Dementia - Alzheimer's disease

---

Alzheimer's causes loss of memory and thinking ability, gradually progressing and affecting the patient's independence.

This article received professional advice from MSc Hoang Tien Trong Nghia and MSc Tran Thi Hoai Thu, Department of Internal Medicine and Neurology, Military Hospital 175.

Define

- Alzheimer's is a brain disease caused by degeneration and death of nerve cells, often mistaken for normal memory loss in the elderly.

- The disease causes impairment of memory, learning and thinking ability.

- The disease progresses gradually over time, affecting the patient's independence in daily activities.

- Sometimes patients have difficulty thinking, communicating and have inappropriate behaviors and emotions. This brings a great burden to families and society.

- Alzheimer's disease is the most common cause of dementia (60-70%).

- It is estimated that about 300,000-400,000 Vietnamese people have Alzheimer's disease.

- 60% of patients are not diagnosed.

- The disease can appear in the body before the patient shows the first signs of forgetfulness, possibly from 5 years, 10 years and even 20 years.

Disease mechanisms

- The degenerative process causes the brain to form beta-amyloid plaques and abnormal accumulation of tau proteins.

- These substances, when deposited, will damage and prevent the transport of nutrients to ensure the survival and normal functioning of nerve cells, affecting memory and other cognitive functions of the brain. patient.

- From then on, they become forgetful, causing a lot of anxiety for the patient and their family members.

Reason

- Scientists believe that the cause of Alzheimer's disease is not just one but a combination of many factors. Among them, the leading factor is age.

- A small number of cases of Alzheimer's can appear as early as age 30-60. Most of these cases are related to genetic factors.

- In addition, there are many other factors related to the environment and medical conditions that can promote disease development such as:

* Head injury.

* Atherosclerosis, hypertension, diabetes, dyslipidemia.

* Life is stressful, full of anxiety and often insomnia.

* Unhealthy lifestyle such as less exercise, less mental exercise, less social interaction, being overweight, smoking, and using alcohol.

Symptom

- Alzheimer's symptoms will gradually worsen over time.

* In the early stages, the main complaints are mild memory loss.

* As the disease becomes more severe, the patient becomes more confused, loses the ability to talk and interact with people around him, cannot eat, bathe or perform personal hygiene on his own and must completely depend on others. take care of.

- Each patient has different symptoms, not completely the same.

- Early signs of Alzheimer's disease:

* Memory loss: Patients forget recent events. Events that took place a long time in the past, at first the patient still remembers them, then gradually lose them and this memory loss is permanent.

* Difficulty expressing language.

* Changes in behavior, mood and personality.

* Difficulty performing familiar daily tasks.

* Difficulty orienting oneself in time and position.

* Reduces the ability to evaluate problems, causing difficulty in making work decisions.

* Difficulty following the conversation.

* Often loses things, has to search for things often.

* Have difficulty understanding visual or spatial information. For example, it is not possible to determine the color of the traffic light to stop or continue.

* Must stop current job or social activities.

Diagnose

- For patients showing signs of forgetfulness, doctors will use many tools and tests to evaluate and diagnose whether they may have Alzheimer's disease, including:

* Ask the patient and relatives about symptoms, duration and progression of the disease, chronic diseases, medications being used, living habits and nutrition.

* Assess memory, cognitive functions (concentration, language, executive function, spatial motor) and psychological behavioral disorders using standardized tests.

* Blood tests, brain imaging (CT scan, brain MRI).

* Cerebrospinal fluid testing, genetics, nuclear imaging (amyloid PET, tau PET) in a few cases of atypical manifestations.

These assessments aim to identify other possible causes of memory loss such as stroke, brain tumor, infection, Parkinson's disease, sleep disorders, nutritional deficiencies or side effects of medication. medicine.

- Some causes and precipitating factors, if treated, can improve the condition.

Mortality risk

- On average, people with this disease can live 8-10 years from the time symptoms appear. However, there are still cases where people can live longer if detected, treated and managed properly.

- People with severe Alzheimer's disease cannot take care of themselves, live on-site and are completely dependent on family members. The functioning of the digestive and urinary tracts is impaired. Over time, they lose the ability to swallow, causing malnutrition and aspiration. Therefore, patients often die from related diseases such as pneumonia, ulcer infections, cardiovascular disease, pulmonary embolism, malnutrition and dehydration...

Treatment

- Currently, there is no way to cure Alzheimer's disease. The main goals are:

* Slows down the progression of the disease and alleviates symptoms.

* Helps patients live with disease symptoms more gently.

* Contribute to improving the quality of life for patients.

- Medicines to treat diseases include:

* Group of drugs that improve memory and cognition.

* Group of drugs that regulate psychological behavior.

* Currently, the FDA (US Food and Drug Administration) has approved a new group of drugs such as Lecanemab and Aducanumab for the treatment of early-stage Alzheimer's disease, helping to prevent the formation of beta-amyloid plaques - a marker of Alzheimer's disease. sick. These drugs need to be prescribed and consulted by specialists.

- Exercise, recovery and cognitive stimulation are also necessary and useful measures when combined with medication.

- Specialists advise brain exercises appropriate to each individual's condition and stage of disease.

- People with Alzheimer's disease need to build a healthy diet, exercise and lifestyle to help stabilize the condition and control factors that can promote more severe disease.

- The encouragement and companionship of relatives is very meaningful and necessary, helping people with Alzheimer's become more optimistic and happier to have faith in the journey to overcome the disease.

Prevent

We can reduce the risk of Alzheimer's disease in many ways such as:

- Exercise your mind, constantly learn.

- Maintain appropriate weight.

- Improve diet and nutrition, fully supplement vitamin B12, D and E.

- Stabilize blood pressure and blood sugar levels.

- Do exercise.

- Do not smoke or drink too much alcohol.

- Improve sleep.