Alzheimers disease (also called dementia of the Alzheimers type [DAT]) is the most common of several types of dementia.

Dementia is a progressive loss of mental functioning that interferes with memory, ability to think clearly and learn, and eventually ability to function. Alois Alzheimer, a German neurologist, first described the disease in 1907. He described pathological changes, now referred to as neurofibrillary tangles and neuritic plaques, that he discovered while performing an autopsy on a patient with dementia. Alzheimers disease is a progressively degenerative disease that is inevitably fatal. The incidence of Alzheimers disease is more common in women than men and doubles for every 5 years a person lives beyond age 65.

 Dementia is a medical term used to describe a number of conditions characterized by the gradual loss of intellectual function.

Alzheimer's disease is defined as a form of dementia characterized by the gradual loss of several important mental functions.

Usually is noted later in life, Often the onset of Alzheimer's perhaps in the 70 to 80 year range. can occur as early as 45 years of age. Certain symptoms of dementia include memory impairment, increased language difficulties, decreased motor skills, failure to recognized or identify objects, and disturbance of the ability to plan or think abstractly. Signs of Alzheimer's disease include memory loss that is much more severe and more serious, such as forgetting the names of your children or perhaps where you've lived for the last decade or two.

1. Alzheimer's is the most common form of dementia

a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. Alzheimer's disease accounts for 50 to 70 percent of dementia cases.

although the greatest known risk factor is increasing age, and the majority of people with Alzheimer's are 65 and older. But Alzheimer's is not just a disease of old age. Up to 5 percent of people with the disease have early-onset Alzheimer's (also known as younger-onset), which often appears when someone is in their 40s or 50s.

Alzheimer's is a progressive disease, where symptoms gradually worsen over a number of years. In its early stages, memory loss is mild, but with late-stage Alzheimer's, individuals lose the ability to carry on a conversation and respond to their environment. Alzheimer's is the sixth leading cause of death in the United States. Those with Alzheimer's live an average of eight years after their symptoms become noticeable to others, but survival can range from three to 20 years, depending on age and other health conditions.

Although current Alzheimer treatments cannot

stop Alzheimer's from progressing, they can temporarily slow the worsening of symptoms and

improve quality of life for those with Alzheimer's

and their caregivers. Today, there is a worldwide effort under way to find better ways to treat the disease, delay its onset, and prevent it from developing.

While disease

scientists

know

Alzheimers brain cell

involves

progressive

failure, they have not yet identified any single

reason why cells fail. However, they have

identified certain risk factors that increase the

likelihood of developing Alzheimers.

The greatest known risk factor for Alzheimers is increasing age. Most individuals with the disease are 65 or older. The likelihood of developing Alzheimers doubles about every five years after age 65. After age 85, the risk reaches nearly 50 percent.

Another risk factor is family history. Research

has shown that those who have a parent, brother or sister, or child with Alzheimers are more likely to

develop Alzheimers. The risk increases if more

than one family member has the illness. When diseases tend to run in families, either heredity (genetics) or environmental factors or both may play a role.

Scientists know genes are involved in

Alzheimers. There are two categories of genes that can play a role in determining whether a person develops a disease. Alzheimer genes have been found in both categories:

Scientists have so far identified one Alzheimer risk gene called apolipoprotein E-e4 (APOE-e4). APOE provides the blueprint for one of the proteins that carries cholesterol in the bloodstream. Everyone inherits a copy of some form of APOE from each parent. Those who inherit one copy of APOEe4 have an increased risk of developing Alzheimers. Those who inherit two copies have an even higher risk, but not a certainty. Scientists do not yet know how APOE-e4 raises risk. In addition to raising risk, APOE-e4 may tend to make symptoms appear at a younger age than usual.

Scientists have found rare genes that directly

cause Alzheimers in only a few hundred extended families worldwide.

When

Alzheimers

disease

is

caused

by

deterministic genes, it is called familial Alzheimers

disease, and many family members in multiple

generations are affected. True familial Alzheimers accounts for less than 5 percent of cases.

Age, family history and heredity are

all risk factors we cant change. Now, research is beginning to reveal clues about other risk factors we may be able to influence.

There appears to be a strong link

between serious head injury and future

risk of Alzheimers. Protect your head by

buckling your seat belt, wearing your

helmet when participating in sports, and

fall-proofing your home.

Some of the strongest evidence links brain health to heart health. Your brain is nourished by one of your bodys richest networks of blood vessels. Every heartbeat pumps about 20 to 25 percent of your blood to your head, where brain cells use at least 20 percent of the food and oxygen your blood carries. The risk of developing Alzheimers or vascular dementia appears to be increased by many conditions that damage the heart or blood vessels. These include high blood pressure, heart disease, stroke, diabetes and high cholesterol. Work with your doctor to monitor your heart health and treat any problems that arise.

Other lines of evidence suggest that strategies

for overall healthy aging may help keep the brain

healthy and may even offer some protection against diseases. developing Try to Alzheimers keep your or weight related within

recommended guidelines, avoid tobacco and excess alcohol, stay socially connected, and exercise both your body and mind.

THE MOST COMMON EARLY SYMPTOM: Difficulty remembering newly learned information.
As Alzheimer's advances through the brain it leads to increasingly severe symptoms, including:

Disorientation
Deepening confusion about events, time and place
Mood and behavior changes

Unfounded suspicions about family, friends and

professional caregivers More serious memory loss and behavior changes Difficulty in speaking, swallowing and walking

1. Agnosia sensory - inability to recognize subjects/objects. 2. Apraxia sensory - inability for purposeful movements. 3. Amnesia Anterograde - recent memory Retrograde past 4. Aphasia sensory - inability for speech and communication

 Experts have developed stages to describe how a persons abilities change from normal function through advanced Alzheimers. It is important to keep in mind that stages are general guides, and symptoms vary greatly. Not everyone will experience the same symptoms or progress at the same rate.
This seven-stage framework is based on a system developed by Barry Reisberg, M.D., clinical director of the New York University School of Medicines Silberstein Aging and Dementia Research Center.

The person does not experience any

memory problems. An interview with a

medical professional does not show any

evidence of symptoms.

The person may feel as if he or she is having memory lapses forgetting familiar words or the location of everyday objects. But no symptoms can be detected during a medical examination or by friends, family or co-workers.

Noticeable problems coming up with the right word or name. Trouble remembering names when introduced to new people. Having noticeably greater difficulty performing tasks in social or work settings. Forgetting material that one has just read. Losing or misplacing a valuable object. Increasing trouble with planning or organizing.

Forgetfulness of recent events. Impaired ability to perform challenging mental arithmetic for example, counting backward from 100 by 7s. Greater difficulty performing complex tasks, such as planning dinner for guests, paying bills or managing finances. Forgetfulness about ones own personal history. Becoming moody or withdrawn, especially in socially or mentally challenging situations.

Be unable to recall their own address or telephone number or the high school or college from which they graduated. Become confused about where they are or what day it is. Have trouble with less challenging mental arithmetic, such as counting backward from 40 by subtracting 4s or from 20 by 2s. Need help choosing proper clothing for the season or the occasion. Still remember significant details about themselves and their family. Still require no assistance with eating or using the toilet.

Lose awareness of recent experiences as well as of their surroundings. Remember their own name but have difficulty with their personal history. Distinguish familiar and unfamiliar faces but have trouble remembering the name of a spouse or caregiver. Need help dressing properly and may, without supervision, make mistakes such as putting pajamas over daytime clothes or shoes on the wrong feet. Experience major changes in sleep patterns sleeping during the day and becoming restless at night. Need help handling details of toileting (for example, flushing the toilet, wiping or disposing of tissue properly). Have increasingly frequent trouble controlling their bladder or bowels. Experience major personality and behavioral changes, including suspiciousness and delusions (such as believing their caregiver is an impostor), or compulsive, repetitive behavior like hand-wringing or tissue shredding. Tend to wander or become lost.

In the final stage of this disease, individuals lose the ability to respond to their environment, to carry on a conversation and, eventually, to control movement. They may still say words or phrases. At this stage, individuals need help with much of their daily personal care, including eating or using the toilet. They may also lose the ability to smile, to sit without support and to hold their heads up. Reflexes become abnormal. Muscles grow rigid. Swallowing impaired.

1. Cholinesterase (KOH-luh-NES-ter-ays) inhibitors prevent the breakdown of acetylcholine (a-SEA-tilKOH-lean), a chemical messenger important for learning and memory.

These drugs: Support communication among nerve cells by keeping acetylcholine levels high. On average, delay worsening of symptoms for 6 to 12 months for about half the people who take them. Some experts believe a small percentage of people may benefit more dramatically.

Three cholinesterase inhibitors are commonly

prescribed: Donepezil (Aricept), approved to treat all stages of Alzheimer's disease. Rivastigmine (Exelon), approved to treat mild to moderate Alzheimer's. Galantamine (Razadyne), approved to treat mild

to moderate Alzheimer's.

2. Memantine (Namenda) works by regulating the activity of glutamate, a different messenger chemical involved in learning and memory. Memantine: Was approved in 2003 for treatment of moderate to severe Alzheimer's disease. It is currently the only drug of its type approved to treat Alzheimer's. Temporarily delays worsening of symptoms for some people. Many experts consider its degree of benefit is similar to the cholinesterase inhibitors.

Antidepressant medications for low mood and irritability: citalopram (Celexa) fluoxetine (Prozac) paroxeine (Paxil) sertraline (Zoloft) trazodone (Desyrel) Anxiolytics for anxiety, restlessness, verbally disruptive behavior and resistance: lorazepam (Ativan)
oxazepam

(Serax)

Antipsychotic medications for hallucinations, delusions, aggression, agitation, hostility and uncooperativeness: aripiprazole (Abilify) clozapine (Clozaril) haloperidol (Haldol) olanzapine (Zyprexa) quetiapine (Seroquel) risperidone (Risperdal) ziprasidone (Geodon)

Regular physical exercise may be a beneficial strategy to lower the risk of Alzheimer's and vascular dementia. Some evidence suggests exercise may directly benefit brain cells by increasing blood and oxygen flow. Even stronger evidence suggests exercise may protect brain health through its proven benefits to the cardiovascular system. Because of the known cardiovascular benefits, a medically approved exercise program is a valuable part of any overall wellness plan.

A number of studies indicate that maintaining strong social connections and keeping mentally active as we age might lower the risk of cognitive decline and Alzheimer's. Experts are not certain about the reason for this association. It may be due to direct mechanisms through which social and mental stimulation protect the brain.

NORMAL

ALZHEIMERs

LAGUANGE

LAGUANGE
VENRTICLE

MEMORY

MEMORY

Frontal lobe:

Impaired reasoning ability. Unable to solve problems and perform familiar tasks. Poor judgment. Inability to evaluate the appropriateness of behavior. Aggressiveness. Impaired language interpretation. Unable to recognize familiar objects. Impaired orientation ability. Impaired visuospatial skills (unable to remain oriented within own environment). Impaired emotions: depression, anxiety, fear, personality changes, apathy, paranoia.

Occipital lobe:

Parietal lobe:

Amygdala:

Temporal lobe:

Inability to recall words. Inability to use words correctly (language comprehension). In late stages, some clients experience delusions, and hallucinations. Impaired memory. Short-term memory is affected initially. Later, the individual is unable to form new memories. Alterations in acetylcholine, dopamine, norepinephrine, serotonin and others may play a role in behaviors such as restlessness, sleep impairment, mood, and agitation.

Hippocampus:

Neurotransmitters: