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September 2009: Alzheimer’s Disease

31 Aug 2009

Dr. Rajesh Jindal is an internist at Weiss Memorial Hospital with a special interest in geriatrics, dementia and Alzheimer’s disease.

Dr. Rajesh Jindal
Internist
Weiss Memorial Hospital
(708) 486-2700

Introduction
Dementia is a word for a group of symptoms caused by disorders that affect the brain. It is not a specific disease. Many different diseases can cause dementia, including Alzheimer’s disease and stroke. Alzheimer’s disease (AD) is the most common form of dementia among older people and it usually occurs in people older than 60. AD is slightly more common in females.

Symptoms

  • AD begins slowly. It initially involves the parts of the brain that control thought, memory and language. At first, the only symptom may be mild forgetfulness.
  • People in the early stage of Alzheimer’s disease may have trouble remembering recent events, activities, or the names of familiar people or things. Simple math problems may become hard to solve. Such difficulties may be a bother, but usually they are not serious enough to cause alarm.
  • However, as the disease goes on, forgetfulness begins to interfere with daily activities. People may forget the way home or find it hard to cope with daily life. Such symptoms are more easily noticed and become serious enough to cause people with Alzheimer's disease or their family members to seek medical help.
  • People in the middle stages of Alzheimer’s disease may forget how to do basic tasks, like brushing their teeth or combing their hair. They can no longer think clearly. They begin to have problems speaking, understanding, reading, or writing.
  • Later on, people with Alzheimer's disease may become anxious, agitated or aggressive, or wander away from home. Eventually, patients need total care.

Risk factors
AD usually begins after age 60. The risk goes up with age. Around 10 percent of people over age 65 and 50 percent of those over 85 have Alzheimer’s. The risk is also higher if a family member has had the disease.

Prevention
There are no treatments, drugs, or pills that can prevent Alzheimer's disease, but people can take some steps that may reduce their risk. These include:

  • Lowering cholesterol and homocysteine levels
  • Lowering high blood pressure levels
  • Controlling diabetes
  • Exercising regularly
  • Engaging in activities that stimulate the mind
  • A healthy diet is important. Although no special diets or nutritional supplements have been found to prevent or reverse Alzheimer's disease, a balanced diet helps maintain overall good health.

Diagnosis
Doctors use several tools to diagnose Alzheimer’s disease:

  • A complete medical history with questions about the person’s general health, past medical problems and any difficulties carrying out daily activities.
  • Medical tests, such as tests of blood, urine or spinal fluid.
  • Tests to measure memory, problem solving, attention, counting and language.
  • Brain scans that allow the doctor to look at a picture of the brain to see if anything does not look normal.

Treatment
Supportive measures

  • Memory aids such as notebooks and posted daily reminders.
  • Emphasize activities that are pleasant and deemphasize those that are unpleasant.
  • Kitchens, bathrooms and bedrooms need to be made safe, and eventually patients must stop driving.
  • Avoid loss of independence and change of environment as it may worsen confusion and cause agitation and anger.

Medical treatment
No treatment can stop Alzheimer’s disease. However, for some people in the early and middle stages of the disease, the drugs Aricept, Exelon or Razidyne may help prevent some symptoms from becoming worse for a limited time. Aricept is also approved for severe symptoms of Alzheimer’s. Another drug, Namenda, is approved for use in moderate to severe forms of the disease.

Some supplements, such as vitamin E and ginkgo biloba, have also been found beneficial.

For more information
If you would like more information about Alzheimer’s disease or dementia or would like an appointment, please call Dr. Jindal’s office at (708) 486-2700.