care to help reduce cognitive impairment. and encourage patients to carry out their daily routines and socialize as much as possible.

Non-Pharmacological Management
There are many forms of treatment in this way. It depends on the severity of the disease and the learning capacity of each patient. The focus is on the patient can be used in daily life according to the stage of the disease. as follows:

  1. Daily care and social skills training.
    Patients are encouraged to take care of their daily routines. The caregiver is supported and assisted according to the patient’s capacity. Encourage patients to participate in family and external social activities as appropriate.
  1. Environmental stewardship and optimization.
    Reduces stimuli that worsen symptoms such as noise. It is easy to operate and maintain a safe, easy-to-use housing environment, such as smoothing the floor. There are no roughly things and enough light to reduce accidents.
  1. Educating patient caregivers.
    As the patient enters a state of reliance on others, Caregivers are the most important person to understand the progression of the disease. and knowledge of patient care in each stage of the disease. As well as supporting the self-care of the caregiver.
  1. Rehabilitation of physical for dementia patients.
    As patients with dementia may have reduced capacity to use various devices. Make it easy-to-use or safe to simplify or simplify elderly activities. This includes practicing the stimulation of the three-touch system by massage. Stimulating movement activity will allow the patient to practice physical fitness better.
  1. Behavioral care and psychotherapy.
    Behavioral and emotional problems are common disorders. Treatment may be required in tandem with both drug treatments, behavioral, and psychotherapy. It may be used to educate caregivers to understand the patient and provide appropriate care. For example, deviating from the patient’s attention from an irritable or angry subject, emotional enhancement with music therapy, etc.

Pharmacological Management.
At present, there is no evidence that there are drugs that can cure the disease. However, there may be some medications that can be used to treat symptom relief and palliative treatment which is divided into two main groups.

  1. Medications are used to treat cognitive symptoms.
    These include a group of drugs that inhibit substances that destroy neurotransmitters in the brain (acetylcholine esterase inhibitor). This increases the number of neurotransmitters. For example, dopezil, galantamine, rivastigmine, etc. Can be used on patients with mild to severe symptoms.
    There is also the NMDA receptor antagonist like memantine. This prevents glutamate from catching up with the receptor, reducing the poisoning of neurons. It is used in patients with moderate to severe symptoms.
  1. Medications are used to treat behavioral, emotional, and mental disorders.
    Behavioral, emotional, and mental disorders are common in dementia patients. This may require medication based on psychotic symptoms. For example, antidepressants, delusional drugs, hallucinations and jitters, anxiety relievers, or sleeping pills. The doctor may adjust the medication according to the symptoms to balance it, considering the benefits and side effects of the drug.

However, the care of dementia and Alzheimer’s patients. It is necessary to take care of the co-conspirator, consisting of physical, psychological, behavioral care, and Socialization. This includes educating and supporting caregivers to ensure a better quality of life.

Guidelines for patient care for Alzheimer’s disease.

  1. Encourage the elderly to perform their daily routines for as long as possible. Stimulating the perception of eating Cleanliness and excretion control
  2. Solve mental and behavioral problems, take care of stress reduction, anxiety, tiredness, walking around all the time. Keep the environment simple, safe, refrain from caffeine, caregivers should be patient and Speak in a soft tone.
  3. Keep the environment safe, the floor is not slippery. Install a handrail for catching along the walkway or staircase. Light fixtures suitable for activities.
  4. Make know yourself and reality. Discuss past experiences that are interested in the elderly, such as daily life.
  5. Maintain balance, relaxation, exercise, society, and communication.

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