Treatment

We have known that Mum would never be the same nice and cheerful self again. There is no cure for Alzheimer’s disease. Despite that, we will not allow her condition to worsen. We, as her family, will always stand with her no matter what happens. We could not stop Alzheimer’s disease, but we can always reduce the risk of other family members against it and slow down the worsening of Mum’s condition.
Here are some things that slow down and reduce the risk of Alzheimer’s disease:
- Following a Mediterranean diet, including food such as fruit and vegetables, bread wheat, may reduce the risk and course of Alzheimer’s.
- Curcumin in curry have shown some effectiveness in preventing brain damage in mouse models.
- Cardiovascular diseases do not help in slowing down Alzheimers, in fact, it speeds things up, however, through a long term use of a non steroidal anti-inflammatory drug, it is believed that it can reduce the likelihood of develping Alzheimer’s disease.
- Intellectual activities such as playing chess, completing cross word puzzles or regular social interaction may delay or reduce the severity of the disease.
- Through the use of a chemical called Cholinesterase inhibitors, the break down of acetylcholine, a chemical messenger important for learning and memory is prevented.
- Using a chemical called memantine, which works by regulating the activity of glutamate, a different messenger chemical involved in learning and memory, it delays worsening of symptoms of Alzheimer’s disease.

Hopefully, though these methods, we are going to delay the worsening of Mum’s condition, it is inevitable that she will leave us eventually, but we will make the days before it the happiest days of her life.

Epidemiology

We should have guessed it earlier. Alzheimer’s disease is the most frequent type of dementia in the elderly and it affect almost half of all the patients suffering from dementia. As Mum grew older, her risk for getting this disease multiplies. Amongst all the people who have an age of 65 years, 2-3% of them show some signs and symptoms of the disease, while 25-50% of all those aged 85 have symptoms and a larger number will have the disease without its usual symptoms. With every 5 years after 65 years old, the probability of contacting the disease doubles. I simply could not imagine how many people in the world suffered the same disease as Mum did. It is such a unexpectedly large number of the people suffering and slowing dying before the eyes of everyone due to Alzheimer’s disease.

Mum's condition has not only taken a toll for the worse, but has also greatly affected everyone of us here at home. We're not the happy family we used to be anymore. All our activities in our daily lives have changed to suit mum. Dad feels depressed and disheartened when he sees Mum in this state, not bring able to recognize him. He has vigorous mood swings and sometimes skip meals or locks himself up in the room with her. We all know that Dad is under a lot of stress as he has to take care of not oly her, but also all of us children at the same time. It must be reallt hard and taxing on him. I wonder what we, as children, could do to help him. Mum should be well taken care of and showered with much care and concern, but we are at a loss as to how to help otherwise. We are really worried for Mum and it hurts us very much to see her in so much pain and suffering, suffering from memoty loss and brain damage. I just hope her condition does not worsen any further. I don't know if we can handle with the stress, especially for Dad.

Upon consulting the doctor, we discovered much to our horror that the brain of an Alzheimer's patient shrinks due to the death of nerve cells and tissue lost throughout the entire brain.

The change is very dramatic as can be seen in the diagram, and the functions of the brain are affected a great deal.

In the brain of the an alzheimer's patient, the cortex shrivels up and affects the parts involved in thinking, planning and memory work. The shrinkage is especially obvious in the hippocampus, which plays a vital role in the forming of new memories. Ventricles in the brain grow larger and expand as well.

When you take a look under the microscope at the brain tissue of an Alzheimer's patient, you will find something that looks like this.

Brain tissues of patients who suffer from Alzheimer's has many fewer brain cells and synapses than a normal person woth a healthy brain. Plaques start to build up between nerve cells. These dead and dying nerve cells contain tangles which are made up of twisted strands of another protein. Causes of nerve cell death adn tissue lost are unknown but scientist think the prime suspects are the tangles and plaques. Plaques are basically formed by protein pieces of beta-amyloid which are chemically "sticky" together. The most damaging form of beta-amyloid is groups each consisting of a few pieces. These small clumps block synapses and may also activate immune system cells that cause inflammation and devour disabled cells. Tangles destroy a vital cell transpoert system that is made up of proteins. When this happens, nutrients and other essential minerals cannot move through the cells, which will eventually die.

Stages of Alzheimer's

This day, we visited the doctor to look at the condition of Mum's illness. It is not improving, and yet we can do nothing about it to return her to her usual state. Sometimes do you know how helpless it feels?

The doctor showed us a chart regarding the different stages of Alzheimer's disease, basically, it is categorized into 7 different stages, these , stage 1 being the slightest and stage 7 being the most severe case of Alzheimer's.

Here are the 7 different stages:

Stage 1: No impairment
In this stage, individuals act as normal people, they do not have any memory problems and none are apparent to the a health care proffessional when going for a medical interview.

Stage 2: Very mild decline
At this stage, individuals will experience a very mild cognitive decline, which may reslut from normal age-related changes or it could be the earliest sign of Alzheimer's disease. They may feel that they have memory lapses, particularly forgetting familiar words, names, or the location of everyday objects such as keys and spectacles. However, these problems are not obvious health check-up or conspicious to friends and the family.

Stage 3: Mild decline
At this stage, friends and family may notice some deficiencies in individuals as they start to have problems with memory, concentration and have the following common difficulties:

- Problems with word and name finding is obvious to family and close associates
- They will have a decreased ability to remember the names of the new people when introduced
- Issues in the performance in both social and work setting are plain to family, friends and co-workers
-Loss or misplacment of a valuable object
-Declination in the capability to plan and organize events

Some individuals could be diagnosed suffering from this disease but not all of them have these problems.

Stage 4 : Moderate decline (Mild/early stage)
At this stage of Alzheimer's, through a careful interview, deficiencies could be detected without much trouble in these areas:
- Knowledge of recent occasions or current events are decreasing
- Ability to perform challenging mental arithmetic problems
- Reduced capability to do complex tasks which includes planning and organisation.
- Memory of personal history is lost
- Individuals suffering form this disease seem subdued and withdrawn, specially in socially or mentally challenging circumstances.

Stage 5: Moderately severe decline
At this stage, major gaps in memory and loss in cognitive function will happen. Assistance with daily activities may be required.
Individuals may:
- Be unable to recall personal information when required
- Become confused with location of themselves or about the date, day of the week and month.
- Less challenging mental arithmetic could pose a challenge to sufferers
- Requires help in choice of propoer clothing which suits the occasion
- Often retain substancial knowledge about themselves, knowing their own name, that of their spouse and children.
- Assistance with eating or using the toilet is usually not needed.

Stage 6: Severe decline
At this stage, memory difficulties will worsen, personality changes emerge and patients require a lot of help with their daily activities.
Patients of Alzheimer's may:
- Lose awareness of recent experiences, events, and their surroundings
- Able to recall their own name name, but not their personal history fully.
- May forget the name of their spouse or caregiver but they can distinguish familiar faces from unfamiliar ones.
-Requires help getting dressed properly
-Disruption in the normal sleep and waking cycle
- Details of toileting required assistance
- Personality change, behavioral symptoms, suspiciousness, delusions, hallucinations, compulsive and reptitive behaviours will be experienced.
- Tend to wander and get himself/herself lost

Stage 7: Very severe decline
This is the last and final stage of the disease.
Here are the following signs:
- Alzheimer patients at this stage will lose their ability of recognizable speech, though uttering of words are occasional
- Eating, toileting must be assisted, leaking of urine unintentionally occurs
- Walking requires assistance
- Ability to sit without support, to smile, to hold the head up, is lost.
- reflexes are abnormal and muscles turn rigid, and swallowing is impaired.

From the clear explanation by the doctor, Mum is at stage 3 of Alzheimer's disease. Mum's condition is likely to worsen, but we will try our very best to keep it at this level, our very best.

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Symptoms of Alzheimer's disease

Perhaps, if we noticed the signs earlier, we could have got her treated earlier. It is not usual for Mum to forget things like taking out the bread before spreading the butter. She did it the other way round. People who suffer from Alzheimer's will be faced with many difficulties in terms of communicating, learning, thinking and reasoning, and as a result, it has a severe impact on an individual's work, social activities and family life.

To summarize the symptoms of Alzheimer's disease, we have come up with a simple list which includes 10 common symptoms of Alzheimer's disease, so as to allow people who are diagnosed with this disease to receive information, care and support from the family as soon as possible.

The 10 common symptoms are:

1. Memory loss: Forgetting recently learned information and being unable to recall the information later.

2. Difficulty in performing familiar tasks: People suffering from Alzheimers disease often faced a problem when completing everyday tasks, losing track of the steps associated with a task.

3. Problems with language: Sufferers of Alzheimer's disease often forget simple words and substitute unusual words, thus their speech or writing becomes hard to understand.

4. Disorientation to time and place: It is possible patients with Alzheimer's disease to become lost in their own neighborhood, and not know how they got there and get back home.

5. Poor and decreased judgement: Alzheimer patients may dress unsuitably, and make poor judgement, for example getting swindled by con-men.

6. Problem with abstract thinking: Alzheimer patients suffer from the inability to perform complex mental task, for example for getting which numbers to be used.

7. Misplacing things: Alzheimer sufferers may place their things at unusual places, for instance putting a bowl of hot soup to be eaten for lunch into the freezer during lunch time.

8. Changes in mood or behavior: Moods and behaviour of people with Alzheimer's will change dramatically, from tears to anger to calm, without any reason at all.

9. Changes in personalities: Personalities of people with Alzheimer's changes dramatically, often becoming confused, wary of a family members or being too dependent on them.

10. Loss of initiative: A person suffering from Alzheimer's may become very passive, sometimes sitting in front of the TV for hours, or sleeping more than usual.

You may notice that you have some of the symptoms mentioned above, but not to worry:

Difference between Alzheimer's and normal age-related memory changes

Someone with Alzheimer's disease symptoms - Someone with normal age-related memory changes

- Forgets entire memories - Forgets part of memory

- Rarely remembers later - Often remembers later

- Gradually unable to follow written/ spoken directions - Is usually able to follow written/spoken directions

- Gradually unable to used notes as reminders - Usually able to use notes and reminders

- Gradually unable to care for self - Usually able to care for self

Risk Factors

My 65-years-old Mum’s memory has got worse day after day. Yesterday, we finally took her to see a neurologist. The doctor diagnosed her with Alzheimer’s disease, a condition where the patient slowly loses her memory, gradually losing minor than major bodily functions and eventually dies. Upon hearing the unfortunate news, we were devastated. The doctor said that the causes of this disease are still unknown but explained to us some of the risk factors which could have caused Mum to get Alzheimer’s disease. They were mainly:

- Age
With increasing age, people are more prone to the disease. The chance of getting the disease doubles every five years when one is 65 years and older. The likeness reaches near fifty percent when one is 85 years old.

- Family history
Research has shown that people with family members who have the disease are more prone to get it as well. The risk increases if more than one family member has Alzheimer’s.

- Genetics (hereditary)
There are 2 types of genes involved in determining whether a person develops a disease or not. Risk genes increase the likelihood of the person getting Alzheimer’s disease but do not guarantee that he/she will get it. Deterministic genes guarantee that anyone who inherits the genes will suffer from the disease.