Understanding Alzheimer’s disease: Diagnosis, symptoms, and management

By: Dr Avi Verma, MD(h)

Alzheimer’s disease is a progressive neurodegenerative disorder that affects memory, thinking, and behavior. It is the most common cause of dementia among older adults, leading to a decline in cognitive function severe enough to interfere with daily life. Understanding its diagnosis, symptoms, treatment options, and preventive measures is crucial for managing and potentially mitigating its impact.

Diagnosis of Alzheimer’s Disease
Diagnosing Alzheimer’s involves several steps to rule out other causes of cognitive impairment and to determine the extent of cognitive decline. The process typically includes:

1. Medical History and Physical Exam: A comprehensive review of the patient’s medical history, family history of dementia, and a physical examination to assess overall health.
2. Cognitive and Neuropsychological Tests: These tests evaluate memory, problem-solving skills, attention, language, and other cognitive abilities. The Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) are commonly used tools.
3. Laboratory Tests: Blood tests help rule out other potential causes of memory loss and confusion, such as vitamin deficiencies or thyroid problems.
4. Brain Imaging: MRI or CT scans can identify brain abnormalities, such as strokes, tumors, or structural changes associated with Alzheimer’s disease.
5. Neurological Examination: This includes testing reflexes, coordination, muscle tone, and strength to assess the functioning of the nervous system.
6. Biomarker Tests: Cerebrospinal fluid (CSF) analysis and positron emission tomography (PET) scans can detect amyloid-beta plaques and tau tangles, which are hallmarks of Alzheimer’s disease.
7. Blood Tests for Alzheimer’s: Recent advancements have led to the development of a simple blood test that detects Alzheimer’s disease with up to 90% accuracy by measuring levels of Plasma Phospho-Tau217, a biomarker linked to Alzheimer’s pathology. This test can identify the disease even before symptoms appear and has shown promise in routine health care settings, providing a less invasive and more accessible diagnostic tool compared to traditional methods.

Symptoms of Alzheimer’s Disease
Alzheimer’s disease progresses through several stages, with symptoms becoming more severe over time. Common symptoms include:
1. Early Stage:
•Memory loss affecting daily activities, such as forgetting names or recent events.
•Difficulty in planning or solving problems.
•Challenges with completing familiar tasks at home or work.
•Confusion with time or place.
•Misplacing items and losing the ability to retrace steps.
•Decreased or poor judgment.
•Withdrawal from social activities or work.

2. Middle Stage:
•Increased memory loss and confusion.
•Difficulty recognizing friends and family.
•Inability to learn new things.
•Difficulty with language and problems with reading, writing, and working with numbers.
•Hallucinations, delusions, or paranoia.
•Wandering and becoming lost.
•Repetitive statements or movements.

3. Late Stage:
•Severe memory loss and cognitive decline.
•Inability to communicate coherently.
•Need for full-time assistance with daily activities.
•Loss of physical abilities, including walking, sitting, and eventually swallowing.
•Increased susceptibility to infections, especially pneumonia.

Treatment and Management
While there is currently no cure for Alzheimer’s disease, several treatments can help manage symptoms and improve quality of life:
1. Medications:
•Cholinesterase inhibitors (e.g., Donepezil, Rivastigmine, and Galantamine) can help improve cognitive symptoms and delay the progression in the early to middle stages.
•Memantine helps regulate glutamate activity, which can improve cognitive function in moderate to severe stages.
•Medications for managing behavioral symptoms like depression, anxiety, agitation, and sleep disturbances.

2. Therapies:
•Cognitive Stimulation Therapy (CST): Engages patients in mentally stimulating activities to improve cognitive function and quality of life.
•Behavioral Therapy: Addresses specific behavioral issues and helps caregivers manage challenging behaviors.
•Occupational Therapy: Assists in adapting the home environment and teaching coping strategies to maintain independence.

3. Lifestyle and Support:
•Healthy Diet: A balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats supports overall brain health.
•Regular Exercise: Physical activity improves cardiovascular health and may slow cognitive decline.
•Social Engagement: Maintaining social connections and participating in meaningful activities can enhance emotional well-being.
•Caregiver Support: Providing education, resources, and respite care for caregivers is crucial for managing the emotional and physical demands of caregiving.
Precautions and Prevention
Although Alzheimer’s disease cannot be prevented entirely, certain lifestyle changes and precautions may reduce the risk or delay the onset of symptoms:

1. Healthy Lifestyle: Regular exercise, a nutritious diet, and maintaining a healthy weight contribute to overall brain health.
2. Mental Stimulation: Engaging in intellectually stimulating activities, such as reading, puzzles, and learning new skills, can help build cognitive reserve.
3.Social Interaction: Staying socially active and connected with friends, family, and community can reduce the risk of cognitive decline.
4.Heart Health: Managing cardiovascular risk factors like hypertension, diabetes, and high cholesterol supports brain health.
5.Quality Sleep: Prioritizing good sleep hygiene and addressing sleep disorders contribute to better cognitive function.
6.Avoiding Head Injuries: Taking precautions to prevent head injuries, such as wearing seat belts and helmets, reduces the risk of traumatic brain injury.

Conclusion
Alzheimer’s disease poses significant challenges for patients and caregivers alike. Early diagnosis, effective symptom management, and preventive measures can help improve quality of life and potentially delay the progression of the disease. Ongoing research continues to explore new treatments and interventions, offering hope for better management and eventual prevention of Alzheimer’s disease in the future. The development of highly accurate blood tests for Alzheimer’s disease marks a significant advancement in early detection and diagnosis, paving the way for more accessible and less invasive diagnostic tools in primary care settings.

For more information and tips on managing diabetes, consult your healthcare provider and stay tuned to Health Corner, IndoUs Tribune.