Alzheimer’s Disease


Alzheimer's Disease

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Alzheimer’s disease is a neurological disorder that affects the brain. The symptoms are minor at first and worsen over time. It is named after Dr. Alois Alzheimer, who characterized the illness for the first time in 1906.

Memory loss, language issues, and impulsive or unpredictable behavior are all common symptoms of Alzheimer’s disease.

The presence of plaques and tangles in the brain is one of the key characteristics of the illness. Another hallmark is a breakdown in communication between nerve cells, or neurons, in the brain.

Because of these characteristics, information cannot easily flow between different parts of the brain or between the brain and the muscles or organs.

As the symptoms increase, it becomes more difficult for people to remember recent events, reason, and recognize people they know. A person with Alzheimer’s disease may eventually require 24-hour care.

According to the National Institute on Aging, Alzheimer’s disease is the sixth greatest cause of death in the United States. However, some recent estimates indicate that it may be the third largest cause of mortality, trailing only heart disease and cancer.

Alzheimer’s disease is a neurological illness in which the death of brain cells causes memory loss and cognitive deterioration.

It is the most common type of dementia, accounting for 60-80% of dementia occurrences in the United States.

Alzheimer’s disease affects about 5 million people in the United States. This figure is expected to nearly quadruple by 2060, according to estimates.

The illness usually affects adults over the age of 65, with only 10% of occurrences occurring in people under this age.

Who is affected by Alzheimer’s disease?

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Alzheimer’s disease can strike young people, but it is uncommon.
The disease’s symptoms may occur after the age of 60, and the risk increases with age.

What do we know about Alzheimer’s?

Scientists are still unsure what causes Alzheimer’s disease. There is most certainly not a single reason, but rather a combination of circumstances that influence each individual individually.

The most well-known risk factor for Alzheimer’s disease is age.

Researchers believe that genetics may have a role in the development of Alzheimer’s disease. However, genes do not determine fate. A healthy lifestyle may help lower your risk of Alzheimer’s disease. Two big, long-term studies suggest that adequate physical exercise, a balanced diet, moderate alcohol use, and quitting smoking may be beneficial.
Brain changes might occur years before the first symptoms appear.
Researchers are investigating whether education, diet, and environment influence the development of Alzheimer’s disease.

There is mounting scientific evidence that healthy activities, which have been found to reduce the risk of cancer, diabetes, and heart disease, may also lower the risk of subjective cognitive decline.

What are the symptoms of Alzheimer’s disease?


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Alzheimer’s disease is not a natural component of the ageing process. Memory issues are frequently one of the early symptoms of Alzheimer’s disease and other dementias.

In addition to memory impairments, people with Alzheimer’s disease may experience one or more of the following symptoms:

Memory loss that interferes with daily life, such as getting lost in a familiar place or asking the same questions repeatedly.
Having difficulty managing money and paying expenses.
Difficulty accomplishing routine duties at home, business, or leisure.
Inadequate or bad judgement.

Misplacing items and being unable to retrace your steps to locate them.

Mood, attitude, or behaviour changes.

What Should You Do If You Suspect Alzheimer’s?

Having your symptoms assessed by a healthcare expert can help identify whether they are due to Alzheimer’s disease or to more manageable problems such as a vitamin deficiency or a drug side effect.

Early and precise diagnosis also allows you and your family to consider financial planning, establish advance directives, enrol in clinical studies, and anticipate care needs.

What Is the Treatment for Alzheimer’s Disease?

Alzheimer’s disease is complex, and no single treatment or other intervention will ever be able to adequately treat it in all persons who have it. Nonetheless, scientists have made enormous progress in recent years in better understanding Alzheimer’s disease and creating and testing new treatments, including numerous drugs in late-stage clinical studies.

The FDA has previously approved many prescription medications to assist manage symptoms in persons with Alzheimer’s disease. In addition, on June 7, 2021, the FDA granted accelerated approval for the newest medication, aducanumab, which helps to reduce amyloid deposits in the brain and may help slow the progression of Alzheimer’s, though it has not yet been shown to affect clinical symptoms or outcomes, such as cognitive decline or dementia progression.

Most medications are most effective for persons who are in the early or intermediate stages of Alzheimer’s disease. However, it is critical to recognise that none of the treatments now available will cure Alzheimer’s.

Treatment for mild to moderate Alzheimer’s disease

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Treating Alzheimer’s symptoms can provide people with more comfort, dignity, and independence for a longer amount of time, as well as motivate and help their carers. Galantamine, rivastigmine, and donepezil are cholinesterase inhibitors used to treat mild to moderate Alzheimer’s symptoms. These medications may help lessen or control some cognitive and behavioural problems.

Although scientists do not fully understand how cholinesterase inhibitors function to treat Alzheimer’s disease, evidence indicates that they limit the breakdown of acetylcholine, a brain neurotransmitter thought to be vital for memory and cognition. Because the brain produces less and less acetylcholine as Alzheimer’s advances, these medications may eventually lose their effectiveness. Because cholinesterase inhibitors act in a similar manner, moving from one to the other may not provide dramatically different outcomes; nonetheless, a person suffering from Alzheimer’s disease may respond better to one treatment against another.

Illness-modifying drugs or therapies are medications that target the underlying causes of a disease. Aducanumab is the only Alzheimer’s disease-modifying drug currently approved for use. This drug is a human antibody, or immunotherapy, that targets the protein beta-amyloid and aids in the reduction of amyloid plaques, which are brain lesions linked to Alzheimer’s disease. Only persons with early-stage Alzheimer’s or mild cognitive impairment were studied in clinical trials to establish the efficacy of aducanumab. Researchers are still investigating if this medicine affects a person’s rate of cognitive deterioration over time.

Before prescribing aducanumab, clinicians may request PET scans or cerebrospinal fluid studies to determine the presence of amyloid plaques in the brain. This can assist doctors in making an accurate Alzheimer’s diagnosis before administering medication. Once on aducanumab, a person’s doctor or specialist may order routine MRIs to check for side effects including brain swelling or haemorrhage.

Alzheimer’s disease treatment for mild to severe cases

To treat moderate to severe Alzheimer’s disease, memantine, an N-methyl D-aspartate (NMDA) antagonist, is administered. The major impact of this medication is to reduce symptoms, which may allow some patients to do some everyday duties for a little longer than they would without the prescription. Memantine, for example, may assist a person in the later stages of Alzheimer’s disease preserve his or her capacity to use the restroom independently for several months longer, which is beneficial to both the person with Alzheimer’s and carers.

Memantine is thought to act by controlling glutamate, a key brain neurotransmitter. When created in excess, glutamate can cause brain cell death. Because NMDA antagonists and cholinesterase inhibitors operate differently, they can be administered together.

For the treatment of moderate to severe Alzheimer’s disease, the FDA has also approved donepezil, the rivastigmine patch, and a combination medicine of memantine and donepezil.

Drug and its types with working

Aducanumab: Disease-modifying immunotherapy is a treatment option for moderate cognitive impairment or mild Alzheimer’s disease.

Removes aberrant beta-amyloid to aid in the reduction of plaques in the brain.
Side-effects: Amyloid-related imaging abnormalities (ARIA) can cause fluid buildup or bleeding in the brain, as well as headache, dizziness, falls, diarrhoea, and confusion.

Intravenous: The dose is determined by a person’s weight; it is administered over one hour every four weeks; most people begin with a lesser dose and gradually increase the amount of medicine to reach the full prescription dose.

Donepezil: A cholinesterase inhibitor is a medication used to treat the symptoms of mild, moderate, and severe Alzheimer’s disease.

Prevents acetylcholine breakdown in the brain.
Nausea, vomiting, diarrhoea, muscle cramps, exhaustion, and weight loss are all possible side effects.

Tablet: once day; dosage may be gradually increased if well tolerated.
Tablet that dissolves in the mouth: The same dose regimen as before.

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Memantine: An N-methyl D-aspartate (NMDA) antagonist is used to treat moderate to severe Alzheimer’s disease symptoms.

Blocks the harmful effects of glutamate excess and controls glutamate activation

Headache, dizziness, diarrhoea, constipation, and disorientation.

Tablet: once day; dosage and frequency may be raised (up to twice daily) if well tolerated.

Dosage for oral solution is the same as for tablet.

Extended-release capsule: once daily; dosage may be increased over time, at least every one week, if well tolerated.

Combination of memantine and donepezil manufactured:

NMDA antagonists and cholinesterase inhibitors are used to treat moderate to severe Alzheimer’s disease symptoms.

Blocks the harmful effects of excess glutamate and inhibits acetylcholine breakdown in the brain.

Anorexia, headache, nausea, vomiting, diarrhoea.

Extended-release capsule: once daily; initial dosage depends on whether the person is already on a stable dose of memantine and/or donepezil; dosage may be increased over time, at least once per week, if well tolerated.

Galantamine: A cholinesterase inhibitor is used to treat mild to moderate Alzheimer’s disease symptoms.

Prevents acetylcholine breakdown and activates nicotinic receptors in the brain to release more acetylcholine

Nausea, vomiting, diarrhoea, appetite loss, dizziness, and headache.

Tablet: Twice daily; if well tolerated, dose may be increased over time at minimum four-week intervals.
Capsule with extended release: The same dosage as the tablet, but just once a day.

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Alzheimer’s disease Medicine Dosage and Side Effects

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Doctors frequently start patients on modest dosages of medication and gradually raise the dosage based on how well the patient tolerates the medication. There is some indication that greater doses of Alzheimer’s drugs may assist some people. The higher the dose, however, the more likely adverse effects will occur.

When a new medication is introduced, patients should be closely watched. Nausea, vomiting, diarrhoea, allergic reactions, and loss of appetite are all possible side effects of these medications. Any odd symptoms should be immediately reported to the prescribing doctor. When taking any prescription, including vitamins and herbal supplements, it is critical to follow the doctor’s instructions. Also, notify your doctor before adding or modifying any drugs.

Managing Alzheimer’s Disease Behavioural Symptoms

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Sleeplessness, wandering, agitation, anxiety, anger, restlessness, and depression are common behavioural signs of Alzheimer’s. Scientists are understanding why these symptoms occur and are researching new drug and nondrug ways to manage them. Treatment of behavioural symptoms has been demonstrated in studies to make patients with Alzheimer’s more comfortable and to make things simpler for caretakers.

Experts agree that drugs for treating these behavioural issues should be used only after alternative non-medication approaches have been exhausted. Learn more about behavioural changes in Alzheimer’s patients and how to manage.

Medicines to be taken with Caution in Alzheimer’s Patients

Some medications, such as sleep aids, anti-anxiety medications, anti-convulsants, and antipsychotics, should only be taken by someone with Alzheimer’s disease:

Following the doctor’s explanation of all the dangers and side effects of the medication
After other, safer nonmedication treatment approaches have failed to alleviate the condition
Side effects from these drugs must be properly monitored by people living with Alzheimer’s disease and their caretakers.

Sleep aids are medications that assist individuals fall and remain asleep. People with Alzheimer’s should not use these medications on a daily basis because they make the person more confused and prone to falling. People can enhance their sleep by making some lifestyle adjustments. Find out how to obtain a good night’s sleep.

Anti-anxiety medications: These medications are used to treat agitation. These medications may induce drowsiness, dizziness, falls, and confusion. As a result, doctors advise only using them for brief periods of time.

What is the economic impact of Alzheimer’s disease in the United States?

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Alzheimer’s disease is one of the top ten killers in the United States.
The sixth biggest cause of death among people in the United States.

The fifth biggest cause of death in persons aged 65 and up.

Alzheimer’s disease was expected to affect 5.8 million Americans aged 65 and over in 2020.
This figure is expected to nearly quadruple to 14 million by 2060.

Alzheimer’s disease treatment expenses were predicted to be between $159 and $215 billion in 2010.

These costs are expected to rise to between $379 and more than $500 billion per year by 2040.

Alzheimer’s disease death rates are growing, although heart disease and cancer death rates are decreasing. Dementia, including Alzheimer’s disease, has been demonstrated to be under-reported in death certificates, suggesting that the number of older persons dying from Alzheimer’s may be far higher.