Alzheimer’s disease (AD), is a chronic condition that causes progressive loss of function and structure of the neurons in the human brain. It usually starts slowly and worsens over time. It is the cause of 60% to 70% of cases of dementia (which is the decline in memory or other thinking skills severe enough to reduce a person’s ability to perform everyday activities). The most common early symptom is difficulty in remembering recent events (short-term memory loss).
In 2015, there were approximately 29.8 million people worldwide with AD. It most often begins in people over 65 years of age, although 4% to 5% of cases begin before this age. It affects about 6% of people 65 years and older. In 2015, dementia resulted in about 1.9 million deaths. It is named after a German psychiatrist and pathologist who first discovered the disease, Alois Alzheimer in 1906.
Nigerians have lower incidence rates for both dementia and Alzheimer’s disease at each age than the African American.
World Alzheimer Day is September 21 of every year.
Sign and symptoms of Alzheimer’s Disease (AD)
Alzheimer’s disease is a progressive disease. The most common early symptom is difficulty in remembering recent events. Other symptoms are;
- Language problems; Gradual shrinkage of vocabulary leads to a gradual impairment in naming objects and processing words. This affects their oral and written English.
- loss of memory; they forget names of family members, repeat questions already asked, forget appointments and can get lost in familiar places.
- Disorientation; they may not know their location or their identity also, they may not know the time and date
- Difficulty in initiating movement.
- Mood swings: They can have a rapid change in their state or quality of feeling at a particular time.
- Loss of Motivation: They usually want to work or do things but they feel they can’t.
- Poor selfcar:; As the disease progresses, they find it difficult to have their bath or comb their hair. In addition, they may not be able to do any of the basic self care they used to do before.
- Behavioral/ psychiatric issues: Wandering, irritability and labile affect are common issues patients face. These can lead to crying, outbursts of unpremeditated aggression, or resistance to caregiving.
Other symptoms patients may experience
In later stages, other symptoms may occur. This includes sleep disturbances, agitation (physical or verbal outbursts, general emotional distress, restlessness, pacing, shredding paper or tissues, yelling), delusions (firmly held belief in things that are not real) or hallucinations (seeing, hearing or feeling things that are not there). About 30% of people with AD develop illusions and other delusional symptoms. Depressive symptoms, irritability and reduced awareness of subtle memory difficulties are also common. Others include;
- Withdraw from family and society.
- Loss of bodily functions; there is a gradual reduction in muscle mass and mobility deteriorates to the point where they are bedridden and unable to feed themselves.
- Death; the cause of death is usually not the disease but the associated complication that occur such as infection of pressure ulcers or pneumonia.
What Causes Alzheimer’s Disease?
The cause of Alzheimer’s disease basically unknown except in 1% to 5% of cases where genetic differences have been identified. Some factors and hypothesis have however been linked to the disease. They are:
- Genetics: The genetic heritability is 49%- 79%. It can be autosomal dominant in 0.1% of this group where it can be present before the age of 65. It is usually due to mutation of some genes.
- Sporadic: Environment and genetic factors can predispose to the disease
- Sex: It is commoner in women because they tend to live longer.
- Age: It increases with increasing age. It is greater in people above 65years.
- Some factors such as obesity, smoking, high blood pressure, lack of exercise, poorly controlled type 2 diabetes have been found to predispose to Alzheimer’s disease. However, doctors require more evidence.
- Cholinergic hypothesis: This proposes that reduced synthesis of neurotransmitter acetylcholine causes Alzheimer’s disease.
- Amyliod hypothesis: This proposes that Alzheimer’s disease is caused by deposit of amyloidal protein (abnormal protein the bone marrow produces and deposits in any tissue or organ) in the brain.
- Neurovascular hypothesis: This proposes that abnormality in blood-brain barrier can lead to Alzheimer’s disease.
How Can One Prevent Alzheimer’s Disease
There is currently no known preventive measure against the disease. However, screening for the abnormal genes can be done amongst the susceptible population to predict the possibility of having the disease.
There is currently no cure for the disease. Nonetheless, patients can get palliative care such as;
- Medications: This helps to improve the functionality of the brain. It also improves their mood.
- Psychosocial care
- Caregiving: The caregiver should ensure they get healthy diets and undergo regular exercise. They should also keep wallets and phones in a particular place. It is also good to keep photographs of family and friends around the house.
Life expectancy of people with Alzheimer’s Disease is less than other people. Following diagnosis, it typically ranges from three to ten years. Men have a less favourable survival prognosis than women