Alzheimer's Disease

How do you recognise it?

Alzheimer's Disease usually appears first as slight memory loss and confusion. The progressive nature of the disease means that eventually irreversible mental impairment occurs which means that a person’s ability to reason, remember, imagine and learn are destroyed. Everyone forgets simple things every day, like where we left our phone or forget someones name who we don't see very often, but the memory problems associated with Alzheimer's don't go away and just get worse. People with Alzheimer's may:

• Repeat things
• Have problems balancing a cheque book
• Lose sense of time/date
• Have problems performing every day tasks such as knowing what to do if food is burning.
• Hoard items, often coins.
• Have difficulty in finding the right word, or keeping a conversation going
• Misplace things or put them in odd locations
• Eventually forget the names of their own family members and everyday object.
• Show mood swings, distrust in others, increased stubbornness, social withdrawal, depression, anxiety, aggressiveness.
• Forget conversations/appointments.

Causes

There is no one thing known to cause Alzheimer's Disease. Instead, doctors believe it takes a combination of lifestyle, environmental and genetic factors to bring about the symptoms of the disease. There are however some risk factors which seem to put you at more risk of developing Alzheimer's.

Risk Factors:

• Sex: Women are more likely than men are to develop Alzheimer's.
• Mild cognitive impairment: Many people who have have existing memory problems go on to develop Alzheimer's Disease.
• Age: Alzheimer's usually affects people older than 65.
• Heredity: Your risk of developing Alzheimer's appears to be slightly higher if a parent, sister or brother has the disease.
• Lifestyle: Factors that put you at risk of heart disease could also put you at risk of Alzheimer's. 

Stages

The progression of Alzheimer's can be broadly divided into three stages — mild, moderate and severe, although it varies from patient to patient. It is a slow developing condition and causes a gradual decline in cognitive abilities, usually over a span of seven to ten years. Eventually, it will affect nearly all brain functions, including memory, language, movement, judgment, behavior, and abstract reasoning. 

Mild Alzheimer's Disease

• Memory loss, lapses of judgment and subtle changes in personality.
• Decreased attention span and less motivation to complete tasks.
• Resist change and new challenges and get lost even in familiar places.
• They may substitute or make up words that sound like or mean something like the forgotten word.
• They sometimes even avoid talking to keep from making mistakes and appear subdued or withdrawn — especially in socially or mentally challenging situations.
• They may also put things in very odd places. For example, a wallet may end up in the freezer, or clothes may go into the dishwasher.
• They may ask repetitive questions or hoard things of no value. When frustrated or tired, they may become uncharacteristically angry.

Moderate Alzheimer's Disease

• Can’t organize thoughts or follow logical explanations.
• Lose the ability to follow written instructions and often need help choosing proper clothing for the season or occasion.
• Eventually, they’ll require help getting dressed because their confusion may cause them to put their pajamas on over their daytime clothes.
• They may also have episodes of urinary or fecal incontinence.
• It’s usually during this stage that people start having problems recognizing family members and friends. They may mix up identities — thinking a son is a brother or that a spouse is a stranger.
• They may become confused about where they are and what day, season or year it is.
• Because they lack judgment and tend to wander, people with moderate Alzheimer's Disease aren’t safe on their own. They may exhibit restless, repetitive movements in late afternoon, or continually repeat certain stories, words or motions, such as tearing tissues.
• Problems with communication worsen during the moderate stage of Alzheimer's. This can lead to a variety of challenging behaviors, including: Paranoia that sometimes provokes accusations of infidelity or stealing. Agitation, frustration or anger that can lead to cursing, kicking, hitting, biting, screaming or grabbing

Severe Alzheimer's Disease

• Require help with all their daily needs.
• Lose the ability to walk without assistance and then the ability to sit up without support.
• Usually incontinent and may no longer speak coherently.
• Rarely recognize family members. Swallowing difficulties can cause choking, and they may refuse to eat.

How do you treat it?

Conventional medicines

Currently, there’s no cure for Alzheimer's Disease. Doctors sometimes prescribe drugs to improve signs and symptoms that often accompany Alzheimer's, including sleeplessness, wandering, anxiety, agitation and depression. Aricept, Exelon and Reminyl increase the levels of certain chemicals in the brain which helps slow the progression of Alzheimer's. But these don’t work for everyone. Ebixa is the first drug approved to treat moderate to severe stages of Alzheimer's. Ebixa protects brain cells from damage caused by a harmful chemical. It sometimes is used in combination with the drugs mentioned above.

Alternative medicine

Strong scientific evidence exists for the following:

Ginkgo: Overall, it seems that ginkgo may benefit people with Alzheimer's by slowing disease progression. and may be as helpful as drugs such as Aricept.

Sage: Sage has long been suggested as a possible therapy for memory and brain function improvement. There is a lot of evidence for the use of sage for this indication.

Omega fish oils: Omega 3 fatty acids are known to improve mental function, mood, memory and concentration and have already demonstrated considerable success in the treatment of conditions such as depression, anxiety, bipolar disorder, and schizophrenia. There is evidence that Omega 3 fatty acids can slow down the aging of the brain and possibly delay the onset as well as slow down the progress of Alzheimer's too.

Alternative therapies

Brain training exercises: Mental exercises for Alzheimer's Disease are not only a powerful preventative measure; they can slow down, halt or even help to reverse the disease, almost as effectively as the drugs. The good news is you're never too old to start boosting your brainpower. The brain is like muscles in your body in that if you exercise it you can make it stronger, but if you don't it will get weaker. Studies have shown that staying mentally active can slash the chance of getting Alzheimer's disease by half. Playing cards, bridge is often mentioned as an exceptionally good card game for mental stimulation. Jigsaw puzzles and games involving matching cards are very useful tools. Solitaire games of FreeCell and Spider are good too. If they're not already on your computer you can download them for free. Crossword puzzles and Scrabble are also effective brain training tools.

Music Therapy: Music therapy is designed to aid physical and emotional health through the use of music. It has been shown to be beneficial in treating symptoms in Alzheimer’s disease such as agitation and improving quality of life.

Exercise body and mind: In normal people, moderately strenuous exercise has been shown to improve cognitive functioning. In people with Alzheimer’s, studies show that light exercise and walking appear to reduce wandering, aggression and agitation, for instance gardening or yoga. As well as a vital part of treating Alzheimer’s, exercise is also regarded as one of the best was of preventing it. Mounting evidence suggests that physical activity may have benefits beyond a healthy heart and body weight. Evidence shows that exercise which raises your heart rate for at least 30 minutes several times a week can lower your risk of Alzheimer's. Physical activity appears to inhibit Alzheimer's-like brain changes in mice, slowing the development of a key feature of the disease.

Massage and aromatherapy: Massage can be of benefit in a number of health conditions, and a great deal of research has shown its benefits in general health. Fewer studies have looked at its usefulness in Alzheimer’s, but there is some evidence that massage therapy may reduce behaviors such as wandering, aggression and agitation.

There is good scientific evidence to show aromatherapy is of benefit in Alzheimer’s. The oils are generally: Applied directly to the skin (after dilution), often accompanied by massage or heated in an oil burner to produce a pleasant odour. The oils can also be placed in a bath. The two aromatherapy oils are Lemon balm (Melissa officinalis)- this may reduce the loss of chemicals in the brain and Lavender – it may reduced agitation and wandering.

Learn all about the drugs used to treat the disease and any complementary medicines or therapies proven to help. Equip yourself with the tools to manage the condition and not be managed by it.

How do you live with it?

Daily Challenges

People who have Alzheimer's disease often need help handling routine daily activities, such as bathing, dressing, eating and using the bathroom. If your loved one needs this type of care, balance the loss of privacy and independence with gentleness and tact.

Bathing

• Bathing may be a frightening, confusing experience for a person who has Alzheimer's. Having a plan can help make the experience better for both of you.
• Find the right routine. Some people prefer showers, while others prefer baths. Time of day is often important as well. Experiment with morning, afternoon and evening bathing.
• Make it comfortable. Make sure the bathroom is warm, and keep towels or bath blankets handy.
• Keep it private. If your loved one is self-conscious about being naked, provide a towel for cover when he or she gets in and out of the shower or tub.
• Help your loved one feel in control. Explain each step of the bathing process to help your loved one understand what's happening.
• Be flexible. If daily bathing is traumatic, alternate tub baths or showers with sponge baths.

Dressing

• The physical and mental impairment of Alzheimer's can make dressing a frustrating experience — but helping your loved one maintain his or her appearance can promote positive self-esteem.
• Establish a routine. Help your loved one get dressed at the same time each day.
• Limit choices. Offer no more than two clothing options each morning. Empty closets and drawers of rarely worn clothes that may complicate the decision.
• Provide direction. Lay out pieces of clothing in the order they should be put on — or hand out clothing one piece at a time as you provide short, simple dressing instructions.
• Be patient. Rushing the dressing process may cause anxiety.
• Consider your loved one's tastes and dislikes. Don't argue if your loved one doesn't want to wear a particular garment or wants to wear the same outfit repeatedly. 

Eating

• A person who has Alzheimer's may not remember when he or she last ate — or why it's important to eat. Some people who have Alzheimer's want to eat all the time and a lock on the fridge may be necessary, while others need encouragement to eat.
• Eat at regular times. Don't rely on your loved one to ask for food. As Alzheimer's progresses, your loved one may not respond to hunger or thirst.
• Vary the menu. Offer limited but healthy food choices with varied textures, colors and spices.
• Choose foods that contrast with the color of the plate. Alzheimer's disease may compromise your loved one's visual and spatial abilities — sometimes making it tough to distinguish food from the plate.
• Serve things one at a time. Placing only one item on the plate at a time can help keep meals pleasant and simple.
• Be careful when serving hot food. Your loved one may not recognize that a food is too hot to eat.
• Limit distractions. Turn off the television or radio and the ringer on the telephone to help your loved one focus on the task at hand.
• Eat together. Make meals an enjoyable social event so that your loved one looks forward to the experience.

Toileting

• As Alzheimer's progresses, problems with incontinence often surface. Help your loved one maintain a sense of dignity despite the loss of control.
• Make the bathroom easy to find. A sign on the door that says "Toilet" may be helpful. You can even use a picture of a toilet.
• Be alert for signs. Restlessness or tugging on clothing may signal the need to use the toilet.
• Establish a schedule. Schedule bathroom breaks every two hours, before and after meals and before bedtime. Don't wait for your loved one to ask.
• Make clothing easy to open or remove. Replace zippers and buttons with Velcro. Choose pants with an elastic waist.
• Take accidents in stride. Praise toileting success — and offer reassurance when accidents happen.
   

Alzheimer's Disease is a type of dementia that causes problems with memory, thinking and behavior. 

References

1. Alzheimer's Disease Research- A history of Alzheimer's Disease                                                  http://www.ahaf.org/alzheimers/about/understanding/history.html

2. Alzheimer's Association- 10 Signs of Alzheimer's Disease                                                      http://www.alz.org/alzheimers_disease_10_signs_of_alzheimers.asp

3. Mayo Clinic- Risk Factors for Alzheimer's Disease                                                                                                        http://www.mayoclinic.com/health/alzheimers-disease/DS00161/DSECTION=risk%2Dfactors