Alzheimer's disease: symptoms and signs, what it is, causes in an article by neurologist T. A. Polyakova.

Senile dementia, or Alzheimer's disease, is a severe neurodegenerative disease characterized by a slow progression. Starting with subtle symptoms, it gradually and steadily progresses and leads to death. Pathology is more often detected in people after they reach 65 years of age. Its main symptoms are memory and speech impairment, loss of orientation, and loss of self-care skills. The disease is irreversible. With timely diagnosis, it is possible to slow down the course of pathological processes for a short period of time.

Alzheimer's - what kind of disease is it?

Alzheimer's disease is a form of primary degenerative dementia that occurs in people of presenile or senile age. Characterized by a gradual and imperceptible onset. Disorders manifest themselves in memory impairment, up to the complete collapse of intelligence. In this case, all mental activity suffers and a complex of psychotic symptoms develops. This pathological condition progresses slowly but steadily.

In Alzheimer's disease, the following are impaired:

memory;
attention;
speech;
perception;
orientation in space;
ability to make decisions;
the ability to create and perform any work.

In addition to these disorders, patients experience behavioral disorders, which manifest themselves in increased anxiety and depression. The disease leads to disability of a person. Due to the destruction of brain neurons, the functioning of vital centers that control thinking, memory, and motor skills is completely disrupted.

Alzheimer's symptoms

In Alzheimer's disease, symptoms and signs of pathology vary depending on the stage of the disease and the degree of mental impairment. The main symptom of the onset of the disease is difficulty in remembering new information. Long-term memory is gradually impaired. Manifestations of dementia (acquired dementia) increase: cognitive functions sharply decrease and the ability to learn is lost. Patients ask the same questions, thinking is disrupted, and they gradually stop recognizing people. Signs of the disease differ at different stages.

Expert opinion
Author:
Vladimir Vladimirovich Zakharov
Neurologist, Doctor of Medical Sciences, Professor, Head of the Center for Diagnostics and Treatment of Memory Disorders
Alzheimer's disease, or senile dementia, is a serious neurodegenerative disease that affects patients over the age group of 50 years. The pathology is characterized by a progressive decline in intellectual abilities, memory impairment and personality changes. The diagnosis is confirmed by examinations: magnetic resonance imaging, electroencephalography, evoked potential method, neuropsychological testing.
Experts are confident that Alzheimer's disease is a hereditary disease caused by genetic predisposition.
Unfortunately, there is no specific treatment for Alzheimer’s disease today, but doctors at the Research Center for Diagnosis and Treatment of Memory Impairments will help slow down the development of the disease. The therapy uses a complex method based on a certain category of medications that are selected experimentally, as well as physical therapy programs.

Signs of Alzheimer's disease in the early stages

Pathological processes in the cerebral cortex and its deep layers begin long before a person notices signs of the disease. Sudden memory loss should always be a concern. In the early stages of Alzheimer's disease, mild forgetfulness occurs. Common signs of early Alzheimer's:

loss of sense of time;
forgetfulness;
difficulties in performing previously familiar actions;
decreased concentration;
memory impairment;
difficulty in spatial orientation;
difficulty finding words;
at the end of the conversation a person forgets what he said at the beginning;
irritability;
anxiety;
sudden aggressiveness.

Alzheimer's in old age

It is not difficult to notice symptoms of the disease in older people. A sure sign of Alzheimer's in older people is difficulty performing simple calculations. You can also notice that the person’s handwriting has changed and has become less legible. Elderly speech becomes confused, their words lose meaning.

Signs of the disease in older people:

minor impairment of short-term memory;
irritability;
inability to think abstractly;
fast fatiguability;
apathy;
sleep disorders.

Symptoms of Alzheimer's disease in young people

Although Alzheimer's disease is considered a pathology of old age, it can rarely occur in young people. Young people whose close relatives have this disease are at risk. In other words, there is a possibility of inheritance. Also, this danger remains in patients with diabetes mellitus, pathologies of the cardiovascular system, and those with traumatic brain injuries. Their early signs can last longer than 10 years.

In the early stages of the disease, short-term memory loss is observed, and then it becomes difficult for the young person to formulate his thoughts. Gradually, they develop absent-mindedness and cognitive functions decline. Interest in previously favorite activities is lost, character changes, and personal qualities are lost. Aggression manifests itself, the young man stops communicating with friends and relatives.

Early-onset Alzheimer's progresses faster than Alzheimer's onset in older people. If in old age the transition from one steel to another lasts for decades, then at the age of 30 the terminal stage may very soon begin.

The last stage of the disease in young people is characterized by the following symptoms:

the appearance of hallucinations;
profound dementia;
psychotic manifestations;
gross personality violations;
the appearance of obsessive and delusional ideas;
aggressive behavior.

Due to the fact that the early onset of the disease is characterized by more severe symptoms, difficulties with diagnosis may arise. Senile dementia in young people is confused with manic-depressive psychosis or schizophrenia. The rate of development of symptoms and its severity depend on the individual characteristics of the central nervous system.

Signs in women

Clinical observations indicate that Alzheimer's disease occurs more often in women. It is more severe than in men and progresses faster. More than 70% of patients are representatives of the weaker sex. Women have difficulty remembering, they become apathetic, and stop taking care of themselves. They exhibit the following behavioral changes:

touchiness;
excessive anxiety;
tearfulness;
increased fatigue;
neglect of household duties;
loss of interest in life;
difficulties in orientation in space and time;
greed.

Difficulties in diagnosing this pathology in women are due to the increase in symptoms of menopause after they reach the age of 55 years. Symptoms are similar: absent-mindedness, constant mood swings, forgetfulness.

Signs in men

Practice shows that men are less likely to experience Alzheimer's disease than women. Their initial symptoms go unnoticed for a long time, especially since men visit doctors less often. The disease progresses more slowly in them than in women. In men, forgetfulness appears, memory deteriorates, and concentration decreases. Impaired thinking is manifested by illogical actions. Other specific features stand out:

irritability;
alternation of aggression with apathy;
isolation;
tendency to vagrancy;
sexual behavior disorder.

Epidemiology

According to the World Health Organization in 2015, 0.441% of the total population of the planet lives with dementia. According to WHO forecasts, by 2030 this figure will increase to 0.556%. According to research, Alzheimer's disease is the most common cause of dementia in older people. And the number of patients will double every 20 years. Analysis of groups of cases shows that 60% of them live in countries with low and middle living standards.

Content:

Epidemiology
Modern classification
Causes
Localization of lesions
Symptoms of the disease
Stages
Diagnostics
Treatment
How to prevent disease
Consequences
Lifespan
Causes of death

The main reason for the spread of the disease on a global scale is the growing number of elderly people. AD most often affects people after 65 years of age, before 65 years of age it is rare, and before 45 years of age it almost never occurs. Although over the past decade, the disease has increasingly affected people at a younger age - up to 60 years. An exception in the statistics is for patients with Down syndrome; in this group of patients, the first signs of the disease often appear by the age of 30. Men get asthma 2-3 times less often than women. In children and adolescents, asthma is not observed.

Diagnosis of Alzheimer's disease

To diagnose Alzheimer's at an early stage, you need to contact a neurologist and psychiatrist. This will reduce the clinical manifestations of the disease and somewhat slow down its progression.

The diagnosis is made based on complaints from the patient and his relatives. The following procedures are also carried out:

study of anamnesis and heredity;
physical examination methods;
psychological testing;
instrumental and laboratory studies.

Neuropsychological test

The patient's condition is assessed through tests adapted to him. Assignments contain questions and situational tasks. The purpose of such a study is to assess cognitive disorders: thinking, speech, memory, etc.

The neuropsychological test for Alzheimer's disease consists of various tasks, you need to:

Name the objects shown in the picture;

· reproduce and repeat words;

· Perform simple arithmetic calculations;

· draw a clock and mark a certain time on it;

· to write a sentence;

· draw a picture.

In this way, the degree of cognitive impairment is determined.

Example test

With senile dementia, functional changes occur in some parts of the brain. This is manifested by impaired memory, speech, attention and intelligence. Such disorders can be detected by special tests. Below is an example of a neuropsychological test for Alzheimer's:

The patient needs to fill in the watch dial, setting the hands and numbers on it in accordance with the given time. For example, set the clock hands so that it shows 2 hours 45 minutes.
Draw a clock - a circle with a dial.
Remember and reproduce words from cards. There is a limited time to complete this task.
Copy a geometric shape from a picture.
Rewrite the sentence.
Working with pictures. The patient must find hidden elements in the image.
Search for characters in text containing the same letter. For example, in a text consisting of 10 lines of the letter M, the letter N is hidden. Numbers can be used instead of letters: among several rows of nines, find the number 6. The search must be carried out within a limited time.

For the timely detection of Alzheimer's disease, tests to diagnose this pathology are recommended for all persons over the age of 65 years. At risk are patients with atherosclerosis, diabetes mellitus, arterial hypertension, and those who have Alzheimer's patients among their relatives.

Magnetic resonance imaging (MRI)

This is the most informative method for identifying degenerative changes in the brain at the beginning of the development of the disease. It provides accurate visualization of the thinnest sections of the brain in various projections. MRI does not expose the patient to radiation.

Using this diagnostic method, structural changes in the brain are visualized, indicating the presence of the disease in question:

impaired glucose metabolism;
expansion of the sulci of the ventricles and brain;
weakening of blood supply to the cerebral cortex.

MRI can help rule out other causes of dementia. It determines: the degree of loss of brain tissue volume, structural features and atrophic changes. Using this method, categorical signs of comorbid diseases are identified, and thinning of the gyri can be seen.

Computed tomography of the brain (CT)

This type of examination allows you to identify pathology at the beginning of its development. The state of the brain is visualized, you can see a decrease in the size of the hemispheres and an increase in the ventricles of the organ, which is a sign of the pathology in question. If a CT scan is performed at later stages, areas of atrophy of the nerve tissue of the brain will be noticeable. CT allows for a layer-by-layer assessment of the brain and predicts how the pathology will develop in the future. The rate of loss of brain functionality in specific areas of the brain is determined with a reliable degree of probability.

Positron emission tomography (PET)

The newest diagnostic method that allows you to identify and evaluate indicators of cellular metabolism in all areas of the brain matter. The examination is carried out with intravenous administration of a contrast agent that selectively accumulates in brain cells. Alzheimer's disease is characterized by disturbances in glucose metabolism, resulting in the death of neurons. Signs of senile dementia during PET will be changes in the temporo-parietal region and in the posterior cingulate cortex.

How to prevent disease

Prevention of asthma means an active and interesting life. When a person’s brain works constantly, new connections between neurons are formed. These connections replace other brain cells that have died for some reason. Since the root cause of the formation of plaques and protein tangles is still being studied, prevention methods are aimed at increasing the resilience of the brain.

To prevent Alzheimer's disease, it is recommended to constantly learn something new. This could be learning languages or new hobbies, learning to play musical instruments or driving.

It is very useful to keep up with the times, master computers and telephone capabilities, electronic payment systems, etc.

Physical activity is good for both muscles and brain function. When playing sports, the blood is saturated with oxygen, which also reduces the risk of dementia. Treatment of diseases of the respiratory and cardiovascular systems refers to both the prevention and treatment of asthma. Normal functioning of the respiratory system, blood vessels and heart reduces the risk of any type of dementia.

A study and analysis of the epidemiology of AD showed that Indians suffer from dementia 5 times less often than other races. Research has shown that this situation may be caused by high consumption of curry. This seasoning contains curcumin, which reduces changes in the brain. If we talk about nutrition, it should be complete and varied, contain cereals and greens. Vitamins A, , , B12 are also useful for the brain. They can be taken with food or as individual vitamins.

Stages of Alzheimer's disease

Senile dementia or Alzheimer's disease goes through several stages in its development: from imperceptible symptoms to complete degradation. Each stage is characterized by specific manifestations, but they all relate to memory impairment and cognitive functions.

Predementia

The stage of pre-dementia is characterized by the occurrence of subtle cognitive impairment. Often they are detected only with detailed neurocognitive testing. Typically, it takes 7-10 years from the onset of early signs of Alzheimer's disease to diagnosis. The main disorder during this period is memory impairment. Forgetfulness concerns recent events or information learned the day before. Also, the elderly experience significant difficulties when they need to remember new information.

In addition, in the stage of pre-dementia, executive functions suffer. Thus, it is difficult for the patient to concentrate on anything and plan future actions. Difficulties are also associated with abstract thinking; it is difficult to remember and remember the meanings of some words. All these phenomena are often attributed to age-related changes. In fact, they are caused by pathological changes in brain structures. Due to the fact that at the onset of Alzheimer's disease the symptoms are mild, predementia refers to the preclinical stage of the disease. After it, cognitive changes become more pronounced.

Early dementia

At this stage of Alzheimer's disease, the main manifestation of the disease is memory impairment. This sign is the basis for the assumption of the progression of degenerative processes in the brain. At the same time, different types of memory suffer in different ways. Short-term memory is most affected, episodic and procedural memory is less affected. The person can still remember some distant events from his life, and semantic and implicit memory is also preserved. Long-learned actions and skills are remembered. At the same time, the patient is no longer able to remember new information and forgets events of the recent past. This disorder is accompanied by agnosia, a disorder of perception.

Forgetfulness of current events gradually increases. This fact becomes obvious to others. The patient has difficulties in chronological and geographical orientation. There are obvious disorders of mental operations. Abstract thinking is significantly impaired, and the ability to judge, generalize, and compare is also affected.

Despite maintaining independent living and self-care skills, patients lose the ability to independently perform financial transactions or conduct correspondence. Alzheimer's disease is accompanied by disorders of higher cortical functions. Speech, optical-spatial activity and the ability to consistently perform related actions suffer. The rate of speech decreases, the vocabulary decreases, a person cannot fully express his thoughts orally or in writing. Such disorders at this stage of disease development are characterized by distinct severity. Nevertheless, the patient adequately operates with simple concepts.

Moderate dementia

The main clinical manifestations of the stage of moderate dementia:

violation of time orientation;
impairment of short-term memory with preservation of long-term memory;
the patient fills memory gaps with fictitious stories;
self-service skills are lost;
clumsiness appears in movements, gait changes;
involuntary bowel movements or urination;
Personality disorders: aggressiveness, tearfulness, irritability, tendency to wander.

The progression of cognitive impairment significantly reduces a person's ability to perform independent actions. At this stage, speech disorders and agnosia (visual perception) clearly appear. It becomes difficult for a person to construct a phrase correctly. Often its meaning is lost because the patient forgets some words or uses them in the wrong context. Such speech disorders lead to dysgraphia and dyslexia. The first is the loss of writing skills, and the second is the loss of reading skills. A progressive praxis disorder deprives the patient of the ability to self-care, even basic skills are lost. Thus, a patient with Alzheimer’s at this stage cannot undress or dress independently, or eat food.

With moderate severity of senile dementia, a “shift of the situation into the past” is observed, in other words, memories of the long past are revived, and the people around him are perceived as persons from this past.

Severe dementia

Regardless of the type of disease, in the last stage of Alzheimer's, profound decay of memory, loss of concepts of time, amnesia and disorientation, delusional inferences and judgments, loss of ideas about one's own personality and psychomotor skills are observed.

The patient's speech consists of single words or individual phrases. Subsequently, speech skills are completely lost. At the same time, the ability to maintain emotional contact and perceive others remains for a long time.

Cholinergic hypothesis

According to this theory, the pathology is provoked by a decrease in the production of the neurotransmitter acetylcholine. However, modern researchers have questioned this theory, since drug supplementation of this substance did not lead to an improvement in the patient’s condition.

Amyloid hypothesis

According to this theory, beta-amyloid deposition is the main cause of the disease. Beta-amyloid plaques are deposited on the outside and inside of neurons. As a result, the transmission of signals between neurons is disrupted, after which they die.

Tau hypothesis

According to it, the disease begins after deviations begin to occur in the structure of the tau protein. This is what leads to disruption of the functioning of brain cells. The affected neuron begins the process of combining strands of tau protein, which disrupts the biochemical transmission of signals between the tiles. After which the cells themselves die. A sequence of neurodegenerative changes is initiated following the accumulation of beta-amyloid.

Hereditary hypothesis

There is a genetic predisposition to Alzheimer's disease. So, if close relatives have this disease, family members have an increased risk of developing this pathology. Mutations on chromosomes 21, 19, 14, and 1 are thought to cause Alzheimer's disease. It is believed that genetic predisposition slightly increases the likelihood of developing the disease, but does not necessarily cause it.

What factors lead to the development of the disease?

It is still not possible to answer this question accurately. Most experts agree that the development of dementia is influenced by three provoking factors:

Decreased acetylcholine production . This connection allows you to maintain normal levels of neuromuscular transmission. This hypothesis was used when planning supportive therapeutic courses for patients with dementia.
Failure of the process of cleaning brain cells from dying protein structures . At this stage of studying Alzheimer's disease, this theory is considered one of the most promising.
Disturbances in the structure of tau proteins, which lead to their death . This theory is gaining more and more followers every day, so it is actively developing along with the others.

Alzheimer's treatment

To date, there are no available methods that would help cure degenerative brain damage. It is also impossible to slow down the course of the disease for a long period. All methods of therapy are palliative and are aimed only at alleviating symptoms. Therefore, drugs used for Alzheimer's disease can be divided into groups: those that slow down the process of deposition of beta-amyloid plaques, restore and protect brain cells and help improve the patient's quality of life.

The effectiveness of treatment depends on the duration of medication use. Some feel better after just a few uses, while others need to take several courses of medication.

Drug treatment

The effectiveness of drug treatment is on average 70%. But a more important indicator is the body’s individual reaction to the medication. To obtain the best treatment result, the doctor will select a therapeutic regimen personally. In order to objectively evaluate the therapeutic effect of the drug, it must be taken continuously for at least 3 months.

In clinical practice for the treatment of Alzheimer's disease, drug regimens are used, including cholinesterase inhibitors and memantine. There is a moderate effect of these drugs in early and moderate dementia.

Anticholinesterase drugs or cholinesterase inhibitors

New drugs used in the treatment of Alzheimer's are cholinesterase inhibitors. These drugs stop the activity of cholinesterase. The expected effect from them is improved memory. Prescription of medications of this pharmacological group is carried out only by the attending physician. They have contraindications and can cause side effects.

Memantine against Alzheimer's

Memantine is the only drug recommended by the world medical community for the treatment of Alzheimer's disease in severe dementia. This neurotropic drug is a derivative of amantadine. It has a neuroprotective effect and inhibits the progression of neurodegenerative processes. Taking it improves memory, increases the ability to concentrate, reduces fatigue, and reduces symptoms of depression.

This drug is contraindicated for epilepsy and severe renal impairment. The drug Memantine has satisfactory tolerability. To prevent stimulation of the central nervous system, it is recommended to take it in the first half of the day.

It has been clinically proven that regular use of the drug for 12 weeks leads to significant improvements in cognitive function, relieves acute behavioral symptoms and increases the ability to self-care.

Tranquilizers, neuroleptics, anticonvulsants

These groups of drugs are designed to relieve behavioral and psychotic symptoms of the disease. Antipsychotic drugs are most often used. But their use increases the risk of developing extrapyramidal symptoms - this is a complex of motor disorders of a neurological nature, such as parkinsonism syndrome, tremors, tics, convulsions, dystonia, chorea (involuntary sweeping movements). Therefore, antipsychotics are used only for severe behavioral disorders, and only drugs without anticholinergic effects are used. Tricyclic antidepressants are contraindicated for Alzheimer's disease.

Nootropics and tissue regeneration stimulators

Nootropic drugs are designed to improve intracellular metabolism in neurons. They prevent their damage and stimulate interneuron connections. Stimulators of tissue regeneration affect the cause of degenerative changes.

Psychotherapy

Psychotherapeutic methods can help patients with Alzheimer's disease overcome feelings of anger and anxiety. The psychotherapist will work with the patient, as a result of which he will be able to understand his feelings. If necessary, the doctor will prescribe medications. Psychotherapy methods are aimed at reducing anxiety and aggressiveness and improving thinking. They are not intended to improve clinical performance. In addition, psychotherapy methods are effective only at the initial stage of the disease. At more severe stages, their use does not make sense.

Art therapy for Alzheimer's patients

Art therapy as a method of psychological correction is used to combat neuroses and behavioral disorders. These are precisely the manifestations that are characteristic of patients with Alzheimer's disease. This method of treatment involves involving patients in various types of art to harmonize their mental state. Thus, through dancing, painting, music or literary creativity, abilities for self-knowledge and self-expression develop.

Art therapy for Alzheimer's disease in the following patient conditions:

Depression and stress;
Emotional instability;
Emotional rejection;
Feeling of loneliness;
Anxiety;
Aggressiveness.

Through commitment to art, an outlet for aggression and other negative feelings is created. Art therapy is used as an auxiliary method of treatment.

Sensory room

A sensory room is about organizing the environment in a special way. It is filled with various stimulants that affect the senses. A calming and relaxing effect is achieved through various combinations of stimuli, such as music, light, sounds, color, smells, and tactile sensations.

Classes in the sensory room for Alzheimer's disease will help with such psychological disorders as:

neurosis;
maladjustment;
depression and psycho-emotional stress;
weakening of sensory functions;

Memory Therapy

Used in late stages of the disease. This is an emotionally focused psychotherapy and it focuses on pleasant memories and happy thoughts. Using videos and photographs, as well as other items from the past, the therapist demonstrates and discusses positive memories experienced in the past. This helps to lift the patient out of depression, which has a positive effect on overall well-being, appearance and volitional functions.

Presence Stimulation

This method implies that recordings with the voices of close relatives will be played in the presence of the patient. Typically, this psychotherapeutic method is used for people with severe dementia when they are in a state of heightened emotional arousal and anxiety.

Sensory Integration

The sensory integration method involves stimulating the functioning of the senses through the coordination of various sensory systems. the purpose of its use is to stimulate the central nervous system. The senses are engaged through various exercises.

Nutrition

Patients with severe Alzheimer's are unable to control their food intake. Therefore, they often have an exhausted body and lack vitamins, nutrients and minerals.

At the beginning of the disease there are no problems with eating food. Then the patient’s diet does not differ from the classic diet of proper nutrition. Patients have no dietary restrictions. Lean protein, complex carbohydrates, unsaturated fats, vitamins and minerals are recommended for Alzheimer's patients. Their diet should consist of the following products:

Turkey and fish;
Broccoli;
Spinach;
Nuts;
Beans;
Pasta from durum wheat;
Legumes;
Cereals (millet, buckwheat);
Whole wheat bread;
Green vegetables;
Olive oil;
Seaweed;
Fruits of all colors.

An Alzheimer's patient must follow a drinking regime and drink the required amount of clean water. When dehydrated, the death of neurons in the brain increases.

You cannot force a patient to eat when he refuses or is in an unfavorable mood. To prevent burns and injuries, food should not be too hot. Number of meals - 4-5 times.

Modern classification

In simple words, Alzheimer's disease is the slow degradation of a person in all aspects of life. It is divided into two forms: senile and presenile. The first is said to occur when the disease begins after 65 years of age, and the latter when it is detected before this age. This classification reflects old ideas about dementia, when it was believed that intellectual disorders in early and late life were different pathologies. At that time, Alzheimer's disease was called the presenile form, and the senile form was simply called senile dementia.

Research into the etiology and pathogenesis of the disease has shown that both forms have the same stages and mechanisms of development. Based on this, both presenile and senile diseases were combined into one disease and designated as “Alzheimer’s disease.” According to ICD 10, this type of dementia was coded G30. Despite the same essence, scientists do not deny the differences in clinical indicators in senile and presenile dementia.

Presenile

Fast-flowing form. It occurs between 45 and 65 years of age, except in rare cases when it affects people over 65 years of age. It differs from senile in its faster pace of development and family history. Distinctive characteristics of the presenile form:

occurs before age 65;
rapid progression;
family history;
The clinical picture shows memory impairment, changes in speech and motor functions.

Most often, the onset of the disease occurs at 55-60 years of age. The first stages develop slowly and can last from several months to 2-4 years. The decay of intelligence begins with forgetfulness of current events: the patient remembers well past events, but forgets recent ones. Unlike senile dementia, the patient is not immersed in the past. In the initial stages of the disease, criticism of one’s own condition remains.

The patient, aware of what is happening, may try to hide the illness. When talking, a person often tries to avoid the topic because he cannot remember the right words or events. Over time, attempts to maintain the “façade of personality” weaken and criticism decreases. The patient quickly loses reading, counting, and writing skills. The perception of the surroundings is also blurred.

Sensory and amnestic disturbances are accompanied by disorientation. As the disease progresses, the person gradually forgets how to use household items. In the future, meaningless movements and gestures are observed. In the final stages, the patient’s set of skills and knowledge is completely exhausted. Speech is limited to incoherent sounds, the patient even forgets automated actions, such as walking or sitting independently.

The full cycle of the disease takes from 1 to 10 years. The rate of progress depends on factors such as heredity, type of activity, standard of living, and the presence of other diseases.

At the end of the pathology, patients are not able to do something themselves, to ask for something. Death in most cases occurs from associated infections.

Senile

A form of later manifestation, most often occurs after 65 years. Senile dementia is called the first type of Alzheimer's disease. It is distinguished from presenile by slow progress and lack of family history. Distinctive characteristics:

occurs after 65 years of age;
family history is not traceable;
progress is slow with temporary plateaus;
the clinical picture is dominated by memory impairment.

Type I BA is also distinguished clinically from the presenile form. In the first case, the patient quickly experiences disturbances in speech, awareness, movements, and gnosis. With senile dementia, personality and mental activity gradually disintegrate. The first stages of pathology are subtle. Over time, the constitution of the individual changes, a person can become gloomy, suspicious, and grouchy.

Among the symptoms of senile dementia, a “shift into the past” is distinguished. In the early stages, a person does not perceive new knowledge, judgments, and skills. They perceive the past as an example. As patients progress, false memories or recognitions occur; people from the current moment are associated with people from the past. Patients may also invent events related to the past.

From the early stages to the last, egocentrism and selfishness progresses. The patient's priorities are narrowed around his personality, health and safety. Emotional memory for loved ones is disrupted, old attachments to people disappear. In behavior, there is a progression of lower drives: gluttony, inappropriate sexualization, accumulation of rubbish, etc.

Unlike the presenile form, in this case there is no complete breakdown of speech and motor function. Patients until the last stage can maintain a rich vocabulary and vividness of speech. However, logical connections suffer greatly due to insanity. Amnesia progresses slowly and affects from the most complex skills to simple ones.

In the final stages, patients, just like in the presenile form, are unable to take care of themselves. The full cycle of pathology takes from 4 to 15 or more years.

What should relatives do? How to care for a sick person?

Daily care for Alzheimer's patients should be carried out in accordance with the following recommendations. They are designed to ensure the psychological and physical well-being of the patient:

Maintaining a clear daily routine. This will allow you to navigate in time.
Maintaining the patient's sense of independence in all available ways.
You cannot discuss his defects with strangers in the presence of the patient.
Maintain a friendly atmosphere;
Avoiding conflict situations.

Prognosis and life expectancy

The prognosis of the disease is unfavorable, since it is based on a progressive neurodegenerative process. It is possible to slow down the progression of the pathology and stabilize the patient’s condition for a limited period of time, no more than 3 years, with adequate and long-term therapy. However, the constantly progressive loss of essential body functions inevitably leads to death. How long people live with Alzheimer's disease at the last stage depends on the rate of death of brain neurons.

The average life expectancy of a patient after diagnosis is 7 years. Less than 3% of patients live longer than 14 years after diagnosis of the disease. The patient's life prognosis worsens due to the fact that Alzheimer's disease is difficult to diagnose in the early stages. Typically, the diagnosis is made when a person's daily activities are impaired by the development of cognitive impairment. But even then the patient remains capable of independent life. The prognosis is also complicated by concomitant pathologies, such as alcoholism, heart and vascular diseases, and diabetes.

Localization of lesions

After the death of his patient, Alois Alzheimer examined parts of her brain, where he discovered senile plaques. Modern pathological studies confirm that patients have protein accumulations. When APP is impaired, insoluble fragments are deposited in the brain parenchyma and the walls of cerebral vessels. Tau protein is part of the inner membranes of neurons. Abnormalities in this protein damage membranes, which in turn leads to the death of brain cells.

Lesions are localized in the cortex and brain cells. The consequences extend to the nervous system and all brain functions. The hippocampus, the area of the brain responsible for memory and learning, is most affected.

Prevention of Alzheimer's

There is currently no specific prevention for Alzheimer's disease. It is believed that intellectual activity is a factor that can delay the onset of the disease or slow down its progression to a certain extent. However, there is no reliable way to prevent the development of Alzheimer's disease. It has been noted that people with healthy hearts and blood vessels are less susceptible to this pathology.

It is not possible to recommend any dietary supplements or medications that can prevent Alzheimer's disease or prevent cognitive impairment. At the same time, course use of Cerebrolysin can reduce the progression of cognitive impairment and dementia in individuals with a genetic tendency to develop Alzheimer's disease, as well as in the elderly with a slight decrease in cognitive function.

Consequences

The main danger of the disease is the collapse of personality. A person cannot fully live through the entire period of illness, so an entire decade may “fall out” of his life. Dementia disrupts the patients’ attachments to family and friends; in the stage of insanity, the person is practically “absent.” Irreversible changes in the structure of the brain lead to actual paralysis, the patient is unable to help himself.

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