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Columns : Todd Reynolds MD Last Updated: Nov 14, 2008 - 12:49:26 PM


Alzheimer’s Dementia
By
Jun 25, 2008 - 10:21:52 AM

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It is a common misconception that most people get “senile” as they get older.  Dementia is not a normal part of aging.  A decline in mental function is usually a symptom of a more specific disease process. 

The word dementia comes from the Latin roots de- (away or apart) and –mentis (mind).  It is simply a deterioration or decline in mental function.  There can be many causes of dementia, both acute and chronic, but one particular form is well-known to most – that is, Alzheimer’s disease.  

Among the many general causes of an acute dementia are infections, anemia, medications, vitamin and electrolyte imbalances, depression, hearing and vision loss, poisonings with metals and other toxins, thyroid dysfunction, and inflammation.  Most of these conditions are usually identified promptly and can be treated.  


Other more slowly developing forms of dementia are more difficult to diagnose.  One of the more common forms of mental decline results from a succession of mini-strokes.  This can occur in individuals with chronic diseases such as high blood pressure, high cholesterol, heart disease, and diabetes.    


Alzheimer’s disease is included in this category of slowly progressive dementias.  The name Alzheimer’s dementia, or Alzheimer’s disease, comes from one of many doctors who described the disease in the early 1900s.  Dr. Alois Alzheimer (1864-1915) was one of the first to describe the typical findings seen within the brain of the victims with this disease.  


In Alzheimer’s dementia, the nerves of the brain develop characteristic “tangles” and “plaques.”  The cause of these changes is still unknown.  Unfortunately, there are no specific Alzheimer’s blood tests or imaging studies that can rapidly pinpoint the diagnosis.  This makes it difficult to determine if an individual has the disease until other possibilities are ruled out.    


As many as 5 million Americans are living with Alzheimer’s disease.  The disease can affect individuals as young as age 40, but is usually seen after age 65.  About seven percent of Alzheimer’s cases have a hereditary or genetic component, termed Familial Alzheimer’s Disease.  However, most cases of Alzheimer’s dementia arise sporadically.  That is, there is no specific family link to the disease.  


The progression of Alzheimer’s disease varies from person to person and can span anywhere from three to twenty years.  Individuals experience a steady deterioration in memory, intellectual function, communication, judgment, personality, and performance of regular daily activities.  


In the early stages of the disease, the decline may not be obvious.  Gradually, there are noticeable lapses in memory, trouble finding words in conversation, misplacing important objects more frequently, and impaired organizational and planning skills.  With more severe decline the individual loses judgment skills, becomes disoriented, becomes less communicative, and some will become agitated.  In the final stages, the individual is unable to care for themselves.


There is no cure for the disease.  However, some medications may temporarily stabilize and slow the inevitable decline in mental status and behavior.  Regular mental and physical assessments should be done to evaluate the progression of the disease and the appropriateness of treatment.  


Support is necessary not only for the patient, but also for the caregivers of persons with Alzheimer’s disease.  Local and national Alzheimer’s agencies are available to help patients and their families cope with this devastating disease.  


The content in this column is for informational purposes only.  Consult your physician for appropriate individual treatment.  Dr. Reynolds practices Family Medicine in Chesterfield.

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