Alzheimer's disease, as an irreversible form of senile dementia, and features of its development

Alzheimer's disease (AD) is an acquired intellectual disorder. The disease is accompanied by a gradual and persistent decrease in intellectual brain activity. A person loses previously acquired skills and knowledge and is unable to learn new ones. Patients with asthma cannot lead a full life and perform even basic household tasks.

The first mentions of this disease are found in ancient sources. But Alois Alzheimer gave it a detailed definition using the example of his ward only in 1907. This form of dementia is called senile dementia of the Alzheimer's type or Alzheimer's disease. It is still being studied in an attempt to reduce the likelihood of new diseases and improve the lives of patients.

Epidemiology

According to the World Health Organization in 2020, 0.441% of the world's population lives with dementia. According to WHO forecasts, by 2030 this figure will increase to 0.556%. According to research, Alzheimer's disease is the most common cause of dementia in older people. And the number of patients will double every 20 years. Analysis of groups of cases shows that 60% of them live in countries with low and middle living standards.

Content:

• Epidemiology
• Modern classification
• Causes
• Localization of lesions
• Symptoms of the disease
• Stages
• Diagnostics
• Treatment
• How to prevent disease
• Consequences
• Lifespan
• Causes of death

The main reason for the spread of the disease on a global scale is the growing number of elderly people. AD most often affects people after 65 years of age, before 65 years of age it is rare, and before 45 years of age it almost never occurs. Although over the past decade, the disease has increasingly affected people at a younger age - up to 60 years. An exception in the statistics is for patients with Down syndrome; in this group of patients, the first signs of the disease often appear by the age of 30. Men get asthma 2-3 times less often than women. In children and adolescents, asthma is not observed.

Stages of development

Scientists have found that Alzheimer's disease (initial symptoms) manifests itself 15-20 years before the pronounced clinical picture, which greatly complicates the prevention of the development of the disease. To date, 3 stages of the pathological process have been identified:

1. Preclinical – pathology is in its infancy, no central nervous system disorders are observed.
2. A period of minor impairment - patients may notice a weakening of intellectual abilities and memory deterioration.
3. The initial degree of dementia - those close to you begin to notice that something is wrong. Most often, the presence of the disease can be confirmed clinically.

Each stage has its own characteristic features and approaches to providing medical care.

Modern classification

In simple words, Alzheimer's disease is the slow degradation of a person in all aspects of life. It is divided into two forms: senile and presenile. The first is said to occur when the disease begins after 65 years of age, and the latter when it is detected before this age. This classification reflects old ideas about dementia, when it was believed that intellectual disorders in early and late life were different pathologies. At that time, Alzheimer's disease was called the presenile form, and the senile form was simply called senile dementia.

Research into the etiology and pathogenesis of the disease has shown that both forms have the same stages and mechanisms of development. Based on this, both presenile and senile diseases were combined into one disease and designated as “Alzheimer’s disease.” According to ICD 10, this type of dementia was coded G30. Despite the same essence, scientists do not deny the differences in clinical indicators in senile and presenile dementia.

Presenile

Fast-flowing form. It occurs between 45 and 65 years of age, except in rare cases when it affects people over 65 years of age. It differs from senile in its faster pace of development and family history. Distinctive characteristics of the presenile form:

• occurs before age 65;
• rapid progression;
• family history;
• The clinical picture shows memory impairment, changes in speech and motor functions.

Most often, the onset of the disease occurs at 55-60 years of age. The first stages develop slowly and can last from several months to 2-4 years. The decay of intelligence begins with forgetfulness of current events: the patient remembers well past events, but forgets recent ones. Unlike senile dementia, the patient is not immersed in the past. In the initial stages of the disease, criticism of one’s own condition remains.

The patient, aware of what is happening, may try to hide the illness. When talking, a person often tries to avoid the topic because he cannot remember the right words or events. Over time, attempts to maintain the “façade of personality” weaken and criticism decreases. The patient quickly loses reading, counting, and writing skills. The perception of the surroundings is also blurred.

Sensory and amnestic disturbances are accompanied by disorientation. As the disease progresses, the person gradually forgets how to use household items. In the future, meaningless movements and gestures are observed. In the final stages, the patient’s set of skills and knowledge is completely exhausted. Speech is limited to incoherent sounds, the patient even forgets automated actions, such as walking or sitting independently.

The full cycle of the disease takes from 1 to 10 years. The rate of progress depends on factors such as heredity, type of activity, standard of living, and the presence of other diseases.

At the end of the pathology, patients are not able to do something themselves, to ask for something. Death in most cases occurs from associated infections.

Senile

A form of later manifestation, most often occurs after 65 years. Senile dementia is called the first type of Alzheimer's disease. It is distinguished from presenile by slow progress and lack of family history. Distinctive characteristics:

• occurs after 65 years of age;
• family history is not traceable;
• progress is slow with temporary plateaus;
• the clinical picture is dominated by memory impairment.

Type I BA is also distinguished clinically from the presenile form. In the first case, the patient quickly experiences disturbances in speech, awareness, movements, and gnosis. With senile dementia, personality and mental activity gradually disintegrate. The first stages of pathology are subtle. Over time, the constitution of the individual changes, a person can become gloomy, suspicious, and grouchy.

Among the symptoms of senile dementia, a “shift into the past” is distinguished. In the early stages, a person does not perceive new knowledge, judgments, and skills. They perceive the past as an example. As patients progress, false memories or recognitions occur; people from the current moment are associated with people from the past. Patients may also invent events related to the past.

From the early stages to the last, egocentrism and selfishness progresses. The patient's priorities are narrowed around his personality, health and safety. Emotional memory for loved ones is disrupted, old attachments to people disappear. In behavior, there is a progression of lower drives: gluttony, inappropriate sexualization, accumulation of rubbish, etc.

Unlike the presenile form, in this case there is no complete breakdown of speech and motor function. Patients until the last stage can maintain a rich vocabulary and vividness of speech. However, logical connections suffer greatly due to insanity. Amnesia progresses slowly and affects from the most complex skills to simple ones.

In the final stages, patients, just like in the presenile form, are unable to take care of themselves. The full cycle of pathology takes from 4 to 15 or more years.

Heredity

The detailed study of the disease was initiated by psychiatrist Alois Alzheimer. Observing his patient with dementia, he described the pathology and tried to find the cause of this phenomenon. Today we are still continuing our search. Several hypotheses have been put forward, one of which is heredity. Intravital and postmortem studies of patients have shown a relationship between gene mutations and disease risk.

Content:

• Heredity
• Psychological reasons
• Hypotheses
• Risk factors

Scientists have suspected a connection between AD and Down syndrome. People with Alzheimer's syndrome develop Alzheimer's disease much more often and earlier than others. In general, asthma is a problem of the older age group - most often it occurs in people 40-65 years old. But with Down syndrome, the disease strikes before the age of 30. Researchers suspected that the reason may lie in the “breakage” of chromosome 21. And they found confirmation of this. But in addition to chromosome 21, it was discovered that the disease occurs when mutations also occur on chromosomes 1, 14 and 19.

Gene mutations can be inherited. The guesses were supported by observations of statistics. Approximately 10% of patients have a family history of an ancestor with asthma. Today it is believed that in a family where one parent is sick, the child’s risk of getting sick is 50%. If both are sick, there is almost a 100% chance that the heir will develop dementia.

But the “breakage” of genes only means a predisposition to the disease. This means there must be other factors that increase this risk. In addition, hereditary dementia accounts for only 10% of all patients. Finding out what happens to the remaining 90% is the main task of psychiatry, neurology and medicine in general.

Causes

Alzheimer's disease is not contagious and is recognized as a multifactorial disease. The exact cause of the development of degenerative processes in the brain remains unclear. The main cause of pathological anatomy is gene defects that can be inherited. Familial dementia accounts for only 10% of the total number of patients, but most pathological studies are devoted to it.

It was possible to identify four genes that lead to the development of Alzheimer's in old age. These genes lead to metabolic disorders at the cellular level. A key role in susceptibility is attributed to defects in the gene encoding the amyloid precursor protein (APP). Normally, it breaks down into identical polypeptides. When mutations occur, APP is divided into fragments of different sizes, while the long ones do not disintegrate and form plaques.

Clusters of APP are deposited in the brain parenchyma and damage neurons. Due to disrupted neural connections, the brain does not fully perform its function. A deviation in the structure of the tau protein also leads to a similar result. Its threads combine and create “balls”. Such compounds disrupt biochemical signaling between cells. Over time, the cells die completely.

It has not yet been possible to accurately determine the cause of mutations in genes, other than heredity. Scientists have compiled a list of factors that increase the risk and can serve as triggers for the onset of the disease.

These include:

• head injuries;
• episodes of depression and psychological distress;
• lack of intellectual activity;
• diabetes;
• diseases of the respiratory and cardiovascular system;
• sedentary lifestyle and sedentary work;
• addiction to sugar and coffee;
• weight gain;
• alcohol and nicotine addiction.

Almost all factors can be classified as both controllable and conditionally correctable. People aged 65 years and older and elderly women are at particular risk. Also, the likelihood of experiencing dementia is higher in people who are overweight, have heart and vascular disease, and have low intellectual activity.

Genetic development factor

Hereditary pathology accounts for up to 10% of all registered cases of the disease. The development of Alzheimer's disease according to the genetic mechanism begins before 65 years of age. The gene is transmitted in an autosomal dominant manner: even if the second parent is not a carrier, the healthy gene transmitted to them is replaced by a pathological one. The chance of transmission to a child usually occurs in half the time.

Despite the proven genetic factor, scientists are convinced that different types of chromosomes contribute to the development of the disease. More recently, research has discovered a gene defect on chromosome 14, which leads to the development of the disease in 70% of cases.

Abnormalities of chromosome 21, which cause Down syndrome, lead to early development of Alzheimer's disease in 5% of cases. The rarest pathology - a defect in the gene of chromosome 1 - has a low probability of a “familial” disease.

Localization of lesions

After the death of his patient, Alois Alzheimer examined parts of her brain, where he discovered senile plaques. Modern pathological studies confirm that patients have protein accumulations. When APP is impaired, insoluble fragments are deposited in the brain parenchyma and the walls of cerebral vessels. Tau protein is part of the inner membranes of neurons. Abnormalities in this protein damage membranes, which in turn leads to the death of brain cells.

Lesions are localized in the cortex and brain cells. The consequences extend to the nervous system and all brain functions. The hippocampus, the area of ​​the brain responsible for memory and learning, is most affected.

Treatment of the initial stage

We have looked at what Alzheimer's disease is in general terms. The causes and treatment of the disease are currently not fully understood by science. Doctors are constantly conducting research in search of an effective medicine, but a unique drug that can defeat the disease has not yet been created.

Treatment is comprehensive, consisting of:

• therapy for mental disorders;
• general strengthening of the body;
• establishing metabolism in the brain;
• strengthening blood vessels;
• general therapy for Alzheimer's.

It is important to start taking medications on time and ensure that all medical recommendations are carefully followed. It is necessary to observe the development of the disease in dynamics.

The following medications are used to treat mild to moderate dementia:

• "Piribedil" - improves the transmission of nerve impulses in dopaminergic and norepinephrine synapses of the central nervous system. Improves memory and mental abilities.
• “Pentoxifylline”, “Vinpocetine” - improve blood circulation, prevent the formation of blood clots in the vessels of the brain.
• Ginkgo biloba extract – stimulates the production of neurotransmitters, protects brain cells from toxins, improves blood circulation.
• “Cinnarizine”, “Nimodipine” - dilate blood vessels in the brain, protect cells from the harmful effects of excess calcium.
• Pyrrolidone and its derivatives improve oxygen supply to the brain and help normalize protein synthesis in brain cells.
• “Actovegin”, “Cerebrolysin” - help restore information chains and stimulate intracellular metabolic processes.

Symptoms of the disease

Establishing the exact time of onset of asthma is very difficult. The onset of the pathology is subtle, and neither the patients themselves nor their loved ones can determine when the first stage began. The first manifestations include a narrowing of the circle of interests, instability of mood, suspiciousness, and lack of concentration. It is very difficult for patients to learn; new material is being absorbed worse and worse.

Also among the symptoms in the first stages:

• difficulty in performing difficult everyday tasks;
• interrupted sleep at night and drowsiness during the day;
• gradual loss of professional skills;
• “loss” of individual words from memory, an attempt to replace them with synonyms;
• frequent changes in mood and behavior;
• periodic disorientation in space, cases of topographic cretinism;
• lethargy and weakening of thought processes.

During the first three years of the disease, dysfunctions of counting, vision, self-awareness and perception of the environment are added to progressive amnesia. With progress, gnosis—orientation in space, events, and dates—is increasingly disrupted. A person gets lost in the area familiar to him, gets confused in dates and numbers, and in a senile form, reality is replaced by events of the past. In the last stages, the patient does not recognize his relatives, is not able to perform basic actions: dress, eat independently, communicate, etc.

Alzheimer's disease: causes and early treatment

The initial stage develops over 7 years. Initial changes in the patient's condition occur under the influence of various factors. If a cause is identified, all efforts are directed towards eliminating it. As a rule, local treatment gives good results.

Patients with Alzheimer's disease may complain of:

• memory impairment;
• the occurrence of forgetfulness;
• loss of ability to think;
• psychoemotional disorders.

Perhaps Alzheimer's disease has already become noticeable to relatives. Initial symptoms do not always directly indicate brain dysfunction, but many still seek medical help and learn about the diagnosis in time.

Memory impairments have a short-term and long-term nature, and the patient is not always able to notice the deterioration. Forgetfulness is the most destructive: often people with Alzheimer's disease leave gas or electricity on, which leads to emergency incidents. Loss of long-term memory may manifest itself in the form of forgetfulness of events that happened in the past. Partial recovery of memories occurs through associations. Memory impairment progresses rapidly: after 6 months, symptoms become more pronounced and life-threatening for the patient.

The loss of the ability to think depends on the level of intelligence before the development of the disease. Sometimes a characteristic symptom is a sharp change in interests: watching TV instead of reading complex literature and other cases. The process of processing information and perceiving the environment is disrupted, as a result of which the patient is lost in space and time.

Stages

The full cycle of the disease can take from 3 to 15 or more years. Life expectancy depends on external and physiological factors. So far, AD is an irreversible pathology; it is impossible to completely stop or reverse the degradation process. Depending on the symptoms and condition of the patient, 4 stages of asthma are distinguished.

Predementia

This is the first stage of the disease, which most often goes unnoticed. It is also called mild cognitive decline. This phase lasts from several months to several years. During this period, the first symptoms already appear. The patient cannot plan his activities, sometimes forgets the meaning of some words, cannot concentrate for a long time, cannot keep his attention on one thing, and has difficulty learning new information.

In pre-dementia, mild short-term memory impairments are observed. A person increasingly forgets why he entered a room, loses the logical chain of conversation, and often gets lost in dates.

At this stage, apathy appears and gradually intensifies and interest in the world around us decreases. Also, the environment can replace minor changes in behavior, the patient can become more suggestible and trusting or, conversely, suspicious and grouchy.

Early

With the progress of degradation, pre-dementia gives way to the early phase of AD. Already at this stage, the patient himself and his relatives may suspect serious problems. Absent-mindedness and forgetfulness worsen, while episodes from the distant past are not erased, short-term memory suffers. Dates and days of the week become confused, and cases of disorientation in place and time become more frequent. A person perceives new information more and more poorly and becomes more and more difficult to learn.

At an early stage, agnosia is added to progressive amnesia - a disorder of tactile, visual, and auditory perception. Speech vivacity and vocabulary slowly decline, although in the senile form they may remain virtually unchanged. There are also disturbances in the coordination of movements and the first cases of forgetting the functions of objects. However, consciousness still remains. In a presenile form, the patient is aware of what is happening to him and may try to hide his condition.

Moderate

The third stage of the disease occurs gradually, moving from the early stage. At this stage, all of the above symptoms intensify, and the person increasingly needs help from those around him. The loss of short-term memory worsens, and there may be “failures” when a person does not recognize loved ones. Deviations in the behavior and character of the patient appear; a craving for overeating, vagrancy, and accumulation of rubbish may appear.

Symptoms such as:

• disorientation;
• counting and reading skills deteriorate;
• orientation in days and numbers is almost completely erased;
• more and more often a person forgets the name and purpose of objects;
• Speech is disrupted, it contains more and more nouns, incorrect pronunciation and long pauses.

But in moderate dementia, the patient can still dress independently, take care of hygiene, and eat. Over time, these skills disappear, and the patient increasingly needs supervision and care.

In the evenings, there is often a change in mood: tearfulness, inappropriate talkativeness or gloominess, businesslikeness or grumpiness. At night, sleep is intermittent, and during the day there is drowsiness. Cases of nocturnal enuresis are becoming more frequent.

Heavy

At this stage, caring for a patient without specialized help is very difficult. The patient cannot care for himself at all. The vocabulary is almost completely exhausted, with the exception of senile dementia. The patient no longer recognizes relatives and friends, does not remember the purpose and name of objects. Apathy reaches its peak, weight decreases. The patient cannot stand up and walk independently, eat, or perform household functions.

In the presenile form, a person lies silently most of the time; in the senile form, he takes a fetal position. Also, in the first case, speech consists of separate passages and syllables; in the senile form, the liveliness of speech may remain, but it is meaningless. Together with objects, a person forgets the meaning of words, and therefore does not understand those around him. Due to a sedentary lifestyle, infections, pressure ulcers, and pneumonia often occur.

Disease history

Previously, symptoms of Alzheimer's syndrome were attributed to age. However, more than a century ago, a famous German scientist published his scientific works, in which he revealed a certain pattern of patient behavior. The illness discovered by the psychiatrist received his name. A hundred years after the documentary mention, new signs are found. At the moment, the medical term denotes a disease that is detected in patients of different ages and is characterized by a number of neuropathological abnormalities.

Diagnostics

Recognizing the disease in the pre-dementia stage is quite difficult. Most often, the diagnosis is made at an early stage, when the patient’s relatives or the patient himself understand what is happening. Senile plaques and tangles of tau protein are deposited in the brain from the onset of the disease. However, they can only be detected during a pathological autopsy. Diagnosing AD is a labor-intensive process that includes neuropsychological assessment, imaging tests, and clinical tests.

Diagnosis begins with an examination by a neurologist and communication with the patient and his relatives. To get the most complete clinical picture, the patient undergoes tests: remembers images and words, reads, counts in his head, etc. Imaging methods such as MRI, PET, etc. are necessarily added to the tests.

MRI

The results of the examination and screening of the patient may coincide with many types of dementia. To establish an accurate diagnosis, brain studies are needed, since this is where the main changes occur. Magnetic resonance imaging shows the most characteristic changes in the structure of the brain. These include:

1. Disturbed metabolism in cells.
2. Cerebral atrophy. Due to disruptions in neural connections and cell death, the brain shrinks, decreases in size and changes its original shape.
3. Expansion of the ventricles and sulci.

Together with the results of other studies and MRI, the chance of establishing an accurate diagnosis and choosing the right therapy increases.

CT

Sometimes the evidence from one of the studies is sufficient if it is comprehensive. But for better visualization, the doctor can combine CT and MRI data. The doctor can see the X-ray density of the substance that changes during the disease. For the patient, the examination process with MRI and CT is almost identical.

PAT

A relatively new scheme for examining the brain is positron emission tomography (PET). It is considered the most effective research method in the early stages of asthma. The principle of PET is to visualize the molecular structure of the brain. This makes it possible to establish a diagnosis at any stage of the disease with maximum accuracy. The person being tested is given a contrast agent and placed in a tomography machine.

The examination process is painless and safe, since the level of radiation is equal to a regular x-ray. Based on the device’s readings, the doctor can examine not the anatomical structure, but the functioning of the brain. This method of analysis records the smallest deviations in the functioning of individual systems and organs. PET may be complemented by CT or MRI.

Diagnostic methods

The main tool in research on the development of dementia is neuroimaging. For this purpose, CT, MRI, and PET scans of the brain are used. The doctor examines the extent of damage to individual lobes, and also evaluates possible causes and concomitant diseases.

Using the EEG procedure allows you to observe brain activity and the degree of disruption of neural connections. Laboratory tests confirming Alzheimer's disease show a sharp decrease in α-β-42 and a simultaneous increase in tau protein.

Treatment

There is no medicine that can help get rid of asthma. Unfortunately, the process of brain degradation in patients is irreversible. But timely examination, good care and symptomatic treatment improve the patient’s quality of life. The earlier the disease is detected, the greater the chance of effective therapy. Drug candidates are already in clinical trials, and a new blood diagnostic method has been discovered in Japan.

In the treatment of asthma, palliative measures are used to alleviate the disease and improve the patient's life. These include:

1. Drugs that optimize synaptic transmission are acetylcholine esterase and memantine. They reduce and slow down the severity of cognitive disorders and support adaptation in everyday life. The drugs can be prescribed at the same time, as they affect different processes in the brain.
2. Diet. The patient is given a menu based on concomitant diseases; the diet includes foods that promote proper brain function.
3. Therapeutic physical education (physical therapy). Physical activity is as necessary as intellectual activity. Patients are shown walking, yoga, light gymnastics, running, swimming.
4. Supportive psychotherapy. The course of treatment includes work with a psychologist or psychotherapist - a specialist prevents the development of depression and apathy, conducts cognitive retraining and orientation to reality. This point of treatment is especially important and effective in the initial stages of the disease.

In addition to medications, other preventative and therapeutic procedures may be used. Also important for the patient is the support and help of loved ones, sensory exercises and memory therapy. To slow down the process of degradation, hobbies, physical activity, intellectual games and tests are recommended.

In most cases, in the last stages of the disease, patients are placed in medical institutions where they can receive professional care. At this point, complex therapy is narrowed to medication and symptomatic. Treatment methods in the final stages are designed to prevent infections and bedsores from occurring. Psychotherapy in this case is no longer effective. With proper treatment from the first stages, it is possible to prolong the patient’s life and maintain normal functioning for decades.

Treatment of Alzheimer's disease

Mechanism of neuronal disease in Alzheimer's disease

Is the disease curable?

Scientists are currently developing a therapy for Alzheimer's disease.
Doctors have tools in their arsenal that inhibit the development of symptoms and improve certain brain functions. By taking the pills, the patient will be able to delay the onset of severe dementia and maintain the ability to self-care. But it is impossible to cure or reverse the disease. Therefore, both the patient and his relatives need to prepare for the development of the process. It is important to study medical and psychological issues and become familiar with legal documents regarding Alzheimer's disease.

How is Alzheimer's disease treated?

There are three stages that Alzheimer's disease goes through. Treatment depends on the phase of the process. There are several treatment strategies for the disease. These are the following directions:

• Cholinergic therapy;
• Glutamatergic therapy;
• Neurotrophic therapy.

Cholinergic treatment is based on identifying the patient's acetylcholine deficiency in Alzheimer's disease. It is a transmitter (chemical molecule) that transmits a signal between neurons. As a result of its decrease, a person loses cognitive functions and dementia accelerates. The drugs Rivastigmine, Donepezil, Galantamine, and Choline Alfoscerate are used in therapy.

It has been proven that during disease, the number of NMDA glutamate receptors . The fewer there are, the more severe the Alzheimer's disease. This condition is treated with the drug Memantine. It helps improve cognitive functions and reduces a person’s dependence on the care of strangers.

Neurotrophic treatment is aimed at eliminating the deficiency of neuronal growth factors and slowing down their degeneration. The drug Cerebrolysin, nootropics, and neuroprotectors are used.

Stem cells

Stem cell treatments for Alzheimer's are currently in clinical trials. First, the technique is tested on animal models. In studies on mice, scientists have noted significant success with such implantation.

The animals were injected with brain stem cells. At the same time, cognitive function improved in mice with dementia. But the number of amyloid plaques did not change. The amount of neuronal growth factor increased, thanks to which brain cells can recover.

In Hong Kong in 2020, doctors announced their readiness to begin human trials. Information about using the method is available on the website of Israeli clinics. But the test results have not yet been published.

Beta amyloid

It is known that in dementia, pathological amyloid proteins accumulate in the brain. Scientists from the United States published a report in January 2020 that a substance had been found that could block their formation. The model was tested on mice. Research will soon be conducted on people with Alzheimer's disease.

The treatment (beta-amyloid) was discovered by chance during testing of the stroke and heart attack drug ZKZA-activated protein C. It turned out that it inhibits the expression of a gene that “assembles” amyloid particles. By the way, the drug itself has already been tested on humans as part of a study of coronary heart and brain disease. If it shows good results in a model of Alzheimer's patients, then doctors will have a new effective drug.

Book by Arkady Eisler

Consultation with a doctor is important for the patient and his relatives. But sometimes you need to know about the experience of a stranger who has encountered a similar disease. Arkady Eizler (“Alzheimer’s Disease: Diagnosis, Treatment, Care”) in his book describes the story of his life.

Arkady Kalmanovich is not a doctor, but a candidate of technical sciences. But as fate would have it, he was faced with Alzheimer's disease when his wife became seriously ill. Without giving up, he collected and systematized a huge amount of material on the treatment of this disease, patient care, and treatment of concomitant diseases. His book was approved by the Scientific and Methodological Center for the Study of Alzheimer's Disease of the Scientific Center for the Study of Alzheimer's Disease of the Russian Academy of Medical Sciences.

Treatment of symptoms

Anxiety, depression

For such manifestations of the disease, antidepressants are prescribed. Only serotonin reuptake inhibitors are used. They do not have the side effects associated with the tricyclic form of drugs. Medicines used for Alzheimer's disease: Trazodone, Citalopram, Sertolin, Paroxetine.

Psychotic symptoms (aggression, agitation)

Patients with moderate and severe forms of the disease may experience psychotic disorders: delusions, hallucinations, delirium, and persecutory delusions.

Before prescribing drug therapy, it is necessary to analyze what may be causing the attacks. Patients with dementia react sharply to comments and criticism. They do not like rearrangements in the apartment, violations of the usual daily routine. If the disorder is treatable without drug therapy, then this is the best option for the patient. Sometimes a simple conversation with a sick relative will help you figure this out.

If symptoms persist or cannot be corrected, the patient should be prescribed antipsychotics, antidepressants, anticonvulsants or tranquilizers. Treatment is selected by a psychiatrist. The dosage for older people should be reduced.

Delusions and hallucinations

In this case, the patient may be dangerous to himself and others. Therefore, drugs are prescribed - atypical antipsychotics (risperidone). Medicines in this group reduce mental and cognitive activity. It is not recommended to use them for a long time.

Insomnia

This symptom can complicate life not only for the patient, but also for the relatives who care for him. The medications Trazadone are used for ongoing therapy. For acute conditions, Zopiclone can be used. However, this Alzheimer's sleep aid is addictive and is not recommended for the treatment of chronic sleep disorder.

Antidepressants

Depression often accompanies Alzheimer's disease. Treatment: drugs should not worsen the patient’s condition or reduce his cognitive function. Tricyclic antidepressants are not used for Alzheimer's depression. They increase acetylcholine deficiency.

For mild to moderate depressive disorders, single-drug therapy (sertoline, paroxetine) is used. Severe forms of the disease with episodes of delusional disorders must be treated with a combination of drugs (antidepressant + antipsychotic).

Treatment for depression in Alzheimer's disease is necessary. The symptoms of this disorder deprive the patient of cognitive activity and make it difficult to communicate with loved ones. In males, the risk of suicide increases due to depression.

Maintenance therapy

Massage

Helps older people relieve muscle tension and restore mobility of muscles and joints. For patients with Alzheimer's, this treatment method is not contraindicated. It will help improve your mood and increase blood supply to the brain. However, you should choose an attentive massage therapist who knows how to work with older people. You should not leave a sick person alone in the office if this causes him anxiety and concern.

Vitamins

Necessary for any person. And the best option is when they enter the patient’s body with food. If an elderly person with Alzheimer's has a decreased appetite and refuses certain types of foods, then vitamin supplements should be taken every 4 months. Vitamin complexes are optimal for this. For example, “Vitrum”, “Supradin”.

Exercise therapy

Non-drug methods are necessary for patients with Alzheimer's. They allow you to stay active. Movement lifts your mood and restores blood circulation. The exercises are best done at home. But the complex should be learned with a physical therapy instructor in the gym. It is important here that relatives remind the patient to do exercises, suggest exercises, and praise him for his diligence. In this case, classes will be beneficial.

Therapy by age

In young people

There is no cure for Alzheimer's. In young people, drugs prescribed in the treatment regimen for the disease are used. When dementia appears at an early age, it is important to make a timely diagnosis and exclude other causes of dementia. Some tumors and hydrocephalus can progress quite quickly, leading to loss of speech and decreased intelligence. In this case, the patient will require surgical treatment to return to normal life.

In the elderly

Treatment of Alzheimer's in older adults must take into account comorbidities. When correcting accompanying symptoms (delusions, hallucinations, aggression), quite strong drugs can be used. For older patients, their dose is calculated individually. Therapy for older people should include psychotherapy and art therapy.

Among women

At an early stage

Treating Alzheimer's at an early stage can be very effective. Women patients follow doctor's recommendations more carefully than men. In addition, women willingly use brain simulators (pictures, crosswords, flashcards, Sudoku). Concomitant conditions (diabetes mellitus, arterial hypertension) must be corrected. Their decompensation can accelerate the development of dementia.

At a late stage

Alzheimer's disease is more common in older women. Treatment must be started immediately. And an elderly person should only be consulted with a psychiatrist. In Russia, only this doctor has the right to diagnose and treat this pathology.

Often, sick women with late-stage Alzheimer's are intractable and refuse to be examined by a doctor. Only close relatives can persuade a sick person. And only they can control his therapy.

At this stage, treatment is carried out according to standard regimens (Rivastigmine, Memantine). Additionally, medications are prescribed to correct depression, sleep disorders and behavior.

In men

At an early stage

The disease is rarely detected in men at an early stage. And if relatives paid attention to the pathology in time, then a mild degree of dementia can be delayed for several more years. For this purpose, neurotrophic treatment (Cerebrolysin, pirocetam) is used. Activities are used to stimulate memory. Obligatory observation of an elderly person by a therapist (correction of underlying disorders).

At a late stage

Men are prone to developing aggression, delirium and delusional disorders. They can be corrected, but you should urgently call a psychiatric team. Even older patients become very strong when they fall into this state. They can harm themselves and others.

Therefore, you should not try to put such an old man to rest on your own. Typically, delirium or hallucinations appear against the background of “jumps” in blood pressure. Have your hypertension treatment adjusted by a cardiologist. This will protect both yourself and the patient.

Drugs

How to treat a patient?

Alzheimer's pills. The name of the first group of drugs is cholinergic drugs. They help improve the patient's cognitive functions. The most commonly used tablets are Rivastigmine, Donepezil, and Galantamine.

The second group is drugs that interact with NMDA receptors. Memantine is the most popular drug for dementia. Unfortunately, it does not return the lost functions of memory and intelligence. But it can maintain brain functions at baseline levels for several years.

The third group is an anti-Alzheimer's drug that restores power to brain neurons. This includes nootropics, neuroprotectors, and agents that affect amyloid formation.

One of the most effective drugs in the group of nootropics is Gliatilin (choline alfoscerate). The drug Gliatilin is an Italian original drug based on a unique phosphate form of choline alfoscerate. This formula allows it to quickly penetrate into brain cells and be better absorbed.

Alzheimer's disease has a number of consequences that significantly affect a person's life: decreased or loss of memory, impaired attention, difficulty doing household chores, emotional distress, etc.

A course of taking Gliatilin helps preserve mental abilities, preserves speech, thinking, motor functions, slows the progression of the disease and stabilizes the emotional background.

Gliatilin improves brain activity, has a positive effect on the transmission of nerve impulses and activates brain function. The drug is well tolerated by patients; it is contraindicated for use in people with hypersensitivity to choline alfoscerate.

New drugs

Every year more information about Alzheimer's disease becomes available. The drugs of 2020 differ from previous ones in fewer side effects.

Rivastigmine was previously used in capsule form. However, patients with dementia often violate the dosage regimen and confuse the dosage of medications. For patients who live alone, this dosage form is not very convenient. In addition, oral use of the drug is associated with a high risk of side effects.

Novartis recently launched a transdermal therapeutic system with Rivastigmine (Exelon). This is a patch that is applied to the skin once a day. The system has fewer side effects and does not cause concern to the patient. Thanks to this form, patient compliance is enhanced. Elderly people do not miss taking the drug, and it is easier for relatives to control the therapy.

Free medicines

After diagnosing Alzheimer's disease, the sick person should be registered at a dispensary. He is assigned a disability group. If the patient can take care of himself and move around, then he can apply for the second group.

Otherwise, at the terminal stage of the disease, the first group is formed (the patient needs constant care from outsiders). A patient with a disability receives preferential medications according to a list that is updated every year. You can get acquainted with them by following the link.

Types of drugs

1. The first group is cholinesterase inhibitors. The drugs increase the content of acetylcholine in neuron synapses. Consequently, the conductivity of the nerve impulse improves. These drugs have evidence class A. This means that the positive effect of these drugs was noted in “large” clinical trials. The first class of ChEIs include galantamine and donepezil. To the second class - rivastigmine.
2. The second group is drugs that antagonistize NMDA-glutamate receptors (Memantine).
3. The third is neurotrophic drugs, nootropics (Phenibut, Adaptol, Afabazol), neuroprotectors. They have a low level of evidence and are rarely used in Europe and the USA.

AChE drugs

The substance galantamine is a cholinesterase inhibitor. Used for mild to moderate Alzheimer's disease. Available in the form of tablets, capsules and injections. It is contraindicated in patients with epilepsy, bronchial asthma, chronic heart and pulmonary failure, arterial hypertension, and after operations on the gastrointestinal tract. The presence of such contraindications may complicate the treatment of patients with Alzheimer's. After all, older people often have concomitant pathologies.

Donepezil is taken orally only. The treatment is supervised by a doctor. During the period of admission you will have to give up alcohol. Contraindications for the drug are similar to the previous drug: gastric ulcer, bronchial asthma, arterial hypertension, COPD. Concomitant use of painkillers (NSAIDs) and donepezil is not recommended.

Rivastigmine is a second class ChEI drug. However, its side effects are similar to previous drugs. But their severity is less. There are oral and transdermal forms that greatly facilitate the treatment of patients with Alzheimer's.

NSAIDs (non-steroidal anti-inflammatory drugs)

Prescribed to patients with Alzheimer's disease for acute pain syndrome. Due to the severity of side effects, the course of treatment should not exceed 10 days. NSAIDs do not combine well with primary treatment. They increase gastrotoxicity and can cause gastrointestinal bleeding.

Drugs that interact with NMDA receptors

Memantine is used for moderate to severe forms of the disease. Used to treat Alzheimer's and Parkinson's diseases. The drug should not be used for epilepsy and thyrotoxicosis, the subacute period of myocardial infarction. Available in the form of film-coated tablets.

List of drugs for dementia

We will publish the names of anti-dementia pills. List of popular medicines:

Rivastigmine:

• Exelon;
• Alcenorm.

Galantamine:

• Nivalin;
• Reminyl;
• Galnora.

Donepezil:

• Alzepil;
• Aricept;
• Got it.

Memantine:

• Akatinol memantine;
• Memantinol;
• Memorel;
• Tingrex.

Treatment of Alzheimer's in older people

Features of therapy in old age:

• Starting treatment with a minimum dose of the drug;

The patient’s body after 75 years has peculiarities of functioning. For example, the function of the kidneys, through which most drugs are eliminated, is reduced. Therefore, the usual doses of medications can become toxic for the elderly. Initial therapy begins with 1/6 or ¼ of the standard dose.

• Assessment of comorbidity (concomitant diseases);

Older people have a “load” of somatic diseases. In some cases, Alzheimer's medications make the condition worse. Therefore, the psychiatrist must carefully review the patient's medical history to identify possible contraindications for medications.

• Compatibility with other drugs;

Before seeing a psychiatrist, make a list of medications that your sick relative uses. This will make the work of the psychiatrist easier.

Doctors

Who treats Alzheimer's disease?

The signs of dementia should be known to every doctor. But the diagnosis and treatment is carried out by a psychiatrist. He conducts testing, determines symptoms of problems with memory, intelligence, and mood disorders.

How can a neurologist help? He needs to be examined. A specialist should examine brain function and vascular disorders. Differential diagnosis of dementia is extremely important.

Before visiting a doctor, collect epicrisis and advisory reports that you have at home. Make a list of the medications you take daily.

List of Moscow psychiatrists

So, Alzheimer's disease is a pathology of psychiatry. Who can I contact with a problem in Moscow? Here is a list of doctors who specialize in treating Alzheimer's.

• Uvarov Vladimir Viktorovich;

Accepted at clinic No. 5 at Plyushchikha St., 14.

• Plyukhina Yulia Alexandrovna;

Consults at clinic No. 5 at st. Plyushchikha, 14.

• Filashikhin Vyacheslav Vyacheslavovich;

Receives appointments at the medical center at Gvozdev, 5.

• Pyatnitsky Nikolay Yurievich;

Receives in the Sokolniki district at the address per. Krasnoselsky 7/9a (psychotherapeutic center Granat).

• Gromov Stanislav Yurievich.

Receives appointments at the medical office at Gvozdev, 5.

Psychologists

A psychologist works with a mood disorder in a sick person. It helps patients accept the disease at an early stage. This specialist will help you cope with anxiety, insomnia and stress.

Psychologists will help you choose relaxation techniques and train your mental skills. Cognitive therapy can be conducted in sessions with a psychologist. The patient is taught how to navigate and perform daily activities.

Speech therapists

Speech therapists help patients with Alzheimer's when communication problems begin. The patient forgets the names of ordinary objects and cannot tell loved ones about his needs. During speech therapy sessions, finger exercises are performed. This technique is used in young children to teach speech. The exercises can also be done at home with relatives. They stimulate the patient's speaking function.

Where to treat Alzheimer's disease?

Boarding houses

Specialized boarding houses are located in many areas. These are commercial institutions, and staying there is expensive for the patient (about 50,000 per month). In boarding houses, a rehabilitation program is developed for each patient. Many institutions have a physiotherapy department where you can undergo procedures and get massages.

A prerequisite is a balanced diet, daily walks, and acceptable physical activity. Patients are advised by psychiatrists, psychologists, and speech therapists. The patient's condition is monitored by a general practitioner.

Clinics

You can take a planned course of intravenous medications or treat an exacerbation of the disease (often during “jumps” in blood pressure, patients experience delusional disorder or delirium) in psychiatric clinics or psychoneurological dispensaries (for example, the Scientific Center for Mental Health) in Moscow at Kashirskoye Shosse, 34.

Hospitalization to inpatient facilities is carried out if there is a referral from the PND, where the patient is registered. In some cases, paid inpatient treatment of patients is possible.

Private centers

Hospitalization of patients with Alzheimer's disease is carried out by private clinics. They provide a full range of diagnostic and treatment services. The price is several times higher than inpatient treatment in public clinics.

Sanatoriums

Alzheimer's treatment is offered at the Altai Castle sanatorium. The course is aimed at slowing down the progression of the patient’s intellectual functions and combines physiotherapy, balneotherapy, classes with a speech therapist and psychologist. Also important for a sick person is a daily routine, lack of stress, a balanced diet, daily walks and moderate physical activity.

It should be noted that sanatorium treatment is acceptable in the stage of pre-dementia or mild Alzheimer's disease. In the moderate and severe phases of the disease, it is not recommended to change the patient’s usual environment.

Such “novelty” will be hard on the memory and cause an aggravation of the condition. A change of residence at a moderate or severe stage of pathology can lead to delirium, acute psychosis, delusions and hallucinations.

Israeli clinics

Israeli medicine is considered one of the most progressive in the world. Israeli clinics offer the following program for the treatment of patients with Alzheimer's:

1. Drug therapy - clinics use second-generation AChE inhibitors, selegelins, memantine, vitamin E;
2. As maintenance therapy, the patient has daily exercise therapy;
3. The Savion computer program allows you to stimulate the patient’s brain, influence individual loci and zones, and restore lost memories.

In addition, the clinics use innovative technologies:

1. Electromagnetic therapy with the Neuro AD device. Pulses of a certain frequency affect the brain, allowing you to restore memory and spoken language. Treatment consists of 30 sessions of 1 hour each;
2. Deep electromagnetic brain stimulation;
3. A nasal spray that destroys beta-amyloid is in clinical trials. Israeli clinics are also participating in testing;
4. The Ichilov Clinic uses stem cell treatment.

Here is a list of Israeli clinics that provide treatment for Alzheimer's disease:

— Ikhilov; — Rambam Medical Center (Haifa); — Assuta Clinic (Tel Aviv); — Beilison Clinic (Petah Tikva); - Clinic named after. Chaima Shiba (Ramat Gan).

Moscow clinics

— Scientific Center for Mental Health; — Psychiatric Clinical Hospital No. 1 named after Alekseev; — Psychiatric Hospital No. 15; — Treatment and rehabilitation center of the Ministry of Health of the Russian Federation; — Psychological Clinic “Salvation”; - Yusupov Hospital.

Treatment with folk remedies

Neumyvakin method

This professor suggested using 3% hydrogen peroxide to prevent age-related diseases. The solution was administered orally, starting with one drop per day, gradually increasing the dose to 10 drops. Then you need to take a break. This technique was justified by the lack of oxygen in the body, which can be obtained by consuming peroxide.

Unfortunately, there is no medical justification for this technique. But if it enters the body, peroxide can cause burns to the esophagus and stomach. People with chronic gastritis, gastric ulcers and intestinal ulcers should not take risks by testing this technique.

At home

People with Alzheimer's are recommended to use tinctures of Ginseng and Eleutherococcus. For excitability and aggression, you can brew soothing teas with valerian, hawthorn, and mint. In case of loss of strength or depressive disorder, decoctions of rose hips and hibiscus will help.

Diet

There is no specific diet for patients with Alzheimer's. It is recommended to prepare food at home. Use boiling, baking, steaming methods. As the disease progresses, it becomes difficult for the patient to chew. In this case, ready-made dishes can be pureed. And prepare meat products in the form of cutlets, meatballs, soufflés.

It is not recommended to eat fatty, salty, smoked foods, and fast food. The diet is limited to sweets, fried foods, canned food and marinades. A complete abstinence from alcohol is recommended.

New in Alzheimer's Treatment 2019

Vaccine

Nasal vaccine CD 106 is aimed at preventive treatment. The drug should destroy the formation of beta-amyloid in the brain. Phase 2/3 clinical trials began in November 2020 and will continue until 2023. The drug is administered to “potential” patients with Alzheimer’s aged 65-70 years who are intellectually healthy. All representatives of the study are homozygous for APOe4, their risk of getting the disease is more than 90%.

Ladostigil

A new acetylcholinesterase inhibitor, Ladostigil, is being tested. It will help patients with Alzheimer's, Parkinson's disease and other dementias. It has neuroprotective and antidepressant effects. Phase 2 trials ended in 2020. The company said improvements in patients were significant, but trials will continue.

Davunetide

The drug davunetide is claimed to be the first drug that destroys neurofibrillary tangles and can restore memory to the patient. In 2012, the results of the second and third phases were published, which did not bring success to the drug. The results were for a nasal spray. But there is an injectable form of the substance, which was tested in 2006-2008. The results of this test were positive.

NeuroAD

Israeli clinics actively use electromagnetic pulse devices that stimulate the brain. These units were developed by local scientists and are not used in world practice. After the testing period, the results of such therapy will be published and, perhaps, this technique will become more popular throughout the world.

Celebrities with Alzheimer's

Margarita Terekhova , a famous actress, has been diagnosed with Alzheimer's disease for several years. Her daughter said that the movie star had memory problems about 10 years ago. Needs help from loved ones and does not appear in public.

Prince Charles . There were reports in the press about memory problems in the eldest son of Elizabeth II in 2011. The heir to the throne may be suffering from Alzheimer's disease. Now Prince Charles remains active and is the first and oldest contender for the British throne.

Monica Viti is an Italian actress, known for the films “Adventure”, “For”, also has a similar diagnosis. She was diagnosed with Alzheimer's in 2011, at the age of 79. Now she needs care and does not go out in public. Fortunately, facilities for the elderly in Italy make it possible to provide the actress with decent care.

List of forums

For patients

• After starting treatment for a mild stage of the disease, you should keep a patient diary. An excellent option is for the patient to work independently. If a person cannot cope, his loved ones help him. Example of a diary .

• At the onset of the disease, the patient should sort out the documents and draw up a will. You should talk to your doctors about your possible disability group. After all, the disease will progress quickly. You can read about planning here , and a summary of recommendations is also available for your reference .

For families

Unfortunately, in our country, care for a sick person is organized by relatives. And as a rule, they are left alone with this problem. Important information about care, legal and medical aspects of the disease can be found on this website.

Relatives communicate on forums. For example, here is the most popular one, there is a Facebook page, as well as a VKontakte group in which you can ask a question on the wall.

How to behave with a sick person

1. It is necessary to maintain the patient's usual daily routine. As the disease progresses, patients begin to worry when things don't go according to schedule;
2. Respect his wishes, do not ignore requests. But try not to make concessions to whims;
3. Do not leave supplies of medications or food in the house. Use the "one serving only" rule;
4. An elderly person with memory loss should not go out alone. Therefore, close the door from the outside. Remove the bolts and frames from the doors. The patient may lock himself and not open the door on his own;
5. There should be a clock with large numbers in the room;
6. Use sticky notes to remind the patient about something important (to eat, watch a show, take medications).

Aggression

In some patients with Alzheimer's, the disease progresses rapidly. Coping with attacks of aggression is difficult, but there are a few simple rules to prevent them.

• Don't scold a sick relative. This will not give results, but will lead to distrust of you;
• If you have been accused of theft, try to redirect the patient’s attention, look for the “stolen” together;
• Talk clearly and often to patients about yourself and your plans together. "Hello! I'm Olya, I'm your granddaughter! We are going to the doctor today!”

Acute phase

If there is an attack of delirium or delirium, patients become very strong. An older woman having a seizure should be kept until the disorder ends.

The advice of a psychiatrist is to throw a towel or blanket over the woman and hold her with all your might. You'll have to hold it for a long time.

Then you should call an emergency team and consult with a psychiatrist. If necessary, place in a medical facility for several days.

If an attack of aggression occurs with a tall man, then run from the apartment and call a team from a specialized institution. Even frail old people can cause serious damage in a bout of delirium.

Olga Gladkaya

Author of the articles: practicing physician Olga Gladkaya.
In 2010 she graduated from the Belarusian State Medical University with a degree in general medicine. 2013-2014 – advanced courses “Management of patients with chronic back pain.” Provides outpatient care for patients with neurological and surgical pathologies. See author's posts

How to prevent disease

Prevention of asthma means an active and interesting life. When a person’s brain works constantly, new connections between neurons are formed. These connections replace other brain cells that have died for some reason. Since the root cause of the formation of plaques and protein tangles is still being studied, prevention methods are aimed at increasing the resilience of the brain.

To prevent Alzheimer's disease, it is recommended to constantly learn something new. This could be learning languages ​​or new hobbies, learning to play musical instruments or driving.

It is very useful to keep up with the times, master computers and telephone capabilities, electronic payment systems, etc.

Physical activity is good for both muscles and brain function. When playing sports, the blood is saturated with oxygen, which also reduces the risk of dementia. Treatment of diseases of the respiratory and cardiovascular systems refers to both the prevention and treatment of asthma. Normal functioning of the respiratory system, blood vessels and heart reduces the risk of any type of dementia.

A study and analysis of the epidemiology of AD showed that Indians suffer from dementia 5 times less often than other races. Research has shown that this situation may be caused by high consumption of curry. This seasoning contains curcumin, which reduces changes in the brain. If we talk about nutrition, it should be complete and varied, contain cereals and greens. Vitamins A, , , B12 are also useful for the brain. They can be taken with food or as individual vitamins.

Stage 3: Mild dementia due to Alzheimer's disease

At this stage of dementia, doctors will be able to diagnose Alzheimer's disease. Friends and family members notice that the person has problems with memory and thinking, which may affect daily life.

Symptoms of mild dementia due to Alzheimer's disease include:

• Difficulty remembering information;
• A person asks the same question several times;
• Problems with solving and completing tasks;
• Decreased motivation to complete tasks;
• Uncharacteristic irritability appears;
• Difficulty finding the right words to describe a thing;
• A person forgets where he puts things.

Consequences

The main danger of the disease is the collapse of personality. A person cannot fully live through the entire period of illness, so an entire decade may “fall out” of his life. Dementia disrupts the patients’ attachments to family and friends; in the stage of insanity, the person is practically “absent.” Irreversible changes in the structure of the brain lead to actual paralysis, the patient is unable to help himself.

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In the final stages of the disease, control over physiological processes is lost. Alzheimer's disease is a challenge for both the patient and family. Due to an immobile lifestyle, which progresses at the stage of moderate dementia and worsens over the years, infections occur.

When and why you need to see a doctor

If minor memory loss, depressive syndrome, or development of asthenia are noticed, it is recommended to consult a neurologist to prevent serious problems in the future.

The earlier neurodegenerative pathology is diagnosed, the greater the chance that the therapy will slow down the progression of disorders.

Neuropsychological tests

To find the disease, special testing of the patient is carried out, during which the degree of cognitive dysfunction is revealed:

• a person names several objects drawn on a piece of paper;
• he is asked to remember 5 words, and then, after a certain period of time, reproduce them;
• it is necessary to solve several simple arithmetic and logical problems;
• The doctor asks you to draw a clock with a certain position of the hands.

Instrumental examination methods

To find Alzheimer's disease, the symptoms and causes of the disease and the first signs, you need hardware research. This includes:

• CT scan;
• electroencephalogram;
• Doppler ultrasound of blood vessels in brain tissue;
• electrocardiogram and ultrasound of the heart;
• positron emission tomography.

Laboratory research methods

There is no special analysis to determine the disease yet. The main ones that can understand whether a person is sick or not are:

• biochemical blood test characterizes the level of the lipid spectrum - allows you to identify the threat of high sugar, cholesterol and other conditions that provoke malfunctions;
• puncture of the cerebrospinal fluid, on the basis of which beta-amyloids are found.

Deterioration of vision as a sign of the development of deviations

Cutting-edge research by scientists has proven that there is a direct connection between decreased vision and the destruction of nerve cells in the brain. High-quality images of intraocular blood flow showed symptoms and signs characteristic of Alzheimer's disease - a decrease in the thickness of the retina and the blood vessels supplying it.

Can we cure the disease?

Today it is incurable. But there are effective methods that inhibit pathology. The earlier it is detected, the greater the patient’s chances of remaining mentally competent longer.

Scientists are conducting research and innovative developments and say that they will soon discover drugs that can block the aggregation of amyloids, which provoke the appearance of plaques on the walls of the blood vessels of the head.

Maintenance therapy

For people who are experiencing symptoms of Alzheimer's disease and know how it manifests itself, leading neurologists have developed a range of high-yield supportive treatments. With early diagnosis and strict adherence to the instructions of the attending physician, the course can be significantly mitigated and the severe stage can be delayed for many years.

Types of Alzheimer's dementia

In psychoneurological practice, experts distinguish types of Alzheimer's disease: early and late onset. The severity of dementia directly depends on the activity of the pathological process. General signs: reduced control over the emotional background, behavior in society and motivational actions.

Presenile or early-onset Alzheimer's disease develops in young (up to 44-45 years) and middle (up to 65 years) age. Behavioral changes quickly gain momentum, irritability, anxiety, and at times aggressiveness are typical. Aggression is often shown by men due to an understanding of a change in their condition and failure as a social individual. Emotional lability can trigger suicidal thoughts.

At an early stage, focal disorders are recorded: fluency of speech, inability to express thoughts in words, impoverishment of speech reserve. However, implicit memory and long-established actions are preserved. The patient deftly uses cutlery, washes dishes, etc.

Senile or late-onset Alzheimer's disease occurs in patients over 65 years of age. In old and senile age, the disease develops slowly, which complicates early diagnosis. The condition is often mistaken for senile dementia and vascular pathologies (atherosclerosis of cerebral vessels, consequences of cerebrovascular accident and transient ischemic attack). Patients forget not only new, but also old learned information, and replace forgotten words with other word forms.

Difficulties arise in self-care and performing routine daily tasks. They walk in the fresh air for a long time and may not return home or become wanderers. People with a calmer temperament can sit on an alley bench for a long time, without noticing that they have become hypothermic during the cold season.

Forecasts

Unfavorable in all cases. The patient cannot be cured. Compensation for the condition is also impossible, as is slowing down the progression of the pathological process. Life expectancy with Alzheimer's disease is a controversial issue. As such, the disease does not provoke lethal consequences until the extremely advanced stages. Their development may take more than a decade. With proper care, a person can live a long time, despite his deplorable condition.

However, caring for dementia patients is an extremely difficult task. This is a lot of physical and psychological stress. There are constant risks of developing congestive pneumonia, blood poisoning (sepsis) against the background of deep bedsores, and thrombosis. It is these conditions that most often lead to death. To ensure proper care, it is recommended to hire a caregiver or regularly rotate with another person who can provide assistance to the sufferer.

There is also no question of preserving the ability to work and the ability to self-care. Persons become deeply disabled from the second or third stages.

Symptoms

The clinical picture is nonspecific in the early stages. In the later stages, assessing symptoms also does not provide enough information. There are other forms of dementia, and mental disorders with similar symptoms are also possible. Additional instrumental research is required. An approximate list of manifestations looks like this:

• Memory disorders

The leading manifestation in Alzheimer's disease clinics. If in the first stages there is a slight drop in the ability to remember and reproduce information (the inability to remember a small amount of data for a short period, forgetting events that happened the day before, general absent-mindedness), in the later stages total amnesia occurs. The patient does not understand who he is, where he is, what the names of his relatives are. The names of objects are also lost. Gross deviations are typical for stage 3 and beyond.

• Thinking disorders

At the initial stages - minimal. Sufferers experience some difficulty solving logical problems and performing tests. Formally, intelligence is slightly reduced, productivity is still high. However, the pace is slowing. Then the violation becomes severe. Solving problems and completing assignments becomes impossible.

• Speech dysfunction

In the first stages, it is impossible to clearly express your thoughts. The patient is unable to choose the correct concept, synonym, or describe his own feelings and thoughts. Lexical structure suffers. The sentences are of the same type, although they may be replete with inappropriate phrases. Which complicates the perception of the interlocutor’s statements. As it progresses, speaking takes on a telegraphic character. Fragmentary, presented in individual words. In the final phase, speech is completely lost, although the patient can still express himself with gestures within the framework of the simplest needs.

• Neurological, reflex disorders

Incontinence of feces and urine. It develops as a result of damage to individual centers of the brain, which leads to disruption of the sphincters. A relatively late sign of a pathological process.

• Emotional-volitional disorders

Alzheimer's disease leads to a whole group of disorders of a similar nature. Apathy is the leading manifestation within the pathological process. It starts with a slight feeling of not wanting to do anything. Falsely it can be perceived as laziness, but unlike the latter, it is a painful sensation for the sufferer. As it progresses, the person cannot even get out of bed. This is associated not only with lethargy, but also with muscle weakness.

The phenomena of emotional lability are increasing. At one moment, outbursts of unmotivated aggression are possible, at another, inappropriate gaiety, playfulness, and tearfulness. Inadequacy of emotional reactions is observed. The main character traits are emphasized. The duration of the episode is about 3-7 years. Then individual personality traits are erased and lost. Deficiency symptoms increase.

• Reduction of fine motor skills

In the simplest cases, this manifests itself as an inability to dress, sew, or work on a computer independently. If a person is interested in music, then play an instrument. Later, the inability to hold a spoon is added. This is due to coordination problems and muscle weakness.

• Movement disorders

According to the type of muscle weakening. The muscles are in hypotonicity, which is clearly noticeable upon palpation. Unsteadiness of gait is noted. And then the ability to move and even get out of bed is completely lost. Most people with Alzheimer's disease are unable to even hold their head up while feeding.

Symptoms of Alzheimer's disease exclude independent living, self-care, and the ability to perform household chores. Not to mention any professional activity. The patient truly becomes disabled. The role of outside help is gradually increasing. Severe neurological manifestations, the inability to move normally and even stand up, combined with apathy, make death inevitable in the later stages even with high-quality care. Patients are physically and mentally exhausted.