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alzheimer's disease…

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aged nervous tissue, senile dementia/alzheimer's type, sdat, alzheimer's disease, ad, one form of dementia, progressive, degenerative brain disease, it affects memory, thinking, behavior, memory impairment, necessary feature, the diagnosis of this, type of dementia, change in one, areas must also be present, language, decision-making ability, judgment, attention, areas of mental function, personality, rate of progression is different, ad develops rapidly, likely to continue to progress rapidly, has been slow to progress, likely continue on a slow course, than 4 million americans currently have ad, older get, greater risk of developing ad, it is not a part of normal aging, family history is another common risk factor, family history, risk factors, ad, longstanding high blood pressure, history of head trauma, high levels of homocysteine, a body chemical that contributes to chronic illnesses heart disease, depression, possibly ad, female gender, women, live longer than men, more likely to develop ad, two types of ad, early onset, late onset, in early onset ad, symptoms first appear, age 60, early onset ad is much less common, accounting, 5-10% of cases, tends to progress rapidly, ad is not entirely known but is thought to include both genetic, environmental factors, a diagnosis of ad is made, characteristic symptoms, by excluding other causes, dementia, prior theories regarding the accumulation of aluminum, lead, mercury, in the brain ad have been disproved, way to know, certain that someone had ad is by microscopic examination of a sample of brain tissue after death, brain tissue shows "neurofibrillary tangles", twisted fragments of protein, nerve cells that clog up the cell, "neuritic plaques", abnormal clusters of dead, dying nerve cells, brain cells, protein, "senile plaques", areas where products of dying nerve cells have accumulated around protein, changes occur to some extent in all brains, many more of them, in the brains of people, ad, destruction of nerve cells, neurons, leads to a decrease in neurotransmitters, substances secreted by a neuron to send a message to another neuron, correct balance of neurotransmitters is critical, brain, by causing both structural, chemical problems, in the brain, ad appears to disconnect areas, the brain that, work together, 10 percent of all people over 70 have significant memory problems, half of those, due to ad, number of people, ad doubles each decade past age 70, having a close blood relative who developed ad increases risk, early onset disease, run in families, involves autosomal dominant, inherited mutations that the cause, far, three early onset genes have been identified, late onset ad, most common form, develops in people 60, older, thought to be less likely to occur in families, late onset ad, run, families, the role of genes is less direct, definitive, genes, not cause the problem, simply increase the likelihood of formation of plaques, tangles, ad-related pathologies, in the brain, early stages, symptoms of ad subtle, resemble signs that people mistakenly attribute to "natural aging", symptoms often, repeating statements, misplacing items, having trouble finding names, familiar objects, getting lost on familiar routes, personality changes, losing interest in things previously enjoyed, difficulty performing tasks that take some thought, balancing a checkbook, playing complex games, bridge, learning new information, routines, advanced stage, more obvious, forgetting details, current events, forgetting events in own life history, losing awareness of who, problems choosing proper clothing, hallucinations, arguments, striking out, violent behavior, delusions, depression, agitation, difficulty performing basic tasks, preparing meals, driving, at end stages of ad, no longer survive, assistance, most people in this stage no longer, understand language, recognize family members, perform basic activities of daily living eating, dressing, bathing, first step in diagnosing alzheimer's disease, establish that dementia is present, type of dementia, clarified, a health care provider, history, a physical exam, a neurological exam, perform a mental status examination, tests ordered to help determine, treatable condition that could be causing dementia, contributing, confusion of ad, conditions include thyroid disease, vitamin deficiency, brain tumor, drug, medication intoxication, chronic infection, anemia, severe depression, ad, has a characteristic pattern of symptoms, diagnosed by history, physical exam, experienced clinician, evaluate, exclude other causes, dementia include computed tomography, ct, magnetic resonance imaging, mri, blood tests, early stages of dementia, brain image scans normal, in later stages, an mri, a decrease, in the size, the cortex, the brain, the area, the brain responsible, memory, hippocampus, scans, not confirm the diagnosis of ad, exclude other causes, dementia, stroke, tumor, unfortunately, no cure, ad, goals in treating ad, slow the progression, manage behavior problems, confusion, agitation, modify the home enviroment, support family members, caregivers, most promising treatments include lifestyle changes, medications, antioxidant supplements, vitamin e, ginkgo biloba, lifestyle changes, ad, walk regularly, a caregiver, reliable companion, improve communication skills, prevent wandering, use bright light therapy to reduce insomnia, wandering, listen to calming music, reduce wandering, restlessness, boost brain chemicals, ease anxiety, enhance sleep, improve behavior, get a pet dog, practice relaxation techniques, receive regular massages, relaxing, provides social interactions, drug treatment, several drugs, try to slow the progression, of ad, possibly improve the person's mental capabilities, donepezil, aricept, rivastigmine, exelon, galantamine, razadyne, formerly, reminyl, tacrine, cognex, all of these drugs affect the level of acetylcholine, a neurotransmitter, brain, all have potential side effects, nausea, vomiting, tacrine also causes, an elevation in liver enzymes, must be taken four times a day, seldom used, aricept is taken once a day, stabilize, improve the person's mental capabilities, generally well tolerated, exelon, a new drug, a similar effectiveness, taken twice a day, medications required to control aggressive, agitated, dangerous behaviors, given in very low doses, adjustment, necessary to stop any medications that worsen confusion, pain killers, cimetidine, central nervous system depressants, antihistamines, sleeping pills, medications must not be stopped, changed, discussion, direction from doctor, supplements, folate, vitamin b9, critical, health, the nervous system, together, other b vitamins, folate is also responsible, clearing homocysteine, a body chemical that contributes to chronic illnesses, blood, high levels of homocysteine, low levels of both folate, vitamin b12 have been found, ad, the benefits of taking these b vitamins, ad is not entirely clear, worth considering them, homocysteine levels, antioxidant supplements, ginkgo biloba, vitamin e, scavange free radicals, products of metabolism, highly reactive, damage cells throughout the body, vitamin e dissolves in fat, readily enters the brain, slow down cell damage, in at least one well-designed study of people, ad who were followed, 2 years, who took vitamin e supplements had improved symptoms compared to those who took a placebo pill, patients who take blood-thinning medications, warfarin, coumadin, should talk to doctor, taking vitamin e, ginkgo biloba, herb widely used in europe, treating dementia, improves blood flow, in the brain, contains flavonoids, plant substances, antioxidants, the studies to date have been somewhat flawed, idea that ginkgo, improve thinking, learning, memory in those, ad has been promising, not use ginkgo, take blood-thinning medications, warfarin, coumadin, a class of antidepressants, monoamine oxidase inhibitors, maois, considering any drugs, supplements, must talk to doctor, herbs, supplements available over the counter, not regulated, support at home, someone, ad, need support, in the home, the disease worsens, family members, caregivers, by trying to understand how the person, ad perceives world, simplify the patient's surroundings, give frequent reminders, notes, lists of routine tasks, directions, daily activities, give the person, ad a chance to talk, challenges, participate in own care, practical steps, ad should have eyes, ears checked, found, hearing aids, glasses, cataract surgery needed, ad, have particular dietary requirements, extra calories, due to increased physical activity from restlessness, wandering, supervised meals, feeding, ad often forget to eat, drink, become dehydrated, safe return program, implemented by the alzheimer's association, that a person, ad wear in identification bracelet, wanders, caregiver, contact the police, national safe return office, where information, the person is stored, shared nationwide, eventually, 24-hour monitoring, assistance necessary, a safe environment, control aggressive, agitated behavior, meet physiologic needs, in-home care, nursing homes, adult day care, alzheimer's disease, caregivers, alzheimer's disease support groups, probable outcome is poor, disorder, progresses steadily, total disability is common, death, occurs, 15 years, infection, a failure of other body systems, loss of ability to function, care, self, bedsores, muscle contractures, loss of ability to move joints, loss of muscle function, infection, particularly urinary tract infections, pneumonia, complications related to immobility, end-stages of ad, falls, broken bones, loss of ability to interact, malnutrition, dehydration, failure of body systems, reduced life span, harmful, violent behavior toward self, abuse, over-stressed caregiver, side effects of medications, someone close to experiences symptoms of senile dementia/alzheimer's type, disorder experiences a sudden change in mental status, a rapid change, indicate other illness, discuss the situation, caring, condition deteriorates, point where, no longer care, no proven way, prevent ad, practices that worth incorporating into daily routine, family history of dementia, of these approaches, those that involve taking a medication, supplement, consume a low-fat diet, eat cold-water fish, tuna, salmon, mackerel, rich in omega-3 fatty acids, at least 2 to 3 times per week, reduce intake of linoleic acid found in margarine, butter, dairy products, increase antioxidants, carotenoids, vitamin e, vitamin c by eating plenty of darkly colored fruits, vegetables, maintain a normal blood pressure, stay mentally, socially active throughout life, consider taking non-steroidal anti-inflammatory drugs, nsaids, ibuprofen, advil, motrin, sulindac, clinoril, indomethacin, indocin, statin drugs, a class of medications, used, high cholesterol, help lower risk of ad, the pros, cons of using these medications, prevention, early testing of a vaccine against ad is underway, alzheimer's association, statistics, alzheimer's disease, alz.org/aboutad/statistics, asp, rakel, p, ed, conn's current therapy 2005, 57th ed, philadelphia, pa, saunders, moore, dp, jefferson, jw, handbook of medical psychiatry, mosby, goetz cg, pappert ej, textbook of clinical neurology, philadelphia, pa, saunders, 2003.



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