Understanding Alzheimer

Health, Dr Tatenda Simango

June is Alzheimer’s & Brain Awareness Month, an opportunity to hold a conversation about the brain, and share the fact that Alzheimer’s disease and other dementias are a major public health issue.

Alzheimer’s disease is a progressive neurologic disorder that causes the brain to shrink (atrophy) and brain cells to die. Alzheimer’s disease is the most common cause of dementia — a continuous decline in thinking, behavioural and social skills that affects a person’s ability to function independently

The early signs of the disease include forgetting recent events or conversations. As the disease progresses, a person with Alzheimer’s disease will develop severe memory impairment and lose the ability to carry out everyday tasks.

Medications may temporarily improve or slow progression of symptoms. These treatments can sometimes help people with Alzheimer’s disease maximise function and maintain independence for a time.

At first, a person with Alzheimer’s disease may be aware of having difficulty remembering things and organising thoughts. A family member or friend may be more likely to notice how the symptoms worsen.

Alzheimer’s disease persists and worsens, affecting the ability to function at work or at home.

• People with Alzheimer’s may:
• Repeat statements and questions over and over
• Forget conversations, appointments or events, and not remember them later
• Routinely misplace possessions, often putting them in illogical locations
• Get lost in familiar places
• Eventually forget the names of family members and everyday objects
• Have trouble finding the right words to identify objects, express thoughts or take part in conversations

Alzheimer’s disease causes difficulty concentrating and thinking, especially about abstract concepts such as numbers. Multitasking is especially difficult, and it may be challenging to manage finances, eventually, a person with Alzheimer’s may be unable to recognize and deal with numbers.

Alzheimer’s causes a decline in the ability to make reasonable decisions and judgments in everyday situations. It may be more difficult to respond effectively to everyday problems, such as food burning on the stove or unexpected driving situations.

Once-routine activities that require sequential steps, such as planning and cooking a meal or playing a favorite game, become a struggle as the disease progresses. Eventually, people with advanced Alzheimer’s often forget how to perform basic tasks such as dressing and bathing.

Brain changes that occur in Alzheimer’s disease can affect moods and behaviours. Problems may include the following:

• Depression
• Apathy
• Social withdrawal
• Mood swings
• Distrust in others
• Irritability and aggressiveness
• Changes in sleeping habits
• Wandering
• Loss of inhibitions
• Delusions, such as believing something has been stolen

Many important skills are preserved for longer periods even while symptoms worsen. Preserved skills may include reading or listening to books, telling stories and reminiscing, singing, listening to music, dancing, drawing, or doing crafts.

These skills may be preserved longer because they are controlled by parts of the brain affected later in the course of the disease.

The exact causes of Alzheimer’s disease aren’t fully understood. But at a basic level, brain proteins fail to function normally, which disrupts the work of brain cells (neurons) and triggers a series of toxic events. Neurons are damaged, lose connections to each other and eventually die.

Scientists believe that for most people, Alzheimer’s disease is caused by a combination of genetic, lifestyle and environmental factors that affect the brain over time.

Less than 1% of the time, Alzheimer’s is caused by specific genetic changes that virtually guarantee a person will develop the disease. These rare occurrences usually result in disease onset in middle age.

The damage most often starts in the region of the brain that controls memory, but the process begins years before the first symptoms.

The loss of neurons spreads in a somewhat predictable pattern to other regions of the brains. By the late stage of the disease, the brain has shrunk significantly.

Increasing age is the greatest known risk factor for Alzheimer’s disease. Alzheimer’s is not a part of normal aging, but as you grow older the likelihood of developing Alzheimer’s disease increases.

Your risk of developing Alzheimer’s is somewhat higher if a first-degree relative — your parent or sibling — has the disease. Most genetic mechanisms of Alzheimer’s among families remain largely unexplained, and the genetic factors are likely complex. Many people with Down’s syndrome develop Alzheimer’s disease.

There appears to be little difference in risk between men and women, but, overall, there are more women with the disease because they generally live longer than men.

People who’ve had a severe head trauma have a greater risk of Alzheimer’s disease. Several large studies found that in people age 50 years or older who had a traumatic brain injury (TBI), the risk of dementia and Alzheimer’s disease increased.

Drinking large amounts of alcohol has long been known to cause brain changes. Several large studies and reviews found that alcohol use disorders were linked to an increased risk of dementia, particularly early-onset dementia.

Research has shown that poor sleep patterns, such as difficulty falling asleep or staying asleep, are associated with an increased risk of Alzheimer’s disease.

Research has shown that the same risk factors associated with heart disease may also increase the risk of Alzheimer’s disease. These include:

· Lack of exercise

· Obesity

· Smoking

· High blood pressure

· High cholesterol

· Poorly controlled type 2 diabetes

Alzheimer’s disease is not a preventable condition. However, a number of lifestyle risk factors for Alzheimer’s can be modified. Evidence suggests that changes in diet, exercise and habits — steps to reduce the risk of cardiovascular disease — may also lower your risk of developing Alzheimer’s disease and other disorders that cause dementia. Heart-healthy lifestyle choices that may reduce the risk of Alzheimer’s include the following:

· Exercising regularly

· Eating a diet of fresh produce, healthy oils and foods low in saturated fat

· Following treatment guidelines to manage high blood pressure, diabetes and high cholesterol

· Asking your doctor for help to quit smoking if you smoke

Studies have shown that preserved thinking skills later in life and a reduced risk of Alzheimer’s disease are associated with participating in social events, reading, dancing, playing board games, creating art, playing an instrument, and other activities that require mental and social engagement.-Mayoclinic.org