The Alzheimer’s disease is chronic brain disease manifesting itself as progressive loss of memory as well as speech and various behavioural disorders affecting daily activities of the patients. The disease is the most frequent cause of dementia (acquired amentia).
The German doctor Alois Alzheimer was the first to describe the disease. He had a 51-years-old patient Auguste Deter brought by her husband Carl Deter, who could not take care of his wife any longer, in 1901. The doctor observed her unexplainable memory disorder, unreasonable suspicions on husband’s adultery and speech disorders. The said symptoms progressed rapidly and thus the woman became the bed-patient in mere 5 years. She died with the outspread infectious complication, pneumonia, in 1906. After her autopsy A. Alzheimer described changes in brain typical to the disease. He presented the case of Auguste Deter to the 37th Psychiatry Community of Southwest Germany on the 3rd of November 1906 describing neurofibrillary tangles and amyloidal plaques as characteristic symptoms of the disease.
The above case and similar ones were later described in the “Textbook for Students and Doctors” by Kraepelin, who called them the Alzheimer’s disease.
The initial cause of the Alzheimer’s disease is unknown in most cases. People older than 65 get the disease most often. Age is the greatest risk factor. Morbidity doubles every 5 years among people older than 60.
Early Alzheimer’s disease that affects people younger than 60 is mostly family-related and hereditary. It is caused by mutations of several genes. However, family-related cases of early Alzheimer’s disease make mere 2-4% of all cases.
Other risk factors of the disease are poor social and economic condition, poor education and brain traumas. Sex of the patient also contributes: women risk development of the disease more often. Also, there is evidence that diabetes mellitus, increased cholesterol levels, low physical activity, hypertension and obesity are related to development of the disease.
The disease usually begins with minor but progressing memory disorder. Impaired memory is the main symptom of the Alzheimer’s disease. Digestion of new information malfunctions first and the most; disorientation in time and space develops. Then recollection of previously memorized information begins to impair: patients forget names and numbers of their children and people they live with, loose all domestic skills, forget how to do previously regular actions or works as well as do not know they have to eat, wash themselves, etc. They may not recognize things, people or their own faces; their ability to focus impairs.
An important element of the Alzheimer’s disease is speech disorders. First stages are marked with difficulty to find required words. Then perception of speech impairs and communication skills decline. This noticeably affects daily activities of the patients.
Repetitive behavioural disorders also develop in case of the Alzheimer’s disease. Agitation, changes in personality and psychoses occur as the disease progresses. Depression and anxiety are frequent manifestations, while delirium and hallucinations occur occasionally.
Suspicion and diagnosis of the Alzheimer’s disease is easy based on its clinical symptoms only. Patients rarely visit doctors for their impaired memory; family members or family doctors usually notice memory or behavioural changes first. The disease is then diagnosed by neurology or psychiatry specialists.
Under suspicion of the Alzheimer’s disease patients and their families are interviewed and the general medical and neurological analysis is carried out. Results of various tests and tasks (the clock test, the mini-test of mental condition, etc.) enable evaluation of memory, speech and other cognitive functions. The necessary laboratory tests and cerebral computer tomography are appointed.
In case of the diagnosis of Alzheimer’s disease doctors select a specific treatment to improve memory and other cognitive processes. In case of manifested psychosis, delirium, hallucinations, depression or anxiety doctors prescribe medications to inhibit the symptoms.