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Alzheimer’s Disease

Dr. Fathi Abdal Qader Ahmed
Consultant Internal Medicine at Al Ahli Hospital

God blessed humans by giving them the brain, while animals live by their instinct. Human uses their brain for many functions that help him to live a better life like thinking, understanding, reasoning, speaking, and making instruments and others. These processes carried out by having a huge number of highly specialized cells that have interconnections to yield a perfect brain function.

What is Alzheimer’s disease (AD)?

It is a disease affecting the brain, resulting from the replacement of the highly specialized brain cells with nonfunctioning proteins of an unknown source causing a decrease in a number of effective cells and a gradual loss in their capabilities and function performance leading to increasing disabilities and difficulty in performing daily life activities.

Who are liable to get AD?

AD can affect all ages, but most commonly seen after the age of 65 years, it is estimated that people above the age of 70 will have 10% affected with AD, and it increases to 20-40% for those above 80 years.

Does AD affect certain people more than others?

AD studies show that it can affect both sexes and all races equally and there is no difference among people living in different social classes or modes of life or life standards.

Are there any diseases that interfere with AD outcome?

Many diseases can alter and fasten the course and symptoms of AD-like hypertension, hyperlipidemia, diabetes mellitus, and cerebrovascular accidents, it also found in many studies that low fruit diet, low education level, low social class, and heavy metal poisoning like mercury all might fasten the speed of disease development.

Is there any genetic predisposition for AD?

The probability of having an AD increase in families with the first-degree relatives having the disease, they also found that genetic factors transmit the disease in 2% of AD patients.

What are the signs and symptoms of AD?

The earliest symptom is the complaint of recent memory loss, the patient notice forgetting recent events like where he kept his keys or mobile, or where he parks his car, or get lost in the streets, or did he take his medicine. 

Then with time start to forget bigger things like names and dates, and start to have the inability to recognize things visually and spatially (by touch) like remote control, also found difficulty in the use of household materials like knives.

Lately, he might experience language difficulty in speaking, writing and reading, with the difficulty of taking care of himself like changing clothes and bathing or take food by himself. In addition, he might show psychiatric symptoms like depression, anxiety, tension, and he may start to have abnormal thoughts that somebody is trying to hurt him or trying to assault him.

What is the usual disease course?

Usually, it takes around 3 – 4 years for the disease to progress from diagnosis to have the full picture.

At first patient and his family are looking for medical advice then with time they accept the patient’s condition and continue to take care of him at home and limit their activities.

How to diagnose AD?

Diagnosis takes place by history and clinical examination, investigations are done to assess the accompanying diseases and how to control them like brain MRI, fasting blood sugar, liver and kidney tests, cholesterol level and hemoglobin.

How to treat AD?

No effective therapy found at present time to stop or treat AD; medicines used to improve symptoms and make patients’ lives better or to control psychiatric issues, they do so by changing the concentrations of the neurotransmitters in the brain especially acetylcholine. FDA approved medicine are rivastigmine, donepezil, galantamine, memontum. Nevertheless, they will not alter the disease progress.

What advice given to the patient family?

The patient family should be instructed about their patient care and safety. The patient should not be irritated by using words that make him angry like disabled, useless, worthless and insignificant.

Other measures are taken to protect him from harm like removing sharp objects, locking doors properly, stairs safety, secure electronic devices and avoiding chances of slip and falls.It is good to benefit from the sharing of social health organizations, which can provide home care and encourage them to visit AD patients at home, for proper follow-up and health assessment with monitoring patient conditions and give training for the patient family on how to take care of the patient.

Recent studies show new information about medications that are promising for AD which need further analysis before use, so we should not stop hoping to find the cure for the disease soon.

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