Alzheimer's Disease

Dr.Kamalakkannan
Tutor
Dept. of. Psychiatry
PMCH
 Definition:
 There are various definitions of Alzheimer ’s disease including:

 - “The slow onset of memory loss leading to a gradual

progression to a loss of judgement and changes in behaviour
and temperament.”

 - “A living death”

 - “The global impairment of higher functions, including

memory, the capacity to solve problems of day to day living, the
performance of learned percepto-motor skills (for example tasks
like washing, dressing and eating), and the control of emotional
reactions in the absence of gross clouding.”
 Memory Loss:
 Memory loss occurs in all cases of
Alzheimer’s disease.
 The most recent memories are the first to be
affected, the things we’ve done in the last few
hours or days.
 Later, as the disease progresses, the past
memory also deteriorates.
 Memory loss occurs in all cases of

Alzheimer’s disease.
The most recent memories are the
first to be affected,
the things we’ve done in the last few
hours or days.
Later, as the disease progresses, the
past memory also deteriorates.
 Questions asked should be extremely basic, for
example:
 - What day is it today?
 - How old are you?
 - Where are we now?
 - What year is it?
 - What month?
 - Count backwards from 20 to 1.
 These questions will test a person’s short term
memory, and also orientation; disorientation being
another problem experienced by Alzheimer's suffers
 Disorientation:
Disorientation,
 or not knowing who or where you
are,
is closely connected to memory loss.
Typically, an Alzheimer’s sufferer will
forget birthdays,
become unsure of what day it is,
and even forgets their own name.
You can understand why Alzheimer’s
has been called
‘a living death’
 Because it is the short-term memory that goes
first,
 suffers who go out alone have often returned
to a house they lived in years ago, thinking
they have come home.
 be a last Disorientation inside the home can become a problem
too
 but not until the disease is in its later stages.
 It is important that nothing is moved or changed in the home
to preserve continuity.
 If their environment and routine remains unchanged, an
Alzheimer’s sufferer will remain more content and confident;
 change the environment however and their confusion and
disorientation becomes readily apparent.
 This is why treatment at home rather than in hospital is
preferred and transfer to hospital should resort
 Personality Change:
 One of the cruellest aspects of Alzheimer’s
disease is the change in personality many
people experience.
 Often, the general behaviour and personality
of Alzheimers suffers in the later stages will be
in complete contrast to their usual behaviour
they exhibited in earlier life.
 Mood swings, from being ecstatically happy to
extremely sad, verbal and sometimes physical
aggression, and extreme anxiety and
nervousness often affect the Alzheimers
sufferer and,
 of course,also the carer who can help best by
offering continuous reassurance and patience.
 Personal Hygiene:
 Personal hygiene often becomes a major issue
with the sufferer forgetting to wash and bathe.
 Body odour, and stained and soiled clothing
and hands can be a cause of great stress and
result in a cruel loss of dignity.
 Communication:
 During the early stages understanding simple
speech remains unaffected,
 but finding the correct words can be a problem
and the Alzheimers sufferer will often leave
sentences unfinished.
 The taking of messages particularly over the
telephone can be difficult and this is often one
of the first signs of dementia
 As the disease worsens communication will
become more difficult as comprehension
skills decrease.
 Eventually their whole speech can become
gibberish until eventually the Alzheimer
sufferer will cease to talk altogether and will
withdraw into his or her small world.
 Sleep
 Although the amount of sleep required by an
Alzheimers sufferer is unlikely to change, their
sleep cycle may do.
 So, instead of wanting to sleep at night and be
awake during the day, this could become
reversed.
 This isn’t a problem of itself except for the
carer who will have his or her nights disrupted.
 The carer is advised to keep the patient active
and awake during the day as much as possible,
 even though it is tempting to seize an
opportunity to do some chores and enjoy some
peace and quiet should the sufferer fall asleep.
 A warm drink at bedtime may help, although
any problems with incontinence should be
considered
 In the worst case scenario, many people use a
night sitting service to ensure the sufferer is
closely supervised while the carer gets a few
nights of undisturbed sleep.
 Malnutrition:
 Eating and drinking can be a problem with
Alzheimer suffers.
 More accurately the lack of food and drink
and the resulting malnutrition is the problem.
 A sufferer may develop an irrational fear of
the food you are providing,
 or they may simply forget or refuse to eat.
 Two likely causes of the latter are ill-fitting
dentures, especially if the sufferer has lost
weight; and constipation.
 A well balanced diet with plenty of roughage
and a high fluid intake will help prevent
constipation.
 Dispelling Myths about Alzheimer’s
 Myth 1: Memory loss is a natural part of
aging.

 Reality: In the past people believed memory

loss was a normal part of aging, often
regarding even Alzheimer’s as natural age-
related decline. Experts now recognize severe
memory loss as a symptom of serious illness.
 Whether memory naturally declines to some
extent remains an open question. Many people
feel that their memory becomes less sharp as
they grow older, but determining whether
there is any scientific basis for this belief is a
research challenge still being addressed.
 Myth 2: Alzheimer’s disease is not
fatal.

Reality: Alzheimer's is a fatal disease.
It begins with the destruction of cells in regions of
the brain that are important for memory.
However, the eventual loss of cells in other regions
of the brain leads to the failure of other essential
systems in the body.
Also, because many people with Alzheimer’s have
other illnesses common in older age, the actual
cause of death may be no single factor.
Myth 3: Drinking out of aluminum
cans or cooking in aluminum pots
and pans can lead to Alzheimer’s
disease.
 Reality: Based on current research,
getting rid of aluminum cans, pots,
and pans
will not protect you from Alzheimer’s
disease.
The exact role (if any) of aluminum in
Alzheimer’s disease
is still being researched and debated.
However, most researchers believe
that not enough evidence exists to
consider aluminum a risk factor for
Alzheimer’s or a cause of dementia.
 Myth 4: There are therapies
available to stop the progression of
Alzheimer’s disease. .

Reality: At this time, there is no medical
treatment to
cure or stop the progression of
Alzheimer’s disease.
FDA-approved drugs may temporarily
improve or
stabilize memory and thinking skills in
some individuals.
Preventing and Curing Alzheimer's

Natural Supplements
Proven to Slow and
Reverse
Alzheimer's Disease


ANTIOXIDANTS REDU
CE RISK AND SYMPTO
MS OF DEMENTIA AND
ALZHEIMER'S
-
New England Journal of
Medicine (JAMA)
 Phosphatidyserine (called P.S.), 1 capsule, 200 mg,
2X daily.
 Phosphatidyserine (PS) functions like a mail or
document delivery service.
 It delivers nutrients and molecular messages to cell
membranes.
 This helps cells to work at their peak ability. Clinical
trials have shown that PS is dramatic in its ability to
do this, and 200 mg of PS taken two times a day may
improve memory and recall in early-stage
Alzheimer's disease patients.
Acetyl-L-Carnitine (ALC) Take 1000 mg daily.
In clinical trials, acetyl-l-carnitine (ALC) improves
cognition in Alzheimer's patients.
One study in particular demonstrates that ALC when

combined with early diagnosis (by age 61),
dramatically slows the progress of the disease. ALC is
a supplement with many positive potential
applications in Alzheimer's treatment.
To start with, it's an antioxidant, and as an
antioxidants it prevents the destruction of cells by free
radicals.
Many of the preventive nutrients available to patients
at risk for Alzheimer's are, and antioxidants may be
able to stop brain cells of patients who already have
 
Pregnenolone, 100 mg a day, 2 tablets daily.
This is considered to be one of the most
important supplements you can take to both
prevent and slow the progression of dementia,
memory loss and Alzheimer's Disease
 
GINKGO BILOBA 180 mg of ginkgo
biloba extract daily is recommended.
Recent research shows that Gingko is as
effective as expensive prescription
medicines in treating Alzheimer's.
Co-Enzyme

Q10 100 mg –
Known for the treatment of congestive
heart failure COQ10 also plays a key role
in preventing senility and Alzheimer's.
To be effective one must take a total of
200-400 mg daily in divided doses with
meals.
 New research shows
curcumin,
 an extract of the
tumeric roots from
which curry Indian
. curry is derived, may
explain why the rates
of Alzheimer's disease
among India's elderly
are 90% lower than in
the US and Canada
 General Advice For Carers:
 It is difficult to judge who has the worse time, the Alzheimers
sufferer or the carer.
 In the early stages of the disease it is probably the sufferer, in
the latter stages it is undoubtedly the carer.
 Help minimise disorientation by not moving anything in the
home.
 To do so will make their confusion worse.
 Admit an Alzheimers suffer to hospital as a last resort.
 Once you do so disorientation and confusion will increase
markedly.
 Do not let a sufferer out alone, they may have difficulty
finding the way back home.
 Do all you can to help the sufferer maintain dignity.
 - A warm drink or a tot of their favourite alcoholic
drink may aid sleep at night.
 - Try to keep the patient active and awake during the
day.
 - Keep a cold drink nearby to remind the sufferer to
take fluids.
 - Keep disruption to routine to a minimum to prolong
the Alzheimers sufferer’s independence as long as
possible
 Closely supervise medication.
It is very easy for the Alzheimers

sufferer to forget they have taken their
medication, and take it repeatedly.
Alzheimer’s disease is progressive and
incurable, although there are drugs that
can slow the progression.
It is one of the saddest diseases in that it
is difficult to care for or regularly visit
someone who no longer knows your
name or recognises you.
 Alzheimer's disease causes more than
memory loss.
Patients develop visual agnosia, the

inability to identify objects and
people.
They develop auditory agnosia, the
inability to process sounds, and other
agnosias as well.
These mental failures are painful to
witness.
You can't change the diagnosis of
Alzheimer's disease, but you can
create a safe and soothing place for
 REMOVE CLUTTER. Too much clutter is
upsetting and makes it harder for your loved
one to find things.
 Clear off the bureau, bedside table, and other
surfaces.
 You may wish to buy open boxes for storage.
 Open shelving made it easier for her to store
and find things.
CLEAR PATHWAYS.
Remove scatter rugs and make
sure

there are no doorway
obstructions.
Shorten or wind up long
electrical cords that could trip
your loved one.
Move furniture away from the
middle of the room if your loved
one uses a walker.
 4. USE VISUAL CLUES
.
The Canadian Government, in an Internet
article called "At Home With Alzheimer's
Disease," says you should "mark the door of
the AD person's apartment in a very distinct
way, perhaps with a photograph, a wreath, or
a flag of some sort.“
Experiment with other visual clues, such as a
picture of socks on the front of a sock drawer
8. BE CAREFUL WITH PATTERN.
"Patients with AD see and hear things that
have no basis in reality," according to the
Alzheimer's Disease Research Center in San

Diego, CA.
This point is made in an Internet story from
The Greater Illinois chapter of the Alzheimer's
Association.
Apparently the residents of one nursing home
thought the vines on the wallpaper were snakes
and they kept beating the walls.
At this time of life plain fabrics and
wallcoverings are better choices for your loved
 HAVE ENOUGH LIGHT.
Accidents can happen in dimly
lit areas or areas with lots of
 shadows.
Make sure the is enough light,
especially in the bathroom.
Put a night light next to the bed
and mark the way to the
bathroom with additional night
lights. "The 36-Hour Day," says
putting reflective tape around the
bathroom door may also help
CUT THE GLARE.
Buy
 flat paint instead of gloss to cut down on
glare.
The floor should also have a non-glare surface.
You may also reduce glare by hanging sheer
drapes at the window and installing blinds.
Use soft light bulbs in lamps.
If your loved one is severely demented, close
the curtains at night and cover up mirrors.
 PREVENT WANDERING.
Hang small posters on the doors to keep
your loved one from wandering. You may
also hang beaded curtains in open
doorways.
Install door and window locks in unusual
and/or hidden places.
The Canadian Government, in its
publication "At Home With Alzheimer's
Disease," recommends two locks - a chain
lock and a dead bolt - on exit doors.
If you have a door that opens onto a busy
ADD LIFE.
A growing plant can give your loved one weeks
ofpleasure.
Before you buy a plant, however, make sure it
isn't toxic.
Provide a watering can if your loved one is still
able to water the plant. (Check for spills later.)
Watching fish is also pleasurable for those with
Alzheimer's, but if you buy fish you should care
for them.
Your loved one may also benefit from pet
therapy
 These action steps will help
your loved one to feel safer
and calmer.
As his or her dementia
progresses you will have to
take more action steps.
 &finally
 The best action step you can take is to keep
saying

 I LOVE YOU
Thank you