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Thursday, December 30, 2010


Alzheimer's disease
Classification and external resources

Comparison of a normal aged brain (left) and an Alzheimer's patient's brain (right). Differential characteristics are pointed out.

(Dementia of the Alzheimer type)
Alzheimer's disease is a brain disorder in which memory, thought processes and behavior become progressively impaired. It is named for Dr. Alois Alzheimer, the German neurologist who first described it in the early 1900s.  He discovered during an autopsy of a woman who had died of progressive dementia that her brain was riddled with plaques and tangles of abnormal nerve cells, the hallmarks of the disease.

What causes Alzheimer's disease remains unknown. Woman have a higher incidence of Alzheimer's than men and recent research indicates that the hormonal changes following menopause may play a role. Brains afflicted with Alzheimer's have large amounts of an abnormal substance, called amyloid protein. Researchers are now trying to determine whether these abnormalities stem from a viral infection or genetic trait or perhaps are caused by an environmental toxin.

Diagnostic Studies and Procedures
Only an autopsy can reveal the brain irregularities of Alzheimer's disease. Thus diagnosis in a living person requires a process of elimination  to rule  out other possible causes of progressive mental deterioration.

The physical examination is usually concentrated on neurological function, although a doctor may also look for circulatory or respirotary disorders. Special studies might include psychological test, blood and urine analyses, skull X-rays, electroencephalography and perhaps a CT brain scan or MRI.

Medical Treatments
Until recently, there was little that doctors could do to prevent or treat Alzheimer's disease. But on-going studies and new drugs are altering this situation. For example, several studies show a 40 percent reduction in the incidence of Alzheimer's among older woman on estrogen replacement therapy. Researchers have also found that estrogen seems to slow progression of  the disease.

In 1997 researchers reported that ibuprofen, a common painkiller, seemed to protect against Alzheimer's. But more study is needed to prove this.

About 20 percent of the Alzheimer's patients who take tacrine (Cognex), a drug released in 1993, show significant improvement in mental functioning and in additional 20 percent the disease's progress is slowed. However, many patients cannot take tacrine because it can cause serious liver damage. Patients taking Cognex must undergo frequent blood tests to determine if there is any liver damage, the major adverse effect of the drug.

Some of the more troubling symptoms of Alzheimer's can be treated with older medications. For example, sedatives may be prescribed for sleep problems, antipsychotic drugs to calm psychosis and aggressiveness and stimulants such as methylphenidate (Ritalin) to improve mood.

Alternative Therapies
As with medical treatments, the goal of any alternative therapy for Alzheimer disease is to provide comfort.

Herbal Medicine. Substances derived from leaves of the ginkgo tree have been shown to increase blood flow to the brain. Herbalist have long recommended ginkgo products to improve memory, recent research supports some of these claims.

Hydrotherapy. As an alternative to drug, some nursing homes use warm baths to soothe agitated or anxious patients. A word of caution, however: To prevent accidental drowning, an elderly person with Alzheimer's should never be left alone in a hot tub or bath.

Music Therapy. There is ample evidence that people with declining mental function can receive a great deal of pleasure from listening to music, both alone and from group activities planned around singing. Even when verbal memory fades, the ability to recognize and remember music remains intact. Music therapists find that playing songs popular during a patient's youth, or music associated with a particular time and place, jogs others memories. 

Nutrition Therapy. Some proponents of vitamin therapy recommend high doses of antioxidants - vitamins A,C and E and the mineral selenium - to slow the progress of Alzheimer's disease. When consumed in food, these nutrients help counter the damage of unstable molecules called free radicals, which are a by-product of oxygen metabolism. As yet, there is no convincing scientific evidence that antioxidant supplements can benefit Alzheimer's patients.
Pet Therapy. Nursing homes often provide gentle cats, dogs or other animals for Alzheimer's patients. Simply making contact with another living creature can be immensely conforting.
Self-Treatment. Following a set routine in a familiar environment helps Alzheimer's patients cope with the early stages of memory loss. Unavoidable changes should be made gradually to avoid disorientation and confussion. In the early stages of  memory loss, some Alzheimer's patients write notes to themselves and post them in obvious places. This eases some of the anxiety over forgetting important task and appointments. Family members can coax memories by recalling past events.

Other Causes of  Dementia
During the diagnostic process, disorders that should be ruled out include alcoholism, nutritional deficiencies, depression, overuse of tranquilizers and other drug effecting mental function, a brain tumor, stroke, Parkinson's disease and circulatory problems.

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