• Alzheimer's disease - Causes, symptoms and treatment. MF.

    The German psychiatrist Alois Alzheimer in 1906 described a degenerative disease, later named in his name - irreversible progressive senile dementia.

    Augusta D. is a patient of Alois Alzheimer's.1901 .

    Causes of Alzheimer's Disease

    In 2000, 12 million patients were registered worldwide, the incidence of this disease is now being recorded. Perhaps, it is important to increase life expectancy and the tendency towards aging of the population. Age after 65 is a major risk factor for the disease. After 85 years, women are more often sick.

    The words "Alzheimer's disease" terrify people. This is a progressive disease in which the higher mental functions are broken - memory, thinking, emotions, identifying oneself as a person and even the closest surrounding people. Over time, there are physical problems - violated the strength and balance, the functions of the pelvic organs. Man disappears as a person, loses his ability to self-service and is completely dependent on extraneous care.

    Alzheimer's disease in 60 to 70% of cases is the cause of dementia. The development of dementia in Alzheimer's disease is due to the degeneration of cortical neurons and the limbic system of the brain, a violation of synoptic connections caused by the accumulation of oligomers of beta-amyloid and tau protein. In accordance with the most widespread theory of the development of Alzheimer's disease to date, insoluble amyloid plaques and neurofibrillary tangles of tau protein are formed in the brain. The number of plaques and tangles is progressively increasing, inter-neural connections are broken, the functioning of neurons and, in the final analysis, their death. The areas of the brain atrophy, the damage is captured by the entire brain. Changes in the brain develop gradually over 10 to 20 years before the clinical debut of the disease.

    The exact mechanism and causes of the disease, as well as biomarkers, is still unknown.

    Symptoms of Alzheimer's disease

    There are two forms of the disease - sporadic, which accounts for 90% of the disease and the family one, which starts at an earlier age - up to 50 years and is caused by a rare genetic mutation.

    During the disease there are 4 stages - pre-dementia, early dementia, severe dementia.

    The first symptoms are mild cognitive impairment - memory disorders. It is difficult to remember and remember new information, to comprehend it, abstract thinking is broken, it is difficult to understand the meaning of words and their mutual relations. Appearance appears - indifference. This condition can last up to 8 - 10 years.

    Further, memory impairments progress, there are speech disorders, sequences of actions. Speech becomes less fluent, vocabulary becomes poorer, it is more difficult to express your thoughts. There are violations of coordination of fine motor skills - it is difficult to dress, fasten buttons, write, draw.

    When the disease progresses, reading and writing skills are lost. The patient replaces the forgotten words with new ones( paraphrases).Long-term memory is broken and the patient ceases to recognize relatives. There are deviations in behavior - irritability, aggression, vagrancy, crying. .. Violated the function of the pelvic organs - there is incontinence.

    At the last stage, speech is lost almost completely, full apathy, exhaustion develops. The patient is completely dependent on extraneous care.

    Diagnosis of Alzheimer's disease

    Diagnosis of Alzheimer's disease is rather difficult. Therefore, it is very important to describe in detail the changes in the state and behavior of a person, often by relatives or employees. The earlier treatment is started, the longer it can support the cognitive functions of the brain.

    You need to contact a neurologist( to exclude other neurological diseases) and a psychiatrist.

    It is necessary to pay attention to the repetition of the same questions and stories, the prevalence of memories over current events, absent-mindedness, violations of the usual household chores( buying, paying bills, cooking. ..), loss of orientation, apathy, changing personal characteristics, disorientation in time.

    Comprehensive examination with obligatory magnetic resonance imaging of the brain, testing of intellectual functions, blood tests will be required.

    The most informative is photon emission tomography or positron emission tomography, which allows you to see amyloid deposits in the brain. Sometimes the diagnosis is confirmed posthumously in the histological analysis of brain tissue.

    For neuropsychological tests, the violation of eight functions - memory, speech, perception, constructive abilities, orientation in space, time, in one's personality, the ability to solve problems of functioning and self-service is important. For the study of cognitive impairment, neurologists often use the MMSE scale, psychiatrists - more detailed tests.

    Differential diagnosis is performed with other dementias.

    At the development stages are the search for objective markers of blood and cerebrospinal fluid for early diagnosis of Alzheimer's disease, for example, evaluation of the level of various peptides, amyloid plaque derivatives and neurofibrillary tangles, beta-amyloid 42, phosphorylated tau proteins and general tau protein levels.

    The time from diagnosis to death varies depending on the age of the individual, the sex, the severity of cognitive impairment at the time of diagnosis, general health, lifestyle, nutrition, and educational level. If the patient is over 80 years old - the forecast is unfavorable, the expected life time is 3-4 years, with the disease at a younger age, it is possible to live for 10 years. The true cause of death will not be Alzheimer's itself, but exacerbations of concomitant diseases-pneumonia, pressure sores. ..

    Treatment of Alzheimer's disease

    There is currently no medicine that can cure a patient suffering from Alzheimer's disease.
    Cholinesterase inhibitors - donepezil, galantamine, rivastigmine and NMDA-antagonistemanthine - are used to treat cognitive disorders in Alzheimer's disease. The use of drugs is constant with a gradual increase in the dose. Cerebrolysin does not cure the disease, but is a unique neuroprotective drug that slows the progression of dementia.

    Antioxidants and substances that improve blood flow to the brain, microcirculation, hemodynamics, which lower cholesterol, are used in complex treatment.

    Prescribe drugs doctors - neurologists and psychiatrists. Symptomatic treatment of psychiatric disorders is prescribed by a psychiatrist.

    It is important for relatives to understand that the disease is responsible for the patient's illness, not for the person and being tolerant, to learn to care for the sick, to provide him with safety, nutrition, prevention of pressure sores and infections.

    It is necessary to organize the mode of the day, you can make inscriptions - reminders, what you need to do, how to use household appliances, sign photos of unrecognizable relatives. .. stressful for sick situations should be avoided.

    Stimulating methods of treatment are music therapy, art therapy, solving crossword puzzles, physical exercises, communication with animals. As long as possible, it is necessary to maintain the physical activity of the elderly person.

    Prevention of Alzheimer's Disease

    There is currently no proven prevention of Alzheimer's disease. There are associations with the likelihood of developing the disease - this is a correction of the diet, reducing the risk of cardiovascular disease, atherosclerosis, intellectual load. It is recommended to adhere to the Mediterranean diet, eat fruits, vegetables, wheat, cereals, olive oil, fish, red wine, vitamins - B12, B3, C, folic acid. Curcumin( turmeric root spice), cinnamon, grape seed extract, coffee-possible, have an anti-amyloid effect. Studies in mice confirm this action.

    High cholesterol, hypertension, diabetes, smoking, obesity, low physical activity, depression are associated with a risk of developing and a more severe course of Alzheimer's disease. Knowledge of several languages ​​stimulates brain activity. The higher a person's intellect, his intelligence, education, language skills, reading, the greater the brain gets, the more likely it is to avoid dementia, to detach her from the beginning or to soften the course of the illness. Force the brain to work!

    Doctor neurologist Kobzeva S.V.