DEMENTIA & ALZHEIMERS DISEASE

There are different causes of cognitive dysfunctions, i.e. memory short & long term, concentration, language, speech, visuo-spatial orientation. Most of them are nearly irreversible condition such as ALZHEIMERS DISEASE, MULTI- INFRACT DEMENTIA, LEWY BODY DISEASE, PICKS DISEASE, PARKINSONS DISEASE, HUNTINGTONS DISEASE etc. Among them ALZHEIMERS DISEASE is the most common cause of degenerative dementia. It is a debilitating, life-altering disease that attacks the brain. Its primary symptom is progressive memory loss, but difficulties with vision, language skills, and emotional control are also common. The progressive deterioration continues for five to 20 years. At some point, a person with Alzheimers disease will require 24-hour care and assistance with daily activities such as eating, grooming, and toileting. Because its impact on the affected person is so great, it profoundly affects family and caregivers. Age is clearly the major risk factor for Alzheimers disease. While only five percent of those over 65 have the disease, nearly half the population over 85have it. Genetics also appears appear to play an important role. The course of Alzheimers disease varies disease varies tremendously, but is always progressive. Symptoms usually begin with memory loss, especially of recent events. For instance, the person will repeat stories in the same conversation. In the early stages, Alzheimers patients cannot learn new information. As the disease progresses, people with Alzheimers disease become increasingly confused and disoriented. Some cannot find words in conversation, and cover by using automatic phrases and clinches. Another common symptom is personality and behavioral changes such as unusual agitation, depression, and paranoia. Judgment and common sense increasingly become impaired. Eventually, patients forget how to perform simple tasks, like combing their hair or brushing their teeth. Personality changes are more distinctive-ranging from progressive passivity to marked agitation. About half of patients have paranoid delusions, such as thinking that caregivers or family members are impostors or that their home is not their real home. About 20-30 percent of Alzheimers patients develop symptoms such as slow movement and trembling. Symptoms may develop gradually and go unnoticed for a long time. Only a physician can properly diagnose the persons condition, which could be a treatable form of dementia. Even if the diagnosis is Alzheimers disease, new treatments are available for patients as is assistance for caregivers. There is no simple test to diagnose Alzheimers disease; a definite diagnosis can only be made by examining brain tissue, usually at autopsy. When Alzheimers disease is suspected, it is important to have a thorough medical and neurological evaluation to identify treatable disorders with Alzheimers-like symptoms. Illnesses like depression, hypothyroidism, vitamin B12 deficiency, hydrocephalus, cerebral vasculitis, neurosyphilis, AIDS, and stroke can cause dementia, as can alcohol and some medications. The cause of Alzheimers disease is currently unknown. It is not contagious. Genetic factors and aging appear to play an important role. Alzheimer patients who have at least one other relative with the disease are categorized as familial. While currently there is no cure for Alzheimers disease, there are some treatments that help manage the symptoms. Several drugs are currently FDA approved for the treatment of mild to moderate Alzheimers disease. None of the drug slows the disease progress, but can ease symptoms in some patients by inhibiting the breakdown of a brain chemical called acetylcholine. Acetylcholine is in short supply in Alzheimers patients. There are also many approved medications for the behavioral symptoms, including drugs to control depression, agitation, anxiety, and delusions. Families and friends can help by recognizing that Alzheimers disease impacts not only the patient, but also the primary caregiver.

MBBS (BD), DTM & H (U.K.), M.D. (NEWYORK, U.S.A), POST- DOCTORAL FELLOWSHIP IN EPILEPSY (NEW YORK, U.S.A) US BOARD CERTIFIED IN NEUROLOGY CONSULTANT NEUROGOLIST, APOLLO HOSPITALS, DHAKA (EX- ASSOCIATE PROFESSOR OF NEUROLOGY, BANGLADESH MEDICAL COLLEGE, DHAKA, EX. - CONSULTANT NEUROLOGIST, VETERANS ADMINISTRATION HOSPITAL SYRACUSE, NEWORK, U.S.A)

DR. ALIM AKHTAR BHUIYAN