MEMORY AND DEMENTIA PART 2- ALZHEIMERS SYNDROME

Hello everyone!!!. In the last blog I had given an overview of amnetia, dementia and its related pathophysiologies. Today, I will be talking about a specific syndrome which involves ‘DEMENTIA’ as a symptom.

ALZHEIMERS SYNDROME:

    Alzheimers disease is a neurodegenerative disorder characterised by progressive loss of memory. That means the memory loss is slow and gradual but it worsens overtime.

This disease is the commonest cause of dmemntia or memory loss which almost acoounts to 60 to 70 percent of all cases of dementia.

As said earlier the disease starts with subtle symptoms like difficulty in remembering recent events (antegrade dementia),which may go unnoticed but gradually advances to bigger problems like difficulty in speaking due to inability to find the proper word, the presence of mind is lost which makes simple daily tasks difficult, sometimes there may also be disorientation of place also as the person easily forgets his way back home or vice versa. Also there may be mood swings and also behavioural problems which makes the disease a bigger of a problem to handle.

CAUSE OF ALZHEIMERS.

    Since the exact cause of AD is not known there have been attempts to figure out the main cause in the form of hypothesis.

1)      CHOLINERGIC HYPOTHESIS: This hypothesis is by far the oldest and the most trusted hypothesis on which most of the drug research is based upon. It states that alzheimers disease is due to lack of secretion of neurotransmitter called acetylcholine.

2)      GENETIC HYPOTHESIS: This hypothesis is based on the familial cases. i.e the cases of alzheimers symdrome and dementia that have been observed to run in families and also twin siblings, which range from 50 to 70 percent . since they occur early in life they are called EARLY ONSET FAMILIAL ALZHEIMERS DISEASE.

3)      Another amyloid beta protein based theory which seems to be complimenting and further explaining the genetic hypothesis explains the reason of early onset of alzheimers disease in children with genetic disorders. As it states that extracellular amyloid beta proteins can cause early onset of alzheimers disease. The reason for this might be an improper functioning of APP gene(amyloid precursor protein) and in addition a specific form of protein called apolipoprotein, which further breaks down more amyloid proteins causing extracellular buildup. Thus, both together may be seen as a risk factor.
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4)      TAU PROTEINS: one of the most important advancement in understanding the disease and that which gives a versatile approach is the tau protein theory.this theory also explains the pathophysiology of alzheimers disease. As per this theory when the tau protein the the brain cells get hyperphosphorylated(excessive phosphate ions) they start getting paired to other tau proteins and form NEUROFIBRILLARY TANGLES inside the brain cells which eventually are destroyed and disintegrated and the cytoskeleton of the cell. i.e the main body of the cell is destroyed leading to damage to nerve cell and eventually loss or reduction of acetylcholine secretion.
  
SYMPTOMS:

 As said, initially the diagnosis may go totally unnoticed, as the person fails to realise the memory loss since its not perceptible without close attention. But with progress in time and damage the memory loss becomes more and more evident.

        The person may forget regular articles and things of day to day requirements, further there may also be disorientation and confusion like confusion about where he is.  In advanced stages there may be total loss of memory uptill the level that the person starts forgetting everything about the people who around him and gradually estranges his family too and in extreme cases forgets himself too.

        There may be mood swings, mental depression and suicidal tendencies.

The subsequent stages of degeneration in Alzheimer's disease^.

1)      Effects of ageing on memory but not AD

• Forgetting daily used things very frequently.
• Misplacing articles sometimes
• Loss of recent memory.
• Not remembering the details of things.

2)      Early stage Alzheimer's

• Frequently forgetting the names of family, friends, colleagues, relatives and neighbours.
• Faulty or improper working memory.
• Difficult comprehension in  unknown situations outside their comfort zone.

3)      Middle stage Alzheimer's

• Greater difficulty remembering recently learned information
• Deepening confusion in many circumstances
• Problems with sleep
• Trouble determining their location

4)      Late stage Alzheimer's

• Inability to think and comprehend.
• Speech difficulties due to slowing of though pattern due to impaired thought process and a low intellect.
• Tendency to be monosyllable or repeating a word or a phase repeatedly.
• The persons seems to be more abusive, anxious, or paranoid than he used to be prior.

DIAGNOSIS:

 The diagnosis is mostly based on the clinical presentation and medical history and sometimes in support of the history given by patient’s relatives.

Moreover tests like ct-scan, PET- scan can further support the diagnosis.

Moreover, the National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) and the Alzheimer's Disease and Related Disorders Association, put up a set of criterias which when fulfilled would be helpful to suspect alzheimers disease and related conditions clinically.

These set of criteria were formed in 1984 but are extensively upgraded till date.

These involve neuropsychological examinations like mini-mental state examination, in supplementation to the necessary clinical neurological examinations in AD, as it becomes more difficult to clinically correlate the incidence of AD in the initial stages.

Supplementary blood tests for differential diagnosis or for finding other causes of dementia and also interview with the patients relatives and colleagues may help to assess the changes in the mental health, intellect and emotional changes of the patient.

CAN HOMOEOPATHY HELP?

                In my personal experience, homoeopathy can help the AD patients, not only to recover symptomatically but also pathologically improving the overall status of the affected person.

Certain remedies in homoeopathy like  alumina, anacardium orientale, merc solubilis, plumbum metallicum, aurum metallicum, hyoscymus niger, baryta carb etc, are helpful remedies. However a constitutional prescription, which would cover the entire entity of the person as a whole is much more beneficial in alleviating the condition.