ALZHEIMER'S DISEASE: SYMPTOMS, CAUSES AND TREATMENT - ECONOMÍA - 2024

The Alzheimer 's disease is a disease whose main characteristic degeneration of parts of the human brain. It is a progressive, slow-evolving dementia that begins in adulthood, and in which the first symptoms that appear are memory failures.

However, memory failures are not the only ones that occur. Alzheimer's begins with a degeneration of the areas of the brain that are responsible for memory, so the first symptoms that appear are frequent forgetfulness, inability to learn and memory failures.

However, it is a progressive disease, so the degeneration of the neurons progresses gradually until it affects all parts of the brain. Therefore, after the first symptoms in memory, as the disease progresses, all other faculties will be lost.

These faculties will begin as deficits in cognitive processes such as attention, reasoning capacity or orientation, and will end up being the totality of the functions of the person, until they are totally incapable of carrying out any activity.

The degeneration progresses until it reaches those areas of the brain that are responsible for carrying out simple actions such as toilet training, the ability to articulate words or be self-aware.

Thus, associating Alzheimer's with memory loss is a mistake, since although it is the main symptom of this disorder, Alzheimer's involves many other things.

Symptoms

The most prototypical symptoms of Alzheimer's disease are those that make up the definition of dementia. The symptoms par excellence of this disorder are those that cause the deterioration of cognitive functions, especially memory.

Memory impairment

It is the main symptom of Alzheimer's and the first to appear. The first symptoms are usually inability to learn things and forgetting recent things.

As the disease progresses, memory failures spread, affecting remote memory, forgetting things from the past until forgetting absolutely everything.

Language impairment

Language is a cognitive function closely linked to memory since we must remember words to be able to speak normally, which is why people with Alzheimer's also have difficulties when speaking.

The first symptoms are usually the presence of anomie by not remembering the name of words while speaking, this causes verbal fluency to be lost, each time speaking in a slower way and having greater difficulties to express oneself.

Orientation impairment

Problems to orient properly are also very typical, and can already present at the beginning of the disease.

The first type of disorientation that usually appears is spatial disorientation, a person with Alzheimer's will have many difficulties to orient themselves beyond their home or neighborhood, or will be totally unable to go alone on the street.

Later, temporary disorientation tends to appear, having enormous difficulties to remember the day, month, season or even the year in which one lives, and personal disorientation, forgetting who he is, what he is like and what defines him.

Impairment of executive functions

Executive functions are those brain functions that start, organize and integrate the rest of the functions.

Thus, a person with Alzheimer's loses the ability to make a simple fried egg, because despite having the ability to take a pan, break an egg or pour oil, they lose the ability to organize all these steps properly to achieve a fried egg.

This deterioration is, together with the forgetfulness that can be dangerous at many times, the first symptom that makes the person with Alzheimer's disease lose autonomy and needs others to be able to live normally.

Praxias

Praxis are the functions that allow our body to start up to perform a specific function.

For example: it allows us to take a scissors and cut a sheet with it, to wave our neighbor when we see him enter or to wrinkle our forehead when we want to express anger.

In Alzheimer's this ability is also lost, so being able to carry out activities will become more complicated… Now it is not that we do not know how to make a fried egg, but that we do not even know how to take the pan properly!

Gnosias

Gnosias are defined as alterations in the recognition of the world, whether by visual, auditory or tactile way. The first difficulty of this type that usually appears in Alzheimer's is usually the ability to recognize complex stimuli.

However, as the disease progresses, difficulties often appear to recognize faces of friends or acquaintances, everyday objects, organization of space, etc.

These are the 6 cognitive failures that usually occur in Alzheimer's… And what else? Are there more symptoms or are these all? Well yes, more symptoms appear!

And it is that cognitive failures, the fact that the person is losing his capacities that have defined him all his life, usually implies the appearance of a series of psychological and behavioral symptoms.

The psychological symptoms can be delusions (especially the idea that someone steals things, caused by the inability to remember where objects are left), hallucinations, misidentifications, apathy and anxiety.

With regard to behavioral symptoms, wandering, agitation, sexual disinhibition, negativism (absolute refusal to do things), outbursts of anger and aggressiveness may appear.

Why does the brain degenerate in the Azheimer?

To the question why Alzheimer's develops in a person's brain, there is still no answer today. As in all degenerative diseases, it is unknown why at a certain moment a part of the body begins to degenerate.

However, something is known about what happens in the brain of a person with Alzheimer's and what are the changes that cause the neurons of that brain to begin to die.

The scientist Braak showed that the disease begins in the entorhinal cortex, spreads through the hippocampus (the main memory structures of the human brain) and

later, as if it were an oil stain, the rest of the brain regions are affected.

But what happens in those regions of the brain? Until what is known today, the degeneration would be caused by the appearance of neuritic plaques in neurons.

These plaques are created by a protein called b-amyloid, so an overproduction of this protein in neurons could be the initial pathological element of Alzheimer's disease.

Risk factor's

At present, it is globally recognized that Alzheimer's is a multifactorial, heterogeneous and irreversible disease, so a combination of genetic and environmental factors is required for its development.

The basic substrate may be an accelerated neuronal aging not counteracted by the compensatory mechanisms that our brain contains. In this way, genetic factors would only predispose the person to suffer from Alzheimer's and other factors would trigger the disease. These are the following:

1. Age: it is the main risk marker for the disease, so the prevalence increases as age increases, doubling every 5 years from the age of 60.
2. Sex: women suffer from this disease more than men.
3. Family history of dementia: between 40 and 50% of patients with Alzheimer's disease have a relative who has or has had dementia.
4. Education: although Alzheimer's can appear in people with any educational level, there is an increase in Alzheimer's among subjects with less education.
5. Diet: a very high calorie intake could be a risk factor for the disease. Likewise, polyunsaturated fatty acids and antioxidant vitamin supplements (vitamins E and C) have shown a neuroprotective role for Alzheimer's.

Statistics

Alzheimer's occurs in older people, usually from the age of 65. Thus, the incidence of this disease in the general population is low, approximately 2%.

However, in the elderly population the prevalence reaches up to 15%, increasing as age increases. Among people older than 85 years the prevalence reaches 30-40%, being the most prevalent type of dementia by far.

The impact of Alzheimer's on the family

Alzheimer's and dementias in general represent a notable change in family dynamics. It is about learning to live with…. while continuing with family, personal and social life.

The person who suffers from this disease will gradually cease to be himself, will lose the ability to support himself and will need intensive care.

The first step that the family must do is to identify the main caregiver of the patient, that is, the person who will be in charge of performing all those functions that the patient is losing.

Stress in the family and especially in the main caregiver will be very high due to the emotional shock that assuming a situation like this entails, and the work and financial overload that having an Alzheimer's patient in the family will entail.

So it is very important to have a good family organization, so that the main caregiver can get support from others when necessary.

In the same way, it is important to be well informed of the existing social and therapeutic resources (day centers, residences, support groups for families, etc.) and use them in the best possible way.

Treatment

If your first question when you get to this section is whether there is any treatment to cure this disease, the answer is clear: no, there is no therapy capable of curing Alzheimer's.

However, there are certain treatments that can help slow down the evolution of the disease, making deficits take longer to appear, and providing a better quality of life to the patient.

Pharmacotherapy

To date, the only drugs that have shown significant, although not intense, efficacy on cognitive and functional alterations in Alzheimer's are acetylcholinesterase inhibitors (IACE) such as Donepezil, Rivastigmine, and Galantamine.

These drugs have shown effectiveness in treating Alzheimer's symptoms, but in no case do they manage to eliminate it or increase the cognitive abilities of the patient.

Cognitive treatment

Cognitive treatment is widely recommended for Alzheimer's. In fact, if you have dementia, you are practically obliged to do some kind of cognitive work to mitigate your deficits.

To do this, Reality Orientation Therapies, Reminiscence Therapy and psychostimulation workshops that work on the different cognitive functions are recommended: attention, memory, language, executive functions, etc.

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