Alzheimer's Disease

General information

Alzheimer's disease is the most frequent type of dementia in the elderly and affects almost half of all patients with dementia. Correspondingly, advancing age is the primary risk factor for Alzheimer's. Among people aged 65, 2-3% show signs of the disease, while 25-50% of people aged 85 have symptoms of Alzheimer's.
The ultimate cause of Alzheimer's is unknown.
During the course of Alzheimer's disease, nerve cells die in particular regions of the brain. The brain shrinks as gaps develop in the temporal lobe and hippocampus, which are responsible for storing and retrieving new information. This in turn affects people's ability to remember, speak, think and make decisions. The production of certain chemicals in the brain, such as acetylcholine is also affected. It is not known what causes nerve cells to die but there are characteristic appearances of the brain after death. In particular, 'tangles' and 'plaques' made from protein fragments are observed under the microscope in damaged areas of brain.

The US National Institute on Aging has formulated seven warning signs of Alzheimer's disease which are:

  1. Asking the same question over and over again.
  2. Repeating the same story, word for word, again and again.
  3. Forgetting how to cook, or how to make repairs, or how to play cards - activities that were previously done with ease and regularity.
  4. Losing one's ability to pay bills or balance one's checkbook.
  5. Getting lost in familiar surroundings, or misplacing household objects.
  6. Neglecting to bathe, or wearing the same clothes over and over again, while insisting that they have taken a bath or that their clothes are still clean.
  7. Relying on someone else, such as a spouse, to make decisions or answer questions they previously would have handled themselves.

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Dementia is by definition a clinical condition, and thus can be confidently diagnosed with careful testing. However, a definitive diagnosis of Alzheimer's disease as a particular cause of dementia must await microscopic examination of brain tissue; which generally occurs at autopsy and less often with a pre-mortem brain biopsy. Therefore, Alzheimer's disease is usually a clinically diagnosed condition based on the presence of characteristic neurological and neuropsychological features and the absence of alternative diagnoses. In this process, determination of neurological characteristics is made utilizing patient history and clinical observation, while neuropsychological evaluation includes memory testing and assessment of intellectual functioning.
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There is currently no cure for Alzheimer's disease. But many of the problems associated with dementia such as restlessness and depression can be treated. It may also be possible, especially in the early stages of dementia, to improve someone's memory with medication.
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Further information and patient organisations

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