Archive | June 2023

Part II What actually is Alzheimer’s Disease? (diagnosing and Rx).

The National Institute of aging states the following procedures also may be used to diagnose dementia:

“Cognitive and neuropsychological tests. These tests are used to assess memory, problem solving, language skills, math skills, and other abilities related to mental functioning.
Laboratory tests. Testing a person’s blood and other fluids , as well as checking levels of various chemicals, hormones, and vitamins, can help find or rule out possible causes of symptoms.
Brain scans. These tests can identify strokes, tumors, and other problems that can cause dementia. Scans also identify changes in the brain’s structure and function. The most common scans are:
- Computed tomography (CT), which uses x rays to produce images of the brain and other organs
- Magnetic resonance imaging (MRI), which uses magnetic fields and radio waves to produce detailed images of body structures, including tissues, organs, bones, and nerves
- Positron emission tomography (PET), which uses radiation to provide pictures of brain activity
Psychiatric evaluation. This evaluation will help determine if depression or another mental health condition is causing or contributing to a person’s symptoms.
Genetic tests. Some dementias are caused by a known gene defect. In these cases, a genetic test can help people know if they are at risk for dementia. It is important to talk with a genetic counselor before and after getting tested, along with family members and the doctor.

Who Can Diagnose Dementia?

Visiting a family doctor is often the first step for people who are experiencing changes in thinking, movement, or behavior. However, neurologists—doctors who specialize in disorders of the brain and nervous system—generally have the expertise needed to diagnose dementia. Geriatric psychiatrists, neuropsychologists, and geriatricians may also be skilled in diagnosing the condition.

If a specialist cannot be found in your community, ask the neurology department of the nearest medical school for a referral. A hospital affiliated with a medical school may also have a dementia or movement disorders clinic that provides expert evaluation.”

Alzheimer’s Disease is complex, and it is unlikely that any one drug or other intervention will successfully treat it. Current approaches focus on helping people maintain mental function, manage behavioral symptoms, and slow down the symptoms of disease.

Several prescription drugs are currently approved by the U.S. Food and Drug Administration (FDA) to treat people who have been diagnosed with Alzheimer’s disease. Treating the symptoms of Alzheimer’s can provide people with comfort, dignity, and independence for a longer period of time and can encourage and assist their caregivers as well.

Most medicines work best for people in the early or middle stages of Alzheimer’s. For example, they can slow down some symptoms, such as memory loss, for a time. It is important to understand that none of these medications stops the disease itself.

Treatment for Mild to Moderate Alzheimer’s

Medications called cholinesterase inhibitors are prescribed for mild to moderate Alzheimer’s disease. These drugs may help reduce some symptoms and help control some behavioral symptoms. The medications are Razadyne® (galantamine), Exelon® (rivastigmine), and Aricept® (donepezil).

Scientists do not yet fully understand how cholinesterase inhibitors work to treat Alzheimer’s disease, but research indicates that they prevent the breakdown of acetylcholine, a brain chemical believed to be important for memory and thinking. As Alzheimer’s progresses, the brain produces less and less acetylcholine; therefore, cholinesterase inhibitors may eventually lose their effect.

No published study directly compares these drugs. Because they work in a similar way, switching from one of these drugs to another probably will not produce significantly different results. However, an Alzheimer’s patient may respond better to one drug than another.

Treatment for Moderate to Severe Alzheimer’s

A medication known as Namenda® (memantine), an N-methyl D-aspartate (NMDA) antagonist, is prescribed to treat moderate to severe Alzheimer’s disease. This drug’s main effect is to decrease symptoms, which could allow some people to maintain certain daily functions a little longer than they would without the medication. For example, Namenda® may help a person in the later stages of the disease maintain his or her ability to use the bathroom independently for several more months, a benefit for both the person with Alzheimer’s and caregivers.

The FDA has also approved Aricept®, the Exelon® patch, and Namzaric®, a combination of Namenda® and Aricept®, for the treatment of moderate to severe Alzheimer’s disease.

Namenda® is believed to work by regulating glutamate, an important brain chemical. When produced in excessive amounts, glutamate may lead to brain cell death. Because NMDA antagonists work differently from cholinesterase inhibitors, the two types of drugs can be prescribed in combination.

Managing Behavior

Common behavioral symptoms of Alzheimer’s include sleeplessness, wandering, agitation, anxiety, aggression, restlessness, and depression. Scientists are learning why these symptoms occur and are studying new treatments—drug and nondrug—to manage them. Research has shown that treating behavioral symptoms can make people with Alzheimer’s more comfortable and makes things easier for caregivers.

Examples of medicines used to help with depression, aggression, restlessness, and anxiety include:

Celexa® (citalopram)
Remeron® (mirtazapine)
Zoloft® (sertraline)
Wellbutrin® (bupropion)
Cymbalta® (duloxetine)
Tofranil® (imipramine)

Experts agree that medicines to treat these behavior problems should be used only after other strategies that don’t use medicine have been tried.

Medicines to Be Used with Caution

There are some medicines, such as sleep aids, anti-anxiety drugs, anticonvulsants, and antipsychotics, that a person with Alzheimer’s disease should take only:

After the doctor has explained all the risks and side effects of the medicine
After other, safer non-medication options have not helped treat the problem

You will need to watch closely for side effects from these medications.

Sleep aids are used to help people get to sleep and stay asleep. People with Alzheimer’s disease should NOT use these drugs regularly because they make the person more confused and more likely to fall. Examples of these medicines include:

Ambien® (zolpidem)
Lunesta® (eszopiclone)
Sonata® (zaleplon)

Anti-anxiety drugs are used to treat agitation. These drugs can cause sleepiness, dizziness, falls, and confusion. For this reason, doctors recommend using them only for short periods of time. Examples of these medicines include:

Ativan® (lorazepam)
Klonopin® (clonazepam)

Anticonvulsants are drugs sometimes used to treat severe aggression. Side effects may cause sleepiness, dizziness, mood swings, and confusion. Examples of these medicines include:

Depakote® (sodium valproate)
Tegretol® (carbamazepine)
Trileptal® (oxcarbazepine)

Antipsychotics are drugs used to treat paranoia, hallucinations, agitation, and aggression. Side effects of using these drugs can be serious, including increased risk of death in some older people with dementia. They should only be given to people with Alzheimer’s disease when the doctor agrees that the symptoms are severe. Examples of these medicines include:

Risperdal® (risperidone)
Seroquel® (quetiapine)
Zyprexa® (olanzapine)

Looking for New Treatments

Alzheimer’s disease research has developed to a point where scientists can look beyond treating symptoms to think about addressing underlying disease processes. In ongoing clinical trials, scientists are developing and testing several possible interventions, including immunization therapy, drug therapies, cognitive training, physical activity, and treatments for cardiovascular disease and diabetes.

QUOTE FOR FRIDAY:

Jun2

“Alzheimer’s disease is a type of brain disease, just as coronary artery disease is a type of heart disease. It is
caused by damage to nerve cells (neurons) in the brain. The brain’s neurons are essential to thinking, walking,
talking and all human activity. In Alzheimer’s, the neurons damaged first are those in parts of the brain responsible for memory, language and thinking. As a result, the first symptoms tend to be memory,
language and thinking problems. Although these symptoms are new to the individual affected, the brain changes that cause them are thought to begin 20 years or more before symptoms start.”.

Alzheimer’s Association (https://www.alz.org › alzheimers-facts-and-figures)

Part I What is actually Alzheimer’s Disease?

Jun2

What structurally happens to the brain and what happens to the individual in brain thinking diagnosed with this disease:

Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. In most people with the disease—those with the late-onset type—symptoms first appear in their mid-60s. Early-onset Alzheimer’s occurs between a person’s 30s and mid-60s and is very rare. Alzheimer’s disease is the most common cause of dementia among older adults.

The disease is named after Dr. Alois Alzheimer. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior. After she died, he examined her brain and found many abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary, or tau, tangles).

These plaques and tangles in the brain are still considered some of the main features of Alzheimer’s disease. Another feature is the loss of connections between nerve cells (neurons) in the brain. Neurons transmit messages between different parts of the brain, and from the brain to muscles and organs in the body. Many other complex brain changes are thought to play a role in Alzheimer’s, too.

This damage initially appears to take place in the hippocampus, the part of the brain essential in forming memories. As neurons die, additional parts of the brain are affected. By the final stage of Alzheimer’s, damage is widespread, and brain tissue has shrunk significantly.

How many affected in the United States by Alzheimer’s Disease:

Estimates vary, but experts suggest that as many as 5.5 million Americans age 65 and older may have Alzheimer’s. Many more under age 65 also have the disease. Unless Alzheimer’s can be effectively treated or prevented, the number of people with it will increase significantly if current population trends continue. This is because increasing age is the most important known risk factor for Alzheimer’s disease.

Symptoms:

Memory problems are typically one of the first signs of Alzheimer’s, though initial symptoms may vary from person to person. A decline in other aspects of thinking, such as finding the right words, vision/spatial issues, and impaired reasoning or judgment, may also signal the very early stages of Alzheimer’s disease. Mild cognitive impairment (MCI) is a condition that can be an early sign of Alzheimer’s, but not everyone with MCI will develop the disease.

People with Alzheimer’s have trouble doing everyday things like driving a car, cooking a meal, or paying bills. They may ask the same questions over and over, get lost easily, lose things or put them in odd places, and find even simple things confusing. As the disease progresses, some people become worried, angry, or violent.

Alzheimer’s disease is not a normal part of aging.

Memory problems are typically one of the first warning signs of cognitive loss.

According to the National Institute on Aging, in addition to memory problems, someone with Alzheimer’s disease may experience one or more of the following signs:

Memory loss that disrupts daily life, such as getting lost in a familiar place or repeating questions.
Trouble handling money and paying bills.
Difficulty completing familiar tasks at home, at work or at leisure.
Decreased or poor judgment.
Misplaces things and being unable to retrace steps to find them.
Changes in mood, personality, or behavioral.

QUOTE FOR THURSDAY:

Jun1

“The Lupus Foundation of America estimates that 1.5 million Americans, and at least five million people worldwide, have a form of lupus! Lupus strikes mostly women of childbearing age. Ninety percent (90%) of people living with lupus are women. However, men, children, and teenagers develop lupus, too. Most people with lupus develop the disease between the ages of 15-44. Most people with lupus develop the disease between the ages of 15-44. Lupus is two to three times more prevalent among African American, Hispanic/Latina, Asian American, Native American, Alaska Native, Native Hawaiian and other Pacific Islander women than among White women.”.

Lupus Foundation of America (https://www.lupus.org/resources/lupus-facts-and-statistics)