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The Development Behind Alzheimer's Disease

Symptoms and diagnosis for Alzheimer’s Disease

By Neurosurgery Singapore

What is Alzheimer’s disease?

Alzheimer’s disease is a progressive disorder that causes brain cells to waste away (degenerate) and die. Alzheimer’s disease is the most common cause of dementia — a continuous decline in thinking, behavioral and social skills that disrupts a person’s ability to function independently.

The early signs of the disease may be forgetting recent events or conversations. As the disease progresses, a person with Alzheimer’s disease will develop severe memory impairment and lose the ability to carry out everyday tasks.

Current Alzheimer’s disease medications may temporarily improve symptoms or slow the rate of decline. These treatments can sometimes help people with Alzheimer’s disease maximize function and maintain independence for a time. Different programs and services can help support people with Alzheimer’s disease and their caregivers.

There is no treatment that cures Alzheimer’s disease or alters the disease process in the brain. In advanced stages of the disease, complications from severe loss of brain function — such as dehydration, malnutrition or infection — result in death.

What are some symptoms of Dementia?

Memory loss is the key symptom of Alzheimer’s disease. An early sign of the disease is usually difficulty remembering recent events or conversations. As the disease progresses, memory impairments worsen and other symptoms develop.

At first, a person with Alzheimer’s disease may be aware of having difficulty with remembering things and organizing thoughts. A family member or friend may be more likely to notice how the symptoms worsen.

Brain changes associated with Alzheimer’s disease lead to growing trouble with:

Memory

Everyone has occasional memory lapses. It’s normal to lose track of where you put your keys or forget the name of an acquaintance. But the memory loss associated with Alzheimer’s disease persists and worsens, affecting the ability to function at work or at home.

People with Alzheimer’s may:

  • Repeat statements and questions over and over
  • Forget conversations, appointments or events, and not remember them later
  • Routinely misplace possessions, often putting them in illogical locations
  • Get lost in familiar places
  • Eventually forget the names of family members and everyday objects
  • Have trouble finding the right words to identify objects, express thoughts or take part in conversations

Thinking and reasoning

Alzheimer’s disease causes difficulty concentrating and thinking, especially about abstract concepts such as numbers.

Multitasking is especially difficult, and it may be challenging to manage finances, balance checkbooks and pay bills on time. These difficulties may progress to an inability to recognize and deal with numbers.

Making judgments and decisions

The ability to make reasonable decisions and judgments in everyday situations will decline. For example, a person may make poor or uncharacteristic choices in social interactions or wear clothes that are inappropriate for the weather. It may be more difficult to respond effectively to everyday problems, such as food burning on the stove or unexpected driving situations.

Planning and performing familiar tasks

Once-routine activities that require sequential steps, such as planning and cooking a meal or playing a favorite game, become a struggle as the disease progresses. Eventually, people with advanced Alzheimer’s may forget how to perform basic tasks such as dressing and bathing.

Changes in personality and behavior

Brain changes that occur in Alzheimer’s disease can affect moods and behaviors. Problems may include the following:

  • Depression
  • Apathy
  • Social withdrawal
  • Mood swings
  • Distrust in others
  • Irritability and aggressiveness
  • Changes in sleeping habits
  • Wandering
  • Loss of inhibitions
  • Delusions, such as believing something has been stolen

“A common concern among individuals living in the early stage of Alzheimer’s is loss of independence. You may feel that by asking others for help, you will lose your sense of self or become dependent. While it may seem like a sign of weakness at first, asking for help when you need it may help you maintain your independence and remain in control.”

What types of diagnosis?

    • Our specialist will usually assess your mental abilities, such as memory or thinking, using tests known as cognitive assessments.

      Most cognitive assessments involve a series of pen and paper tests and questions, each of which carries a score.

      These tests assess a number of different mental abilities, including:

      • short- and long-term memory
      • concentration and attention span
      • language and communication skills
      • awareness of time and place (orientation)
      • abilities related to vision (visuospatial abilities)

      It’s important to remember that test scores may be influenced by a person’s level of education.

      For example, someone who cannot read or write very well may have a lower score, but they may not have Alzheimer’s disease.

      Similarly, someone with a higher level of education may achieve a higher score, but still have dementia.

      These tests can therefore help doctors work out what’s happening, but they should never be used by themselves to diagnose dementia.

      To rule out other possible causes of your symptoms and look for possible signs of damage caused by Alzheimer’s disease, your specialist may recommend having a brain scan.

      This could be a:

      • CT scan – several X-rays of your brain are taken at slightly different angles and a computer puts the images together
      • MRI scan – a strong magnetic field and radio waves are used to produce detailed images of your brain
    • In rare special circumstances, it may be recommended that fluid from your spinal canal is taken to analyse for proteins related to dementia (known as a lumbar puncture).

Living with Alzheimer’s disease 

    • Set realistic goals and focus on what you can do today. Set realistic expectations for yourself and use the skills you have to be successful in dealing with challenging tasks. Some tasks may become too difficult for you to complete even with reminder aids. Reduce stress by asking family or friends for help, if needed.
    • Develop a daily routine. Make a daily plan to keep track of the few tasks you want to accomplish each day. Having a schedule can reduce the time you spend figuring out what needs to be done and when, and makes you more successful in accomplishing your goals and limiting mistakes.
    • Approach one task at a time and don’t get stuck. Give yourself enough time to complete a task. Don’t pressure yourself to succeed. If something becomes too difficult, take a break and try again later. Spending time to change something you cannot control can be a waste of energy and can prevent you from focusing your attention on what you can control.
    • Know that you have more than one chance to solve most problems. It’s not uncommon to have to try different strategies to achieve your overall goal. Assess what could have been done differently and make adjustments as needed.
    • Recognize the triggers that cause you stress. What are the triggers that cause you anxiety, worry or stress? For example, if others are hurrying you, explain what you are trying to accomplish and ask that they provide you the time needed to be successful. Knowing what causes stress allows you to make plans in advance or decisions about the type of activities/tasks you choose to participate in.
    • Use your sources of strength. Family, friends, prayer, your inner strength, pets — all these sources can get you through hard times, even as you face daily challenges or setbacks.
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