Alzheimer's Disease

Alzheimer’s disease is a disease of older age that results from damage to certain groups of cells in the brain and shows itself mainly through impairment of memory, intellectual activities and ordinary daily behavior. The steady growth of the aging population worldwide is also increasing the frequency of the disease. However, the increase in Türkiye appears to be above the world average. In fact, by 2050 Türkiye is at risk of becoming the country with the 4th highest number of Alzheimer’s patients in the world.

SYMPTOMS OF THE DISEASE

• Forgetfulness: This is the most important and earliest sign of the disease. Recent events in particular are forgotten. For example, simple lapses such as forgetting names, appointments, the way home or where rooms are are among the early signs. Gradually, daily living activities are negatively affected, and the person becomes unable to manage them alone.
• Psychiatric disorders: Mental and behavioral disorders are among the conditions that most negatively affect the patient’s quality of life. Examples include disproportionate emotional states such as sudden crying, anger or laughter, and behavioral disorders such as talking to mirrors, eating constantly, and hiding belongings and then being unable to find them.
• Speech difficulties: Patients may have trouble finding words. Instead of a word, they use sentences that describe the concept. For example, instead of “glass” they may say “the glass thing we put water in to drink.”
• Confusion about time and place: They may mix up days, months, seasons or their immediate surroundings.
• Difficulty with judgment and decision-making: There may be unusual choices when selecting food and clothing, such as wanting to wear a coat in summer.
• Problems with abstract thinking and understanding concepts,
• Personality disorders,
• Loss of desire to do things.

The disease can go through different stages, from appearing normal from the outside to very serious impairment.

DIAGNOSTIC METHODS

• Patient history: Information provided by the patient and the people close to them is the most important diagnostic tool. The Alzheimer’s Association has defined the 10 most important warning signs as follows.
• Confusion with time and place,
• Forgetfulness that disrupts ordinary daily life,
• Growing difficulty with planning and calculating,
• Trouble understanding visual images,
• Weakness in speaking, understanding and perceiving,
• Losing belongings and blaming others for it,
• Difficulty with judgment and making choices,
• Withdrawing from social activities,
• Changes in personality and behavior,
• Being unable to do tasks that were previously done without difficulty.
• Mental Status Test:
• Clock-drawing test : The patient is asked to draw a clock, put the numbers in it and mark a given time. The test provides information on the person’s ability to perform a geometric task and their comprehension and planning skills.
• Other laboratory tests: These are useful for ruling out other possible causes.
• Brain imaging methods: CT, MRI, PET. Alzheimer’s disease is characterized by the buildup of neurofibrillary tangles and amyloid plaques that impair function in the brain’s memory center, called the hippocampus. These unwanted deposits start the process by disrupting communication between cells and causing tissue to shrink.

CAN ALZHEIMER’S DISEASE BE PREVENTED?

Because the exact cause of Alzheimer’s disease is not known, how it can be definitively prevented is also debated. However, lifestyle changes can reduce or delay the onset of the disease. For this purpose, a mentally and physically active, dynamic life and regular exercise are important. Blood sugar and blood pressure should be kept within normal limits.

Eating habits in the style of a Mediterranean diet rich in vegetables and fruit have a positive effect.

Taking precautions against traffic accidents and other injuries reduces the risk of head trauma. Alcohol and smoking should be avoided completely.

RISK FACTORS

• Age: Its frequency increases steadily over the age of 65, doubling every 5 years.
• Sex: It is more common in women because their average life expectancy is longer.
• Depression,
• Past illnesses: Hyperlipidemia, diabetes, thyroid diseases,
• Previous head injuries
• Education,
• Heredity and genetics,
• Abeta 42 and tau proteins, known as pathological proteins in laboratory tests, may be elevated in the cerebrospinal fluid even 25–30 years before the disease begins.

TREATMENT APPROACHES

Alzheimer’s disease is an irreversible, chronic, progressive disease. The aims of treatment are to relieve symptoms, improve accompanying conditions and raise quality of life.

• Medical Treatment: The aim is to increase acetylcholine, the substance responsible for learning, and to try to reduce glutamate, a harmful factor.
• Psychological support: Psychological support should be provided not only to the patient but also to the people close to them who are involved in their care.
• Exercise
• Adjusting eating habits: Refined and sugary foods make it easier for the disease to progress. Instead, a diet rich in milk and dairy products, legumes, eggs, oilseeds and omega-3 should be preferred. Patients’ relatives must be educated on how to communicate with patients.

At İzmir Özel Can Hastanesi and Salihli Özel Can Hastanesi, our neurology, psychiatry and dietetics specialists work together for our patients with dementia and Alzheimer’s disease, which leads to very positive outcomes for patients with Alzheimer’s disease and their families.