Alzheimer’s disease is the most common neurodegenerative disease. Although some people start their disease before the age of 65, most people start after this age, and its prevalence increases in parallel with aging.
Causes of Alzheimer’s disease
The cause is unknown, only in a small percentage of hereditary cases some specific mutations have been identified. Although in some families there is a higher incidence, in most cases there is no demonstrable inheritance with the usual genetic studies. Alzheimer’s disease involves two proteins, beta-amyloid and tau, which are deposited in various areas of the brain. In general, the disease begins in the hippocampus, the area of the brain related to recent memory, but over the years it spreads to other brain areas. These proteins are responsible for the slow and progressive disappearance of neurons in the cerebral cortex, leading to the manifestations of the disease.
Symptoms of Alzheimer’s disease
The most frequent onset is a slow loss of memory, which lasts for years as an isolated symptom. At this stage it is important to perform the so-called neuropsychological tests, which are the only ones that can differentiate cases of memory loss due to simpler causes from Alzheimer’s disease. Most people who notice memory loss usually have more benign causes, an emotional origin (stress), being associated with age, or the so-called “Mild Cognitive Impairment” (slow memory loss, without great progression but that does not end with the loss of other brain functions). In Alzheimer’s disease, manifestations of impairment of other brain functions such as disorientation in time and space, speech difficulties, loss of ability to perform gestures and motor actions of daily life (dressing, feeding, driving, etc.) appear over the years. The loss of speech makes it difficult for the patient to communicate verbally. There may be behavioral alterations with aggressiveness or apathy, episodes of mental confusion with hallucinations, urinary incontinence, and others. Depression is also frequent.
The first years are usually relatively bearable while the disease is maintained with few symptoms. Eventually, in years, a situation of disability for the basic actions of daily living (washing, dressing, feeding) and dependence is reached, since the patient needs help for all these activities and constant monitoring.
Treatment of Parkinson’s disease
There is currently no curative treatment despite being one of the most intensively researched diseases in the last 30 years. There are some drugs that improve the evolution, although they do not delay the disease. It is clear that the treatments available to us have improved the course of the disease. Throughout the course of the disease it is often necessary to add drugs to control sleep disorders, depression, anxiety or agitation.
The important contribution of caregivers and support organizations
Over the last few years, a whole network of support for these patients has been built up with memory workshops, trained caregivers, day hospitals and other organizations that have made a significant contribution to improving the long evolution of these patients. When the disease moves into the advanced stages, the caregivers are put to the test, as their dependence for basic functions and the need for constant vigilance generates a considerable degree of stress and leads to exhaustion. It is important to remember the slogan “the caregiver must be cared for” to avoid burnout and depression and to give them rest periods to allow them to rest as these patients require 24-hour care.
In the early stages of the disease it is important to maintain a daily physical activity, surprisingly several studies have shown that daily walking improves memory, as well as maintaining a mental activity, typically crossword puzzles, Sudoku and even word search puzzles are recommended. If the patient can maintain a daily routine activity at home, contributing to household or other activities, his self-esteem is much better maintained and the feeling of “uselessness” that often causes the affected person to feel self-conscious is avoided.
There are other diseases that lead to similar situations, such as frontotemporal dementia with a strong genetic component, Lewy Body disease associated with Parkinson’s disease, dementia due to vascular lesions or other less common forms. The treatments and evolutionary situation present problems similar to those of Alzheimer’s disease.