Alzheirmer’s Disease

Dementia is most commont in the elderly that cause of morbidity and mortality. Alzheimer’s disease is one of the etiology of dementia. Memory, orientation, visuspatial perception, language and higher executive function may be impaired. Five percent of people between ages 65 and 70 have dementia; this increase to more than 45% above age 85. Alzheirmer’s disease contribute for 50 to 70% of cases of dementia

Alzheimer’s Disease (AD)
Nearly 4% of people older than 65 years have severe AD. The population for Ad is the fastest growing segment of society becase of increased life expectancy. There are many factors that associated with an increase frequency of AD,such as; age, female sex, history of severe head trauma,and Down syndrome.
Clinical Manifestations
At the beginning of the illness, the exam shows no difficulty with language, reasoning or performance of normal social and personal behaviors. The aspects of cognitive function are lost; ability to speak, understand, think and make decisions. Characteristically, in contrast to patients with vascular dementia, elementary neurologic functions ( motor, visual, somatosensory, and gait) remahn normal until very late in the disease.

Psychiatric manifestation are common at this time:

  • Personality changes: Apathetic or impulsive.
  • Aggressive behaviour: Physical or verbal.
  • Paranoid thoughts and delusion.
  • Sleep disturbances
  • Hallucinations
  • Deppression

Dignostic Evaluation
MRI may show reduction of up to 40% in the size of the hippocampus, amygdala, and thalamus. PET and SPECT ( single-photon emission computed tomography) ,used to quantify cerebral metabolism and blood flow, may help to differentiate AD from other dementia.

TREATMENT
Theraphy consist of the following:

  • Preventing associated symptoms ( depressions, agitation, sleep disorder, hallucinations, and delusions ).
  • Preventing or delaying progression.
    by using acethylcholinesterase inhibitor such as donepezil (aricept), rivastigmine (exelon).
  • Prophylaxis.
    Use of vitamin E ( 800- 2000 IU po daily), NSAIDs ,and estrogen (conjugated estrogens) has been proposed. (dr. rend-san)
Source: Alzheirmer’s Disease @ HealthyCase
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