Dementia & Alzheimer's disease

Alzheimer's disease (AD) is a chronic neurodegenerative disease that usually starts slowly and worsens over time. It most often begins in people over 65 years of age, although 4% to 5% of cases are early-onset Alzheimer's which begin before this. It affects about 6% of people 65 years and older. It is the cause of 60% to 70% of cases of dementia. The most common early symptom is difficulty in remembering recent events (short-term memory loss). As the disease advances, symptoms can include problems with language, disorientation (including easily getting lost), mood swings, loss of motivation, not managing self care, and behavioral. As a person's condition declines, they often withdraw from family and society. Gradually, bodily functions are lost, ultimately leading to death. Although the speed of progression can vary, the average life expectancy following diagnosis is three to nine years.

The cause of Alzheimer's disease is poorly understood. About 70% of the risk is believed to be genetic with many genes usually involved. Other risk factors include a history of head injuries, depression, or hypertension. A probable diagnosis is based on the history of the illness and cognitive testing with medical imaging and blood tests to rule out other possible causes. Initial symptoms are often mistaken for normal ageing. Mental & physical exercise and avoiding obesity may decrease the risk of AD; however, evidence to support these recommendations is not strong. There are no medications or supplements that decrease risk.

No treatments stop or reverse its progression, though some may temporarily improve symptoms. There are four drugs currently approved by the FDA for the treatment of Alzheimer’s, and they all act on the cholinergic system: Donepezil, Galantamine, Rivastigmine and Memantine. Although these medications are not the cure for Alzheimer’s, symptoms may be reduced for up to eighteen months for mild or moderate dementia.

Affected people increasingly rely on others for assistance, often placing a burden on the caregiver; the pressures can include social, psychological, physical, and economic elements. Exercise programmes may be beneficial with respect to activities of daily living and can potentially improve outcomes. Treatment of behavioral problems or psychosis due to dementia with antipsychotics is common, but not usually recommended, as there is little benefit with an increased risk of early death.