Dementia and Alzheimer's disease.
Dr. Michael MichaelNeurologist
3 & 5 Agiou Athanasiou
Globe Business Centre
Office 101 , Paphos
26944050Dementia
Dementia is not a specific disease.
It's an overall term that describes a wide
range of symptoms associated with a
decline in memory or other thinking skills
severe enough to reduce a person's ability
to perform everyday activities.
Alzheimer's is the most common type of
dementia.
Dementia
Your memory often changes as you grow older.
But memory loss that disrupts daily life is not a typical part of aging. It may be a symptom of dementia.
• It may be hard to know the difference between age-related changes and the first signs of Alzheimer’s disease.
• Some people may recognize changes in themselves before anyone else notices.
• Other times, friends and family will be the first to observe changes in memory, behavior or abilities.
To help identify problems early, the Alzheimer’s Association® has created a list of warning signs for Alzheimer’s and other dementias.
• Individuals may experience one or more of these in different degrees.
10 warning signs of Alzheimer’s disease
1.Memory loss that disrupts daily life
2.Challenges in planning or solving problems
3.Difficulty completing familiar tasks
4.Confusion with time or place
5.Trouble understanding visual images and spatial relationships
6.New problems with words in speaking or writing
7.Misplacing things and losing the ability to retrace steps
8.Decreased or poor judgment
9.Withdrawal from work or social activities
10.Changes in mood and personality
1. Memory loss that disrupts daily life
One of the most common signs of Alzheimer’s disease, especially in the early stage, is forgetting recently learned information. Others include forgetting important dates or events, asking for the same information over and over,
include forgetting important dates or
events, asking for the same information over and over, and increasingly needing to rely on memory aids (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own.
What’s a typical age-related change?
Sometimes forgetting names or appointments, but remembering them later.
2. Challenges in planning or solving problems
Some people may experience changes in their ability to develop and follow a plan or work with numbers.
They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.
What’s a typical age-related change?
Making occasional errors when balancing a checkbook
3. Difficulty completing familiar tasks at
home, at work or at leisure
People with Alzheimer’s disease often find it hard to complete daily tasks. Sometimes they may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game.
What’s a typical age-related change?
Occasionally needing help to use the settings on a microwave or to record a television show.
4. Confusion with time or place
People with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.
What’s a typical age-related change?
Getting confused about the day of the week but figuring it out later.
5. Trouble understanding visual images and spatial relationships
For some people, having vision problems is a sign of Alzheimer’s. They may have difficulty reading, judging distance, and determining color or contrast, which
may cause problems with driving.
What’s a typical age-related change?
Vision changes related to cataracts.
6. New problems with words in speaking or writing
People with Alzheimer’s disease may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to
continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name
(e.g., calling a “watch” a “hand-clock”).
What’s a typical age-related change?
Sometimes having trouble finding the right word
7. Misplacing things and losing the ability to retrace steps
A person with Alzheimer’s may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes they may accuse others of stealing. This may occur more frequently over time.
What’s a typical age-related change?
Misplacing things from time to time and retracing steps to find them.
8. Decreased or poor judgment
People with Alzheimer’s may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean.
What’s a typical age-related change?
Making a bad decision once in a while.
9. Withdrawal from work or social activities
A person with Alzheimer’s disease may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced.
What’s a typical age-related change?
Sometimes feeling weary of work, family and social obligations
10. Changes in mood and personality
The mood and personalities of people with Alzheimer’s can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone.
What’s a typical age-related change?
Developing very specific ways of doing things and becoming irritable when a routine is disrupted.
Note: Mood changes with age may also be a sign of some other condition
What’s the difference?
Signs of Alzheimer’s/dementia
—Poor judgment and decision making
—Inability to manage a budget
—Losing track of the date or the season
—Difficulty having a conversation
—Misplacing things and being unable to retrace steps to find them
Typical age-related changes
—Making a bad decision once in a while
—Missing a monthly payment
—Forgetting which day it is and remembering later
—Sometimes forgetting which word to use
—Losing things from time to time
Dementia
—In some cases, individuals with One meta-analysis, (a method of analysis in which results of multiple studies are examined), reported that 9 percent of people with dementia-like symptoms did not in fact have dementia, but had other conditions that were potentially
Cardiovascular Disease Risk Factors
Common causes of dementia-like symptoms
- depression
- delirium
- side effects from medication
- thyroid problems
- certain vitamin deficiencies
- excessive use of alcohol
Mild Cognitive Impairment (MCI)
—Approximately 15 to 20 % of people age 65 or older have MCI.
—People with MCI, especially MCI involving memory problems, are more likely to develop Alzheimer’s and other dementias than people without MCI.
—A recent systematic review of 32 studies found that an average of 32 percent of individuals with MCI developed Alzheimer’s disease in 5 years.
—This is similar to an earlier meta-analysis of 41 studies that found that among individuals with MCI who were tracked for 5 years or longer, an average of 38 percent developed dementia.
Alzheimer’s disease Diagnosis
No single, simple test exists to diagnose Alzheimer’s disease
—Obtaining a medical and family history from the individual and history of cognitive and behavioral changes.
—Asking a family member or other person close to the individual to provide input about changes in thinking skills or behavior.
—Conducting cognitive tests and physical and neurologic examinations
—Having the individual undergo blood tests and brain imaging to rule out other potential causes of dementia symptoms, such as a tumor or certain vitamin deficiencies
Mild dementia
The person has noticed deterioration in their memory, particularly for recent events.
• For example, they may forget that their daughter/son had visited the previous day, or when or whether they had taken their last medication.
• They also find it difficult to concentrate, think flexibly, plan, and take decisions.
• They are likely to feel bewildered, anxious and sad.
• They may become angry and defensive when others point out errors.
Moderate dementia
The person has severe memory problems. Only early memories are retained. Recent events are not remembered, or rapidly forgotten.
• They may not know the day, date or time of day.
• They often do not know where they are.
• They cannot communicate clearly, having problems finding the right word and using the wrong words.
• They may hear voices or see things that are not there, and can develop false beliefs, for example that children are entering their house and stealing things.
• They are likely to be anxious, sad, bewildered, and can become agitated or aggressive.
Severe dementia
The person has complete memory loss.
- They may no longer recognize their close family.
- They have severe speech difficulties or are unable to communicate.
- They may be apathetic and totally inactive, but at times can be agitated and verbally and physically aggressive.
- They cannot coordinate their physical movements; may have lost the ability to walk and feed themselves and have difficulty swallowing.
- They are likely to be incontinent of urine and faeces
Alzheimer’s disease
—The pace at which symptoms advance from mild to moderate to severe varies from person to person.
—As the disease progresses, cognitive and functional abilities decline.
—In the more advanced stages, people need help with basic activities of daily living, such as bathing, dressing, eating and using the bathroom; lose their ability to communicate; fail to recognize loved ones; and become bed-bound and reliant on around-the-clock care.
—When individuals have difficulty moving, they are more vulnerable to infections, including pneumonia (infection of the lungs). Alzheimer’s-related pneumonia is often a contributing factor to the death of people with Alzheimer’s disease
Risk Factors for Alzheimer’s Disease
—Age
—Family History
—Apolipoprotein E (APOE)-e4 Gene
Age
—Most people with Alzheimer’s disease are age 65 or older
—As age increases, so does the likelihood of having Alzheimer’s
—15 percent of those with Alzheimer’s are ages 65-74, while 44 percent are ages 75-84
—Although older age is a risk factor, Alzheimer’s is not a normal part of aging, and older age alone is not sufficient to cause the disease
Family History of Alzheimer’s Disease
—A family history of Alzheimer’s is not necessary for an individual to develop the disease
—However, individuals who have a parent, brother or sister with Alzheimer’s are more likely to develop the disease than those who do not have a first-degree relative with Alzheimer’s
—Those who have more than one first-degree relative with Alzheimer’s are at even higher risk
Cardiovascular Disease Risk Factors
—Many factors that increase the risk of cardiovascular disease are also associated with a higher risk of dementia. These factors include smoking, obesity in midlife and diabetes
—Some studies propose that impaired glucose processing (a precursor to diabetes) may also result in an increased risk for dementia
—Midlife hypertension, and midlife high cholesterol are also implicated as risk factors for dementia
—Physical activity protect the heart may also protect the brain and reduce the risk of developing Alzheimer’s and other dementias
—consuming a diet that benefits the heart, such as one that is lower in saturated fats, may be associated with reduced Alzheimer’s and dementia risk.
APOE-e4 Gene
ØThose who inherit one copy of the e4 form have a three-fold higher risk of developing
Alzheimer’s than those without the e4 form
Ø Those who inherit two copies of the e4 form have an 8- to 12-fold higher risk
Ø More than 20 recently identified genes that appear to affect the risk of Alzheimer’s
Traumatic Brain Injury (TBI)
Compared with no TBI, moderate TBI is associated with twice the risk of developing Alzheimer’s and other dementias, and severe TBI with 4.5 times the risk
Education
—People with fewer years of formal education are at higher risk for Alzheimer’s and other dementias than those with more years of formal education
—
—According to the cognitive reserve hypothesis, having more years of education increases the connections between neurons in the brain and enables the brain to compensate for the early changes of Alzheimer’s by using alternate routes of neuron-to neuron communication to complete a cognitive task.
Modifiable Risk Factors
—Regular physical activity and management of cardiovascular risk factors (especially diabetes, obesity, smoking and hypertension) reduce the risk of cognitive decline and may reduce the risk of dementia
—There is sufficiently strong evidence that a healthy diet and lifelong learning/cognitive training may reduce the risk of cognitive decline
Social and Cognitive Engagement
Additional studies suggest that remaining socially and mentally active throughout life may support brain health and possibly reduce the risk of Alzheimer’s and other dementias.
Alzheimers Association Paphos Branch:
Christalla Themistokleou 99 430187
chryskontou@gmail.com
Self-Help Group:
Sonia Royer 26 621530
royer@cytanet.com.cy
Rionagh Walker 97 839247
rionagh@gmail.com
Bank of Cyprus Account No:
IBAN CY770020019500002357016704380
BIC BCY2N
or
Bank of Cyprus Branch N0 0672.Account no 357016704380
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