Difference between revisions of "Alzheimer's disease"

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'''Alzheimer's disease''' ('''AD''') is a [[neurodegeneration|neurodegenerative disease]] that usually starts slowly and progressively worsens.<ref name=WHO2020/> It is the cause of 60–70% of cases of [[dementia]].<ref name=WHO2020/> The most common early symptom is difficulty in [[short-term memory|remembering recent events]].<ref name="BMJ2009">https://doi.org/10.1136%2Fbmj.b158</ref> As the disease advances, symptoms can include [[primary progressive aphasia|problems with language]], [[Orientation (mental)|disorientation]] (including easily getting lost), [[mood swing]]s, loss of [[motivation]], [[self-neglect]], and [[challenging behaviour|behavioral issues]].<ref name=BMJ2009/><ref name=WHO2020/> As a person's condition declines, they often withdraw from family and society.<ref name=BMJ2009/> Gradually, bodily functions are lost, ultimately leading to death.<ref name="NIA2019"/> Although the speed of progression can vary, the typical life expectancy following diagnosis is three to nine years.<ref name=NEJM2010>https://doi.org/10.1056%2FNEJMra0909142</ref>
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The cause of Alzheimer's disease is poorly understood.<ref name=BMJ2009/> There are many environmental and genetic [[risk factor]]s associated with its development. The strongest genetic risk factor is from an allele of [[Apolipoprotein E|APOE]].<ref name="NIA2021">https://www.nia.nih.gov/news/study-reveals-how-apoe4-gene-may-increase-risk-dementia</ref> Other risk factors include a history of [[head injury]], [[major depressive disorder|clinical depression]], and [[hypertension|high blood pressure]].<ref name=BMJ2009/> The disease process is largely associated with [[amyloid plaques]], [[neurofibrillary tangle]]s, and loss of [[Synapse|neuronal connections]] in the [[human brain|brain]].<ref name="NIA2019"/> A probable diagnosis is based on the history of the illness and [[cognitive test]]ing with [[medical imaging]] and [[blood test]]s to rule out other possible causes.<ref name=NICE2014Diag>https://web.archive.org/web/20141205184403/http://pathways.nice.org.uk/pathways/dementia/dementia-diagnosis-and-assessment.pdf</ref> Initial symptoms are often mistaken for normal aging.<ref name=BMJ2009/> [[Histopathology|Examination of brain tissue]] is needed for a definite diagnosis, but this can only take place [[postmortem studies|after death]].<ref name="NIA2019"/> Good [[nutrition]], physical activity,  and [[Social engagement|engaging socially]] are known to be of benefit generally in aging, and these may help in reducing the risk of cognitive decline and Alzheimer's; in 2019 clinical trials were underway to look at these possibilities.<ref name="NIA2019"/> There are no medications or supplements that have been shown to decrease risk.
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No treatments stop or reverse its progression, though some may temporarily improve symptoms.<ref name=WHO2020/> Affected people increasingly rely on others for assistance, often placing a burden on the [[Caring for people with dementia|caregiver]].<ref name=Thom2007/> The pressures can include social, psychological, physical, and economic elements.<ref name=Thom2007>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1951962</ref> Exercise programs may be beneficial with respect to [[activities of daily living]] and can potentially improve outcomes.<ref name=Forb2015>http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802014000300195</ref> Behavioral problems or [[psychosis]] due to dementia are often treated with [[antipsychotic]]s, but this is not usually recommended, as there is little benefit and an increased risk of early death.<ref>https://web.archive.org/web/20141205183329/https://www.nice.org.uk/advice/ktt7/resources/non-guidance-lowdose-antipsychotics-in-people-with-dementia-pdf</ref><ref>https://web.archive.org/web/20141129015823/https://www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm124830.htm</ref>
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As of 2015, there were approximately 29.8 million people worldwide with AD<ref name="GBD2015Pre">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055577</ref> with about 50 million of all forms of dementia as of 2020.<ref name="WHO2020">https://www.who.int/en/news-room/fact-sheets/detail/dementia</ref> It most often begins in people over 65&nbsp;years of age, although up to 10 per cent of cases are [[Early-onset Alzheimer's disease|early-onset]] affecting those in their 30's to mid 60's.<ref name="NIA2019">https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet</ref> Women get sick more often than men.<ref>https://pubmed.ncbi.nlm.nih.gov/20442496/#:~:text=Abstract,longevity%20of%20women%20versus%20men.
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</ref> It affects about 6% of people 65 years and older.<ref name=BMJ2009/> In 2015, all forms of dementia resulted in about 1.9 million deaths.<ref name=ncbi>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5388903</ref>
 
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Latest revision as of 09:37, 6 January 2023

Concept.png Alzheimer's disease 
(disease,  death cause)Rdf-entity.pngRdf-icon.png
Alzheimers brain.jpg
Interest ofMichael Nehls
A neurodegenerative disease that usually starts slowly and progressively worsens

Alzheimer's disease (AD) is a neurodegenerative disease that usually starts slowly and progressively worsens.[1] It is the cause of 60–70% of cases of dementia.[1] The most common early symptom is difficulty in remembering recent events.[2] As the disease advances, symptoms can include problems with language, disorientation (including easily getting lost), mood swings, loss of motivation, self-neglect, and behavioral issues.[2][1] As a person's condition declines, they often withdraw from family and society.[2] Gradually, bodily functions are lost, ultimately leading to death.[3] Although the speed of progression can vary, the typical life expectancy following diagnosis is three to nine years.[4]

The cause of Alzheimer's disease is poorly understood.[2] There are many environmental and genetic risk factors associated with its development. The strongest genetic risk factor is from an allele of APOE.[5] Other risk factors include a history of head injury, clinical depression, and high blood pressure.[2] The disease process is largely associated with amyloid plaques, neurofibrillary tangles, and loss of neuronal connections in the brain.[3] A probable diagnosis is based on the history of the illness and cognitive testing with medical imaging and blood tests to rule out other possible causes.[6] Initial symptoms are often mistaken for normal aging.[2] Examination of brain tissue is needed for a definite diagnosis, but this can only take place after death.[3] Good nutrition, physical activity, and engaging socially are known to be of benefit generally in aging, and these may help in reducing the risk of cognitive decline and Alzheimer's; in 2019 clinical trials were underway to look at these possibilities.[3] There are no medications or supplements that have been shown to decrease risk.

No treatments stop or reverse its progression, though some may temporarily improve symptoms.[1] Affected people increasingly rely on others for assistance, often placing a burden on the caregiver.[7] The pressures can include social, psychological, physical, and economic elements.[7] Exercise programs may be beneficial with respect to activities of daily living and can potentially improve outcomes.[8] Behavioral problems or psychosis due to dementia are often treated with antipsychotics, but this is not usually recommended, as there is little benefit and an increased risk of early death.[9][10]

As of 2015, there were approximately 29.8 million people worldwide with AD[11] with about 50 million of all forms of dementia as of 2020.[1] It most often begins in people over 65 years of age, although up to 10 per cent of cases are early-onset affecting those in their 30's to mid 60's.[3] Women get sick more often than men.[12] It affects about 6% of people 65 years and older.[2] In 2015, all forms of dementia resulted in about 1.9 million deaths.[13]

 

A Alzheimer's disease victim on Wikispooks

TitleDeath dateLocation of DeathDescription
Kaúlza de Arriaga2 February 2004LisbonPortuguese soldier politician who attended a November 1977 meeting of Le Cercle with his aide
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References

  1. ↑ a b c d e https://www.who.int/en/news-room/fact-sheets/detail/dementia
  2. ↑ a b c d e f g https://doi.org/10.1136%2Fbmj.b158
  3. ↑ a b c d e https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet
  4. ↑ https://doi.org/10.1056%2FNEJMra0909142
  5. ↑ https://www.nia.nih.gov/news/study-reveals-how-apoe4-gene-may-increase-risk-dementia
  6. ↑ https://web.archive.org/web/20141205184403/http://pathways.nice.org.uk/pathways/dementia/dementia-diagnosis-and-assessment.pdf
  7. ↑ a b https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1951962
  8. ↑ http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802014000300195
  9. ↑ https://web.archive.org/web/20141205183329/https://www.nice.org.uk/advice/ktt7/resources/non-guidance-lowdose-antipsychotics-in-people-with-dementia-pdf
  10. ↑ https://web.archive.org/web/20141129015823/https://www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm124830.htm
  11. ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055577
  12. ↑ https://pubmed.ncbi.nlm.nih.gov/20442496/#:~:text=Abstract,longevity%20of%20women%20versus%20men.
  13. ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5388903

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