Alzheimer’s disease is a progressive neurodegenerative disorder that causes memory loss, cognitive decline, and behavioral changes.
It is the most common cause of dementia in older adults.
Causes
Genetic Factors: Family history and specific genetic mutations (e.g., APOE ε4 allele).
Age: The greatest risk factor; most cases occur in people aged 65 and older.
Brain Changes: Accumulation of amyloid-beta plaques and tau tangles in the brain.
Cardiovascular Factors: Conditions such as hypertension, diabetes, and high cholesterol.
Symptoms
Early Stage: Memory loss, confusion about time or place, difficulty finding words, and trouble with familiar tasks.
Middle Stage: Increased memory loss, confusion, mood swings, and changes in behavior.
Late Stage: Severe memory loss, loss of communication ability, complete dependence on caregivers, and physical decline.
Diagnosis
Clinical Evaluation: Detailed medical history, cognitive testing, and neurological examination.
Cognitive and Neuropsychological Tests: Assess memory, problem-solving skills, attention, language, and other cognitive abilities.
Imaging Tests: MRI or CT scans to rule out other causes of cognitive decline and to observe brain changes typical of Alzheimer’s.
Biomarker Tests: Analysis of cerebrospinal fluid for amyloid-beta and tau proteins, or PET scans to detect amyloid plaques.
Pathophysiology of Alzheimer’s Disease
Amyloid Plaques: Extracellular deposits of amyloid-beta peptides that disrupt cell function.
Neurofibrillary Tangles: Intracellular accumulations of hyperphosphorylated tau protein leading to neuronal dysfunction and death.
Synaptic Dysfunction and Neuronal Loss: Resulting in progressive cognitive decline and memory loss.
Cholinergic Deficiency: Reduced levels of acetylcholine, a neurotransmitter important for learning and memory.
Treatment
1. Medications:
Cholinesterase Inhibitors: Donepezil, rivastigmine, and galantamine to improve neurotransmission and manage symptoms.
NMDA Receptor Antagonist: Memantine to regulate glutamate activity.
Antidepressants and Antipsychotics: For mood and behavioral symptoms.
2. Cognitive and Behavioral Interventions:
Memory training, cognitive stimulation therapy, and behavioral strategies to manage symptoms.
3. Supportive Care:
Assistance with daily living activities, structured routines, and a safe environment.
4. Caregiver Support:
Education, support groups, and respite care to assist those caring for individuals with Alzheimer’s.
Lifestyle and Preventive Measures
Healthy Diet: Mediterranean diet or DASH diet.
Physical Activity: Regular exercise to maintain cardiovascular and brain health.
Mental Stimulation: Engaging in activities that challenge the brain.
Social Engagement: Maintaining social connections to support cognitive function.