10/07/2020
# # ALZHEIMER'S DISEASE & DEMENTIA # #
Many of us have memory lapses as we age. Dementia is different because it affects our ability to carry out everyday tasks, such as driving, managing finances, cooking, shopping, or in more severe stages being able to feed yourself. A “cognitively normal” person may occasionally forget where they put their keys; a patient with mild dementia frequently forgets this, and may even forget what keys are for.
Dementia is defined as a “clinical syndrome” that can result from many diseases, including Alzheimer’s. It is generally defined as impairment in at least two domains of cognitive function. (These domains include things like the ability to comprehend and verbalize language, form short-term memories, and understand geographic information.) The impairments must also affect daily function and be chronic rather than acute.
CAUSES & TYPES
Once a doctor determines that a patient has dementia, the next question is: what’s causing it? Alzheimer’s disease is the most common form of dementia, accounting for approximately two-thirds of all cases. Vascular dementia and mixed dementia (vascular dementia plus Alzheimer’s disease) account for another quarter. Other, less common types include Levy body dementia and fronto temporal degeneration (FTD). In every one of these diseases, the dementia is caused by neuro degeneration, which is the death of brain cells.
The cause of brain cell (i.e., neuron) death and/or its location in the brain define whether the dementia is Alzheimer’s disease or another type.
In Alzheimer’s, neurons are first lost in the hippocampus, our brain’s centre for memory and learning. While we do not know the cause of Alzheimer’s disease, we believe that a number of biological processes related to aging— including inflammation, oxidation, and the accumulation of toxic proteins (e.g., beta-amyloid and tau)—contribute to the process.
Vascular dementia is caused by damage to blood vessels that supply energy and nutrients to neurons and generally appears as “silent strokes” on MRI brain scans. Levy body dementia refers to Parkinson’s disease dementia and dementia with Levy bodies, both of which involve toxic accumulations of proteins called alpha-synuclein. FTD and its subtypes occur when neurons die in the frontal and temporal lobes of the brain.
Other conditions can result in “reversible dementia,” which is treatable. These include depression, poly pharmacy (due to the side effects of medications), thyroid disorders, vitamin B12 deficiency, head trauma, tumours, vasculitis, and alcoholism.
SYMPTOMS
Memory loss is the key symptom of Alzheimer's disease. An early sign of the disease is usually difficulty remembering recent events or conversations. As the disease progresses, memory impairments worsen and other symptoms develop.
At first, a person with Alzheimer's disease may be aware of having difficulty with remembering things and organizing thoughts. A family member or friend may be more likely to notice how the symptoms worsen.
Brain changes associated with Alzheimer's disease lead to growing trouble with:
Memory; everyone has occasional memory lapses. It's normal to lose track of where you put your keys or forget the name of an acquaintance. But the memory loss associated with Alzheimer's disease persists and worsens, affecting the ability to function at work or at home.
People with Alzheimer's may:
• Repeat statements and questions over and over;
• Forget conversations, appointments or events, and not remember them later;
• Routinely misplace possessions, often putting them in illogical locations;
• Get lost in familiar places;
• Eventually forget the names of family members and everyday objects;
• Have trouble finding the right words to identify objects, express thoughts or take part in conversations;
• Thinking and reasoning; Alzheimer's disease causes difficulty concentrating and thinking, especially about abstract concepts such as numbers.
Multitasking is especially difficult, and it may be challenging to manage finances, balance check books and pay bills on time. These difficulties may progress to an inability to recognize and deal with numbers.
Making judgments and decisions
The ability to make reasonable decisions and judgments in everyday situations will decline. For example, a person may make poor or uncharacteristic choices in social interactions or wear clothes that are inappropriate for the weather. It may be more difficult to respond effectively to everyday problems, such as food burning on the stove or unexpected driving situations.
Planning and performing familiar tasks
Once-routine activities that require sequential steps, such as planning and cooking a meal or playing a favourite game, become a struggle as the disease progresses. Eventually, people with advanced Alzheimer's may forget how to perform basic tasks such as dressing and bathing.
Changes in personality and behaviour
Brain changes that occur in Alzheimer's disease can affect moods and behaviours. Problems may include the following:
• Depression;
• Apathy;
• Social withdrawal;
• Mood swings;
• Distrust in others;
• Irritability and aggressiveness;
• Changes in sleeping habits;
• Wandering;
• Loss of inhibitions;
• Delusions, such as believing something has been stolen;
• Preserved skills
Many important skills are preserved for longer periods even while symptoms worsen. Preserved skills may include reading or listening to books, telling stories and reminiscing, singing, listening to music, dancing, drawing, or doing crafts.
These skills may be preserved longer because they are controlled by parts of the brain affected later in the course of the disease.
Diagnosis
A key component of a diagnostic assessment is self-reporting about symptoms, as well as the information that a close family member or friend can provide about symptoms and their impact on daily life. Additionally, a diagnosis of Alzheimer's disease is based on tests your doctor administers to assess memory and thinking skills.
Laboratory and imaging tests can rule out other potential causes or help the doctor better characterize the disease causing dementia symptoms.
The entire set of diagnostic tools is designed to detect dementia and determine with relatively high accuracy whether Alzheimer's disease or another condition is the cause. Alzheimer's disease can be diagnosed with complete certainty after death, when microscopic examination of the brain reveals the characteristic plaques and tangles.
Tests
A diagnostic work-up would likely include the following tests:
Physical and neurological exam
Your doctor will perform a physical exam and likely assess overall neurological health by testing the following:
• Reflexes
• Muscle tone and strength
• Ability to get up from a chair and walk across the room
• Sense of sight and hearing
• Coordination
• Balance
Lab tests
Blood tests may help your doctor rule out other potential causes of memory loss and confusion, such as a thyroid disorder or vitamin deficiencies.
Mental status and neuropsychological testing
Your doctor may conduct a brief mental status test or a more extensive set of tests to assess memory and other thinking skills. Longer forms of neuropsychological testing may provide additional details about mental function compared with people of a similar age and education level. These tests are also important for establishing a starting point to track the progression of symptoms in the future.
Brain imaging
Images of the brain are now used chiefly to pinpoint visible abnormalities related to conditions other than Alzheimer's disease — such as strokes, trauma or tumours — that may cause cognitive change. New imaging applications — currently used primarily in major medical centres or in clinical trials — may enable doctors to detect specific brain changes caused by Alzheimer's.
Imaging of brain structures includes the following:
• Magnetic resonance imaging (MRI). MRI uses radio waves and a strong magnetic field to produce detailed images of the brain. MRI scans are used primarily to rule out other conditions. While they may show brain shrinkage, the information doesn't currently add significant value to making a diagnosis.
• Computerized tomography (CT). A CT scan, a specialized X-ray technology, produces cross-sectional images (slices) of your brain. It's currently used chiefly to rule out tumours, strokes and head injuries.
Imaging of disease processes can be performed with positron emission tomography (PET). During a PET scan, a low-level radioactive tracer is injected into the blood to reveal a particular feature in the brain. PET imaging may include the following:
• Fluorodeoxyglucose (FDG) PET scans show areas of the brain in which nutrients are poorly metabolized. Identifying patterns of degeneration — areas of low metabolism — can help distinguish between Alzheimer's disease and other types of dementia.
• Amyloid PET imaging can measure the burden of amyloid deposits in the brain. This imaging is primarily used in research but may be used if a person has unusual or very early onset of dementia symptoms.
• Tau Pet imaging, which measures the burden of neurofibrillary tangles in the brain, is only used in research.
In special circumstances, such as rapidly progressive dementia or very early onset dementia, other tests may be used to measure abnormal beta-amyloid or tau in the cerebrospinal fluid.
Future diagnostic tests
Researchers are working on tests that can measure the biological evidence of disease processes in the brain. These tests may improve the accuracy of diagnoses and enable earlier diagnosis before the onset of symptoms.
Genetic testing generally isn't recommended for a routine Alzheimer's disease evaluation. The exception is people who have a family history of early-onset Alzheimer's disease. Meeting with a genetic counsellor to discuss the risks and benefits of genetic testing is recommended before undergoing any tests.
# # ALZHEIMER'S DISEASE & DEMENTIA # #
Many of us have memory lapses as we age. Dementia is different because it affects our ability to carry out everyday tasks, such as driving, managing finances, cooking, shopping, or in more severe stages being able to feed yourself. A “cognitively normal” person may occasionally forget where they put their keys; a patient with mild dementia frequently forgets this, and may even forget what keys are for.
Dementia is defined as a “clinical syndrome” that can result from many diseases, including Alzheimer’s. It is generally defined as impairment in at least two domains of cognitive function. (These domains include things like the ability to comprehend and verbalize language, form short-term memories, and understand geographic information.) The impairments must also affect daily function and be chronic rather than acute.
CAUSES & TYPES
Once a doctor determines that a patient has dementia, the next question is: what’s causing it? Alzheimer’s disease is the most common form of dementia, accounting for approximately two-thirds of all cases. Vascular dementia and mixed dementia (vascular dementia plus Alzheimer’s disease) account for another quarter. Other, less common types include Levy body dementia and fronto temporal degeneration (FTD). In every one of these diseases, the dementia is caused by neuro degeneration, which is the death of brain cells.
The cause of brain cell (i.e., neuron) death and/or its location in the brain define whether the dementia is Alzheimer’s disease or another type.
In Alzheimer’s, neurons are first lost in the hippocampus, our brain’s centre for memory and learning. While we do not know the cause of Alzheimer’s disease, we believe that a number of biological processes related to aging— including inflammation, oxidation, and the accumulation of toxic proteins (e.g., beta-amyloid and tau)—contribute to the process.
Vascular dementia is caused by damage to blood vessels that supply energy and nutrients to neurons and generally appears as “silent strokes” on MRI brain scans. Levy body dementia refers to Parkinson’s disease dementia and dementia with Levy bodies, both of which involve toxic accumulations of proteins called alpha-synuclein. FTD and its subtypes occur when neurons die in the frontal and temporal lobes of the brain.
Other conditions can result in “reversible dementia,” which is treatable. These include depression, poly pharmacy (due to the side effects of medications), thyroid disorders, vitamin B12 deficiency, head trauma, tumours, vasculitis, and alcoholism.
SYMPTOMS
Memory loss is the key symptom of Alzheimer's disease. An early sign of the disease is usually difficulty remembering recent events or conversations. As the disease progresses, memory impairments worsen and other symptoms develop.
At first, a person with Alzheimer's disease may be aware of having difficulty with remembering things and organizing thoughts. A family member or friend may be more likely to notice how the symptoms worsen.
Brain changes associated with Alzheimer's disease lead to growing trouble with:
Memory; everyone has occasional memory lapses. It's normal to lose track of where you put your keys or forget the name of an acquaintance. But the memory loss associated with Alzheimer's disease persists and worsens, affecting the ability to function at work or at home.
People with Alzheimer's may:
• Repeat statements and questions over and over;
• Forget conversations, appointments or events, and not remember them later;
• Routinely misplace possessions, often putting them in illogical locations;
• Get lost in familiar places;
• Eventually forget the names of family members and everyday objects;
• Have trouble finding the right words to identify objects, express thoughts or take part in conversations;
• Thinking and reasoning; Alzheimer's disease causes difficulty concentrating and thinking, especially about abstract concepts such as numbers.
Multitasking is especially difficult, and it may be challenging to manage finances, balance check books and pay bills on time. These difficulties may progress to an inability to recognize and deal with numbers.
Making judgments and decisions
The ability to make reasonable decisions and judgments in everyday situations will decline. For example, a person may make poor or uncharacteristic choices in social interactions or wear clothes that are inappropriate for the weather. It may be more difficult to respond effectively to everyday problems, such as food burning on the stove or unexpected driving situations.
Planning and performing familiar tasks
Once-routine activities that require sequential steps, such as planning and cooking a meal or playing a favourite game, become a struggle as the disease progresses. Eventually, people with advanced Alzheimer's may forget how to perform basic tasks such as dressing and bathing.
Changes in personality and behaviour
Brain changes that occur in Alzheimer's disease can affect moods and behaviours. Problems may include the following:
• Depression;
• Apathy;
• Social withdrawal;
• Mood swings;
• Distrust in others;
• Irritability and aggressiveness;
• Changes in sleeping habits;
• Wandering;
• Loss of inhibitions;
• Delusions, such as believing something has been stolen;
• Preserved skills
Many important skills are preserved for longer periods even while symptoms worsen. Preserved skills may include reading or listening to books, telling stories and reminiscing, singing, listening to music, dancing, drawing, or doing crafts.
These skills may be preserved longer because they are controlled by parts of the brain affected later in the course of the disease.
Diagnosis
A key component of a diagnostic assessment is self-reporting about symptoms, as well as the information that a close family member or friend can provide about symptoms and their impact on daily life. Additionally, a diagnosis of Alzheimer's disease is based on tests your doctor administers to assess memory and thinking skills.
Laboratory and imaging tests can rule out other potential causes or help the doctor better characterize the disease causing dementia symptoms.
The entire set of diagnostic tools is designed to detect dementia and determine with relatively high accuracy whether Alzheimer's disease or another condition is the cause. Alzheimer's disease can be diagnosed with complete certainty after death, when microscopic examination of the brain reveals the characteristic plaques and tangles.
Tests
A diagnostic work-up would likely include the following tests:
Physical and neurological exam
Your doctor will perform a physical exam and likely assess overall neurological health by testing the following:
• Reflexes
• Muscle tone and strength
• Ability to get up from a chair and walk across the room
• Sense of sight and hearing
• Coordination
• Balance
Lab tests
Blood tests may help your doctor rule out other potential causes of memory loss and confusion, such as a thyroid disorder or vitamin deficiencies.
Mental status and neuropsychological testing
Your doctor may conduct a brief mental status test or a more extensive set of tests to assess memory and other thinking skills. Longer forms of neuropsychological testing may provide additional details about mental function compared with people of a similar age and education level. These tests are also important for establishing a starting point to track the progression of symptoms in the future.
Brain imaging
Images of the brain are now used chiefly to pinpoint visible abnormalities related to conditions other than Alzheimer's disease — such as strokes, trauma or tumours — that may cause cognitive change. New imaging applications — currently used primarily in major medical centres or in clinical trials — may enable doctors to detect specific brain changes caused by Alzheimer's.
Imaging of brain structures includes the following:
• Magnetic resonance imaging (MRI). MRI uses radio waves and a strong magnetic field to produce detailed images of the brain. MRI scans are used primarily to rule out other conditions. While they may show brain shrinkage, the information doesn't currently add significant value to making a diagnosis.
• Computerized tomography (CT). A CT scan, a specialized X-ray technology, produces cross-sectional images (slices) of your brain. It's currently used chiefly to rule out tumours, strokes and head injuries.
Imaging of disease processes can be performed with positron emission tomography (PET). During a PET scan, a low-level radioactive tracer is injected into the blood to reveal a particular feature in the brain. PET imaging may include the following:
• Fluorodeoxyglucose (FDG) PET scans show areas of the brain in which nutrients are poorly metabolized. Identifying patterns of degeneration — areas of low metabolism — can help distinguish between Alzheimer's disease and other types of dementia.
• Amyloid PET imaging can measure the burden of amyloid deposits in the brain. This imaging is primarily used in research but may be used if a person has unusual or very early onset of dementia symptoms.
• Tau Pet imaging, which measures the burden of neurofibrillary tangles in the brain, is only used in research.
In special circumstances, such as rapidly progressive dementia or very early onset dementia, other tests may be used to measure abnormal beta-amyloid or tau in the cerebrospinal fluid.
Future diagnostic tests
Researchers are working on tests that can measure the biological evidence of disease processes in the brain. These tests may improve the accuracy of diagnoses and enable earlier diagnosis before the onset of symptoms.
Genetic testing generally isn't recommended for a routine Alzheimer's disease evaluation. The exception is people who have a family history of early-onset Alzheimer's disease. Meeting with a genetic counsellor to discuss the risks and benefits of genetic testing is recommended before undergoing any tests.
Treatment
Classical homeopathy aims to find or match one remedy to the whole condition the person is suffering. Symptoms presented - such as difficulties in thinking, forgetfulness, reasoning, communication as well as feeling lost in familiar places and unable to recognize one's family members and friends with lots of words and loss of judgment - is only the beginning; taken alone, these symptoms do not define the choice of the correct homeopathic remedy.
There are so many remedies in homeopathy to treat such diseases; as Agaricus, Belladonna, Hyoscamus, Anacardium, Baryta carb, Calcarea Carb, Merc Sol, Lilium Tig, Nux Vomica, Natrum Sulph, Kali Phos, Alumina, Helleborus, Graphites, Kali Brom, Ambra Gricea, Ginkogo Biloba etc. etc.
