What Are The Effects Of Alzheimer’s For The Patient

Vascular Contributions To Alzheimers Disease

People with dementia seldom have only Alzheimers-related changes in their brains. Any number of vascular issuesproblems that affect blood vessels, such as beta-amyloid deposits in brain arteries, atherosclerosis , and mini-strokesmay also be at play.

Vascular problems may lead to reduced blood flow and oxygen to the brain, as well as a breakdown of the blood-brain barrier, which usually protects the brain from harmful agents while allowing in glucose and other necessary factors. In a person with Alzheimers, a faulty blood-brain barrier prevents glucose from reaching the brain and prevents the clearing away of toxic beta-amyloid and tau proteins. This results in inflammation, which adds to vascular problems in the brain. Because it appears that Alzheimers is both a cause and consequence of vascular problems in the brain, researchers are seeking interventions to disrupt this complicated and destructive cycle.

Outcome And Adverse Events

One hundred and twenty-six patients completed the study: 61 in group A and 65 in group B. Sixteen patients dropped out prematurely : marked T2-DM worsening in 6 poor compliance in 4 severe adverse events in 3 unknown cause in 2 and one death occurred during the study and judged unrelated to treatment. ALA was well tolerated in all patients. Forty-four percent of patients in group A and 41% in group B showed adverse events . AEs included muscle cramps, gastrointestinal symptoms, and sleep disturbances in both groups. Among dropped out patients, two had severe sleepiness and one profuse diarrhoea. All SAEs were judged to be related to donezepil treatment. Thus, only 126 patients were included in the analysis .

Patients flow-chart. Sixteen patients dropped out of trial: 11 in group A and 5 in group B for marked diabetes mellitus worsening in 6 poor compliance in 3 severe adverse events in 3 unknown cause in 2 , and 1 death .

Brain Changes Associated With Alzheimer’s Disease

A healthy adult brain has about 100 billion neurons, each with long, branching extensions. These extensions enable individual neurons to form connections with other neurons. At such connections, called synapses, information flows in tiny bursts of chemicals that are released by one neuron and detected by another neuron. The brain contains about 100 trillion synapses. They allow signals to travel rapidly through the brain’s neuronal circuits, creating the cellular basis of memories, thoughts, sensations, emotions, movements and skills.

The accumulation of the protein fragment beta-amyloid outside neurons and the accumulation of an abnormal form of the protein tau inside neurons are two of several brain changes associated with Alzheimer’s.

Plaques and smaller accumulations of beta-amyloid called oligomers may contribute to the damage and death of neurons by interfering with neuron-to-neuron communication at synapses. Tau tangles block the transport of nutrients and other essential molecules inside neurons. Although the complete sequence of events is unclear, beta-amyloid may begin accumulating before abnormal tau, and increasing beta-amyloid accumulation is associated with subsequent increases in tau.,

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What Newer Medications Are Under Study

All currently approved medications target Alzheimers disease after it develops. Scientists are currently researching ways to stop or slow the progress of Alzheimers disease before it starts.

Some of the drugs in late-stage investigation are called monoclonal antibodies. These drugs target the amyloid protein that builds up in brain cells. They work by attaching to the amyloid proteins as they float in the brain and remove them, before they form into the plaques and tangles that interfere with the brains ability to properly function.

These drugs are still in clinical trials and are several years away from Food and Drug Administration approval in the United States. Early results have been mixed, with some trials showing no improvement in brain function others showing a slight improvement . Despite the mixed results, researchers are excited about this new potential method to modify the disease process.

Dont Forget The Children And Teens

With so much focus on the person who has dementia, sometimes younger family members donât get the attention they need, or the illness is not explained in a way they can understand.

Children often experience a wide range of emotions when a parent or grandparent has Alzheimerâs disease. Younger children may be fearful that they will get the disease or that they did something to cause it. Teenagers may become resentful if they must take on more responsibilities or feel embarrassed that their parent or grandparent is âdifferent.â College-bound children may be reluctant to leave home.

Reassure young children that they cannot âcatchâ the disease from you. Be straightforward about personality and behaviour changes. For example, the person with Alzheimerâs may forget things, such as their names, and say and do things that may embarrass them. Assure them that this is not their fault or intentional, but a result of the disease.

Find out what their emotional needs are and find ways to support them, such as meeting with a counsellor who specializes in children with a family member diagnosed with Alzheimerâs disease. School social workers and teachers can be notified about what the children may be experiencing and be given information about the disease. Encourage children and teens to attend support group meetings, and include them in counselling sessions.

Here are some examples that might help you cope with role changes within the family:

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Genetic Risk Factors And Research On Other Potential Contributors

Researchers have not pinpointed a gene that directly causes late-onset Alzheimers disease. But having one form of the apolipoprotein E gene on chromosome 19 does increase a persons risk, according to the National Institute on Aging.

The early-onset form of the disease is sometimes caused by an inherited change in one of three genes: APP, PSEN1 and PSEN2. Some research suggests it is possible for early-onset Alzheimers to be caused by genetic changes that occur outside of these three genes as well.

Aside from genetic influences, studies have suggested that gum disease bacteria, lack of sleep, proton pump inhibitors or iron buildup from like consuming red meat, among other things, may be contributors to the development of the disease, although findings are mixed and scientists still do not know for sure.

Gum Disease

A 2019 study published in the journal Science Advances found Porphyromonas gingivalis in the brains of people with Alzheimers disease. The type of bacteria is involved in gum disease. In addition to the bacteria, scientists also found evidence of gingipains, which are toxic enzymes produced by the bacteria.

Although earlier studies also support a link between gum disease and the brain disorder, Business Insider reported that some experts are being cautious about the most recent findings.

Gum disease can contribute to a number of health problems, including heart disease, premature and low-birth weight babies, and rheumatoid arthritis.

Sleep

Loss Of Neuronal Connections And Cell Death

In Alzheimers disease, as neurons are injured and die throughout the brain, connections between networks of neurons may break down, and many brain regions begin to shrink. By the final stages of Alzheimers, this processcalled brain atrophyis widespread, causing significant loss of brain volume.

Learn more about Alzheimer’s disease from MedlinePlus.

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Total Cost Of Health Care And Long

Table reports the average annual per-person payments for health care and long-term care services for Medicare beneficiaries age 65 and older with and without Alzheimer’s or other dementias. Total per-person health care and long-term care payments in 2019 from all sources for Medicare beneficiaries with Alzheimer’s or other dementias were over three times as great as payments for other Medicare beneficiaries in the same age group .,

• * Payments from sources do not equal total payments exactly due to the effects of population weighting. Payments for all beneficiaries with Alzheimer’s or other dementias include payments for community-dwelling and facility-dwelling beneficiaries.
• Created from unpublished data from the Medicare Current Beneficiary Survey for 2011.

How Is Alzheimer Dementia Diagnosed

An Alzheimer Dementia diagnosis may take some time. There is no test that can tell your doctor whether you have the disease. Give your doctor plenty of information to help determine the cause of your symptoms. Your doctor may want to evaluate the following in you or your loved one:

• Current health and medical history.
• Daily routine and any changes in your behavior.
• Memory, problem-solving, attention, and language abilities.
• Lab tests, such as blood or urine tests.
• Brain scans to look for problems, such as stroke, that may be causing symptoms.

Based on this information, your doctor can almost always tell whether you have dementia. Your doctor will likely be able to tell whether Alzheimer Dementia is the cause of your dementia. However, Alzheimer Dementia can only be diagnosed with certainty after death. That is when the brain is examined under a microscope. The brain of a person who had Alzheimer Dementia will show very distinct changes that only happen when Alzheimer Dementia is the cause of dementia.

If you are worried that you or a loved one might have some of the warning signs of Alzheimer Dementia, talk to your doctor. An early diagnosis will help you get treatment earlier. Also, it will give you time to address questions of care, finances, and legal issues with your family.

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The Basics Of Alzheimers Disease

Scientists are conducting studies to learn more about plaques, tangles, and other biological features of Alzheimers disease. Advances in brain imaging techniques allow researchers to see the development and spread of abnormal amyloid and tau proteins in the living brain, as well as changes in brain structure and function. Scientists are also exploring the very earliest steps in the disease process by studying changes in the brain and body fluids that can be detected years before Alzheimers symptoms appear. Findings from these studies will help in understanding the causes of Alzheimers and make diagnosis easier.

One of the great mysteries of Alzheimers disease is why it largely affects older adults. Research on normal brain aging is exploring this question. For example, scientists are learning how age-related changes in the brain may harm neurons and affect other types of brain cells to contribute to Alzheimers damage. These age-related changes include atrophy of certain parts of the brain, inflammation, blood vessel damage, production of unstable molecules called free radicals, and mitochondrial dysfunction .

Understanding And Supporting A Person With Dementia

This page can help you understand what a person with dementia is going through in order to give them the help and support they need to live well.

Understanding and supporting someone with dementia

Living with dementia can have a big emotional, social, psychological and practical impact on a person. Many people with dementia describe these impacts as a series of losses and adjusting to them is challenging.

This page aims to give people – and carers in particular – a better understanding of what it is like to have dementia. It looks at ways to support someone to live well with the condition, based on that understanding. It also looks at how supporting someone with dementia can affect carers.

Press the orange play button to hear an audio version of this page:

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Questions To Ask Your Doctor

• How would I recognize signs of dementia in myself?
• Is being forgetful a sign of Alzheimer Dementia?
• How does Alzheimer Dementia affect my ability to care for myself or a loved one?
• What are the pros and cons of participating in clinical trials?
• Can brain games help your memory after youve been diagnosed with Alzheimer Dementia?
• If I am caring for a loved one with Alzheimer Dementia, how can I reduce my stress levels?

Support For Families And Alzheimer’s Disease Caregivers

Caring for a person with Alzheimers can have significant physical, emotional, and financial costs. The demands of day-to-day care, changes in family roles, and decisions about placement in a care facility can be difficult. NIA supports efforts to evaluate programs, strategies, approaches, and other research to improve the quality of care and life for those living with dementia and their caregivers.

Becoming well-informed about the disease is one important long-term strategy. Programs that teach families about the various stages of Alzheimers and about ways to deal with difficult behaviors and other caregiving challenges can help.

Good coping skills, a strong support network, and respite care are other things that may help caregivers handle the stress of caring for a loved one with Alzheimers. For example, staying physically active provides physical and emotional benefits.

Some caregivers have found that joining a support group is a critical lifeline. These support groups enable caregivers to find respite, express concerns, share experiences, get tips, and receive emotional comfort. Many organizations sponsor in-person and online support groups, including groups for people with early-stage Alzheimers and their families.

Read about this topic in Spanish. Lea sobre este tema en español.

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Key Biological Processes In The Brain

Most neurons have three basic parts: a cell body, multiple dendrites, and an axon.

• The cell body contains the nucleus, which houses the genetic blueprint that directs and regulates the cells activities.
• Dendrites are branch-like structures that extend from the cell body and collect information from other neurons.
• The axon is a cable-like structure at the end of the cell body opposite the dendrites and transmits messages to other neurons.

The function and survival of neurons depend on several key biological processes:

Neurons are a major player in the central nervous system, but other cell types are also key to healthy brain function. In fact, glial cells are by far the most numerous cells in the brain, outnumbering neurons by about 10 to 1. These cells, which come in various formssuch as microglia, astrocytes, and oligodendrocytessurround and support the function and healthy of neurons. For example, microglia protect neurons from physical and chemical damage and are responsible for clearing foreign substances and cellular debris from the brain. To carry out these functions, glial cells often collaborate with blood vessels in the brain. Together, glial and blood vessel cells regulate the delicate balance within the brain to ensure that it functions at its best.

Risk Of Dementia & Alzheimers Disease

Alzheimers is a progressive disease that affects behavioral and cognitive functions, especially memory. Alzheimers may be a cause of dementia, which is the loss of cognitive abilities that is severe enough to interfere with your life.

Several studies have shown benzos to be a risk factor for dementia and Alzheimers in geriatric patients. However, early symptoms of dementia mimic symptoms of anxiety and insomnia, which is a possible reason for this association.

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Emotion And Behavior Treatments

The emotional and behavioral changes linked with Alzheimers disease can be challenging to manage. People may increasingly experience irritability, anxiety, depression, restlessness, sleep problems, and other difficulties.

Treating the underlying causes of these changes can be helpful. Some may be side effects of medications, discomfort from other medical conditions, or problems with hearing or vision.

Identifying what triggered these behaviors and avoiding or changing these things can help people deal with the changes. Triggers may include changing environments, new caregivers, or being asked to bathe or change clothes.

It is often possible to change the environment to resolve obstacles and boost the persons comfort, security, and peace of mind.

The Alzheimers Association offer a list of helpful coping tips for caregivers.

In some cases, a doctor may recommend medications for these symptoms, such as:

• antidepressants, for low mood

My Family Of The Dominican Republic

There I was, getting off the airplane in the Dominican Republic, anxious to visit my family especially my grandfather due to the fact that I had not seen him for about three years. On our way to his house I was so exited. I was 12 at the time. Once we got to his house, I saw him and went to give him a hug but the problem was the plain look that he had on his face once he saw me as if he did not recognize me. I thought to myself maybe he is sick, but then that can not be possible because he recognized

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Metabolic And Clinical Features

At presentation , mean BMI, WC, serum lipid, and triglycerides were similar in groups A and B. Mean HOMA value was 10.2 ± 4.2 in group A and 1.6 ± 0.8 in group B, respectively . At visit V3: HOMA index value between groups was lower compared to baseline, but remained significantly higher in group A the other metabolic parameters did not show significant differences between the two groups. Besides, at the beginning of the study, 9 patients in group A were taking insulin therapy alone or in combination with oral antidiabetic agents, the other patients were taking only oral antidiabetic drugs. At the end of the study, 5 patients required the administration of insulin, while the 12 patients increased oral antidiabetic dosage .

The Role Of Amyloid Plaques

Amyloid plaques are mostly made up of a protein called B-amyloid protein which is itself part of a much larger protein called APP . These are amino acids.

We do not know what APP does. But we do know that APP is made in the cell, transported to the cell membrane and later broken down. Two major pathways are involved in breakdown of APP . One pathway is normal and causes no problem. The second results in the changes seen in Alzheimer’s and in some of the other dementias.

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