Neurosurgery

Alzheimer

Alzheimer

 

Alzheimer's is a common type of dementia, a progressive neurological disease that causes the destruction of brain cells. In this disease, which causes a decrease in thought, memory and behavioral functions, the symptoms appear gradually with age. It may take years for the disease to reach advanced stages. As it is a progressive disease, early symptoms in Alzheimer's are usually seen as forgetting recent events, but within a few years, individuals may have difficulty in performing their daily activities on their own. Social skills, behaviors, and the ability to think logically are also negatively affected over time. Advanced-stage Alzheimer's patients often lose the ability to have a conversation with a person and begin to have difficulty in responding to the questions asked and the events surrounding them. Although the disease mostly affects individuals aged 65 and over, it cannot be described as a disease of old age because younger-onset cases are also frequently encountered.

 

What are the symptoms of Alzheimer's?
Alzheimer's patients usually apply to clinics with complaints of poor cognitive and behavioral performance. Although the symptoms of the initial stage of the disease are milder, the findings are more pronounced in patients with advanced stages. Symptoms of Alzheimer's onset are usually minor memory problems, but forgetting recent conversations and events; It includes symptoms such as inability to remember the names of people, objects, and places. The most common Alzheimer's symptoms with further progression of the disease are:

  • Clouding of consciousness
  • Difficulty adapting to one's environment
  • Getting lost in places one knows well
  • Problems with speech and language skills
  • Development of personality disorders such as aggression, making unusual demands on family and friends, and suspicion of the environment
  • Hallucinations and delusions
  • Low motivation and self-esteem
  • Difficulty in performing daily activities unaided
  • Denial of events that the person cannot remember
  • Anxiety and depression

The above symptoms are usually common symptoms when the disease is first diagnosed. With the progression of the disease, these symptoms increase in severity and reach much more advanced dimensions, such as the patient's inability to recognize family members, forgetting his recent past completely, and having difficulty even recognizing himself. In this case, patients often need a caregiver to continue their daily lives.

 

What are the causes of Alzheimer's?
Although Alzheimer's is a disease that has been the subject of scientific research for many years, the cause of the development of the disease has not yet been determined. However, possible reasons that are considered as a risk factor in the emergence of the disease, in other words, that may play a role in the development of the disease are as follows:

  • Advanced age
  • Having a family history of Alzheimer's
  • Having Down syndrome
  • Past head traumas
  • Sleep disorder
  • Insufficient physical activity
  • Obesity
  • Smoking or being constantly exposed to secondhand smoke
  • High blood pressure and high cholesterol
  • Having poorly controlled type 2 diabetes
  • Inadequate, unbalanced and unhealthy diet

When we look at the studies investigating the incidence of Alzheimer's disease in two different genders, it is seen that the incidence of Alzheimer's disease is slightly higher in the female gender than in the male gender. However, the possibility that this situation may be related to the higher average life expectancy in women is emphasized. Apart from the above reasons, which are considered as risk factors for the development of the disease, beta amyloid plaques seen around the brain cells that died are found in brain tissue examinations performed on Alzheimer's patients. Studies on the factors that may cause these formations and the death of brain cells in patients provide a ray of hope for the determination of the exact cause of the disease in the future.

 

How is Alzheimer's diagnosed?
There is no differential diagnostic test that can provide clear information for the diagnosis of Alzheimer's disease. Therefore, many medical diagnostic tests are evaluated together in the diagnosis of the disease. Patients who apply to health institutions with symptoms related to the disease are directed to neurology clinics. First of all, a detailed history of the patient is taken by neurologists. At this stage, it may be necessary to ask some questions to the family or close circle of the patient as well as to the patient. After the medical history is taken, various scans are performed to measure neurological functions, balance, sensation, behavior, memory and reflexes. Applications such as blood tests, ultrasonography, computed tomography (CT), magnetic resonance imaging (MR) and personality screening tests to investigate depression can also be applied to support the diagnosis and rule out the possibility of similar diseases. Since Alzheimer's disease may show similar symptoms with some genetic diseases, it may be necessary to perform gene screening to investigate these diseases. In addition to this, although gene scans can be applied to investigate the gene called APOE-e4, which is claimed to play a role in the development of Alzheimer's disease, this method is not a proven screening method. As a result of all these diagnostic tests, if findings that increase the suspicion of Alzheimer's disease are obtained, a definitive diagnosis of the disease can be made by the physician after the tests for the evaluation of cognitive functions, also known as the Alzheimer's test, are performed.

 

How is Alzheimer's treated?
People who experience the above symptoms that indicate Alzheimer's disease should apply to a health institution without wasting time. In patients diagnosed with Alzheimer's as a result of the evaluations to be made by the physician, the treatment process is planned individually, taking into account the age of the patient, the level of progression of the disease and other accompanying diseases. There is no known definitive treatment for Alzheimer's disease. However, with some applications, it is possible to reduce or eliminate the symptoms caused by the disease in the patient and to slow the progression of the disease. Necessary arrangements should be made in the home environment of Alzheimer's patients, and measures should be taken to prevent forgetfulness and facilitate remembering, especially for patients who have to live alone. These can be notes or conspicuous signs to be posted in certain parts of the house. Psychiatric therapies such as cognitive stimulation therapies that can be applied individually or collectively can contribute to the strengthening of memory, problem solving and preservation of language skills. In order to reduce the symptoms of the disease and increase the quality of life, the use of certain drugs may be recommended by the physician. Cholinesterase inhibitors such as Donepezil, Rivastigmin, Takmin and drugs such as Memantine are the most commonly used drugs for this purpose. These drugs are not a direct treatment tool for the disease, but can be considered as a part of symptomatic treatment.

In individuals with a family history of Alzheimer's but who have not yet been diagnosed with the disease, the exact cause of the disease cannot be known, so only measures can be taken to eliminate risk factors. These are measures such as avoiding smoking, adopting an active lifestyle and eating healthy. In addition, these individuals should be made aware of Alzheimer's disease and the symptoms that indicate the disease. If you or a loved one observes Alzheimer's symptoms such as memory problems, you should immediately apply to a health care provider and have the examination and necessary diagnostic tests performed to investigate the disease. If the disease is diagnosed, you can significantly slow down the progression of the disease by starting the treatment process as soon as possible.

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