September 21 has been designated as World Alzheimer's Day, with the aim of raising awareness and awakening the public to Alzheimer's disease. The disease was first described in 1906 by the German psychiatrist and neuropathologist Alois Alzheimer, from whom it takes its name.
What is Alzheimer's disease?
Alzheimer's disease is the most common form of dementia. It is a major medical, social and economic problem for developed societies. Today, there are more than 160,000 thousand patients in Greece and, according to scientists' predictions, the number of patients will increase dramatically in the future.
Alzheimer's disease is a degenerative disease of the brain, characterized by progressive decline in cognitive functions of memory, thinking, perception, computation, language, learning and judgment. It is a disease of "old age", although cases are occasionally seen in people younger than 65 years of age.
How is it different from dementia?
There are many different forms of dementia and each comes from different causes. The most common form of dementia is Alzheimer's disease.
The term dementia describes the symptoms of a large group of diseases that lead to a gradual decline in a person's functioning. Most people with dementia are of advanced age, usually over 65.
What causes Alzheimer's disease?
Although the exact molecular processes that cause it are not fully known, what characterises the disease histologically is the gradual deposition of protein aggregates in areas of the brain. These proteins form two characteristic structures:
- Amyloid plaques: they consist of deposits of a peptide called beta-amyloid.
- Neurofibrillary tangles (neurofibrillary tangles): composed of the protein t.
These structures cause damage to the connections between brain cells, interfering with the transfer of messages within the brain. Brain cells eventually die, resulting in the loss of certain functions or abilities.
What are the causes?
The exact causes of the disease are not known. It seems that genetic factors play an important role. At the same time, environmental factors - including vascular diseases (diabetes, hypertension, dyslipidemia) and lifestyle (education, occupation, intellectual and social activities, physical activity, diet) - seem to influence the likelihood of developing the disease.
Is the disease hereditary?
According to what we know so far, the vast majority of cases are not hereditary. Recently, some genes have been discovered that are associated with the disease. However, their presence does not imply the presence of the disease. It simply increases the chances of developing the disease. In cases of families where the disease is detected at a young age, a specific genetic mutation responsible for the disease has been identified.
What are the symptoms?
The onset of Alzheimer's disease is slow and gradually leads to complete disorganization of the patient's personality. The symptoms manifest themselves differently in each person.
There are symptoms that may occur before the disease, but can be attributed to something else, such as stress or other psychological disorders. Usually, the first perceived symptoms directly linked to the disease are memory disorders.
The course of the disease is divided into three stages:
- Early stage
- Confusion about space
- Lack of initiative in starting new activities
- Avoiding unfamiliar situations
- Delayed reactions and reduced learning ability
- Slow speech
- Lack of critical faculty
- Symptoms of depression and nervousness
These symptoms are usually more severe when the person is in a new place or is called upon to deal with an unusual or unfamiliar incident.
- Medium stage
- Failure to recognise close friends, even family members
- Psychological disorders
- Difficulty in organising thought, writing and reading
- Nervousness and hostile behaviour
- Irrational beliefs
- Lack of sense of time
- Need for continuous supervision
- Final stage
- Failure to carry out daily activities such as eating, dressing and toileting
- Lack of stability and balance
- Sitting in bed or in a wheelchair
- Difficulty in verbal communication
- Confusion during the evening hours
- Incontinence
How is the diagnosis made?
The diagnosis of the disease is confirmed by mental evaluations and cognitive testing, combined with brain imaging tests.
Is there a cure?
Unfortunately, there is as yet no treatment that reverses the course of the disease. However, there are some drugs which, when given at an early stage, can temporarily slow down the progression of the disease.
The management of psychological symptoms, with appropriate medication, is also important for the management of the disease.
In addition to medication, cognitive rehabilitation plays a key role in treatment. It involves a series of activities and exercises that help the brain to be constantly alert and to maintain as much of its cognitive reserve as possible.
Finally, as the disease progresses, the person needs constant supervision and care.
The optimistic news is that in recent years there has been a major research effort to find new treatments that will more effectively treat the disease and significantly improve patients' quality of life.
Bibliography
https://www.moh.gov.gr/articles/news/1383-pagkosmia-hmera-nosoy-altsxaimer
https://www.onmed.gr/ygeia/story/347543/21-septemvrioy-pagkosmia-hmera-nosoy-altsxaimer
https://www.diaplasis.eu/21-σεπτεμβρίου-παγκόσμια-ημέρα-νόσου-alzheimer/
https://www.sami.gov.gr/kentrokoinotitas-hmera-Alzheimer2022
https://neyrologos.gr/alzheimer-symptomata-stadia-aitia-therapeia/
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