INTRODUCTION Diseases such as Alzheimer’s represent one of the great challenges facing today’s society
Diseases such as Alzheimer’s represent one of the great challenges facing today’s society, with an increasingly aging population and a greater number of people affected by this disease, each time cases are detected with younger age, there are only 42 years. This disease is detected “not when you fail to remember where you left the keys but when you have the keys but do not know what they are for”. Alzheimer’s disease or senile dementia Alzheimer type is a neurodegenerative disease that manifests with cognitive impairment and behavioral disorders. It is an incurable and terminal disease.
Alzheimer’s disease is a dementia that already has more than 100 years of history. The disease serves its name from Dr. Alois Alzheimer, in 1906 this doctor noticed changes in the tissues of a woman who had died of a rare mental illness, and its symptoms included memory loss, difficulty in language and unpredictable behavior. In 1906 Dr. Alzheimer published the discoveries he made when studying his brain, post-mortem, where he observed several abnormal masses (currently called amyloid plaques) and twisted bundles of fibers (currently tangles or neurofibrillary tangles)
The incidence in studies show rates of 10 and 15 new cases every 1,000 people a year for the onset of any form of dementia and between 5-8 for the onset of Alzheimer’s disease, that is half of the cases are Alzheimer’s. In the United States, Alzheimer’s disease is the sixth cause of death, after heart disease and stroke. The data are alarming in the United States 5.7 people have been diagnosed and it is estimated that by 2025 there will be approximately 1.7 million patients.
The causes of Alzheimer’s disease have not been completely discovered. You are more prone to suffer from this disease if:
You are older. However, suffering from this disease is not part of normal aging.
Have a blood relative, as a brother / a father / mother with the disease.
Having certain genes linked to Alzheimer’s disease such as the APOE allele Epislon4.
There are other factors that can increase the risk, although they are not well proven, such as:
Belonging to the female sex
Have high blood pressure for a long time.
History of cranial trauma.
Scientific studies conducted in recent years have shown that aluminum is associated with several processes that cause the characteristic degeneration of Alzheimer’s.
STAGES OF ALZHEIMER’S ILLNESS
The evolution of the disease is very variable: an average of 10 to 12 years. Schematically, 3 stages are described:
Memory: the patient forgets his appointments, the name of the people, the familiar objects. Start having problems to follow a conversation.
Behavior: sudden changes of mood. A tendency to isolate
Language and comprehension: although the patient continues to reason, patient has trouble finding the right words.
Activities of the daily life: it is able to realize them without too many problems.
Memory: the recent memory is progressively altered, the patient forgets recent events; however, the memory of distant events persists.
Behavior: aggressive reactions and unjustified fears.
Language and comprehension: their vocabulary becomes impoverished, always repeating the same phrases. Answer the questions slowly looking for the words with caution, the sentences do not end.
Coordination of gestures: they are imprecise. It hits easily and falls are frequent.
Activities of daily life: loses autonomy and ability to make their own decisions about daily events.
Memory: the patient forgets the recent and past events. Does not recognize your spouse or your children.
Behavior: his humor is unpredictable. It does not react coherently to a certain situation or understand the meaning of an explanation.
Language and expression: the patient babbles, only uses some specific words correctly.
Coordination of gestures: does not know how to get up, sit or walk. He does not control potty training and incontinence appears.
Activities of daily life: they have totally disappeared.
The 10 warning signs of Alzheimer’s disease that can warn us to suggest that a person is perhaps initiating the disease are:
Loss of memory that affects the ability to work.
Difficulty to carry out familiar tasks;
Problems with the language;
Disorientation in time and place;
Judgment poor or diminished;
Problems with abstract thinking;
Things placed in wrong places;
Changes in mood or behavior;
Changes in personality;
Loss of initiative.
ACCORDING TO STARTING AGE
Presenile or early. – Early start; starts before, it is fast course, is between 0.5% and 2.5% of cases.
Senile or late. – Appears after constitutes between 0.5% and 2.5% of cases.
Senile or late. – Appears after age 65 and represents more than 95% of cases
ACCORDING TO THE CAUSE
Family- It has a genetic cause and coincides in most cases with Alzheimer’s disease.
Sporadic .- It is the most common type, begins at age 65 and coincides with cases of senile or late Alzheimer.
The diagnosis is based first on the history and clinical observation, both by doctor and the one referred by the family. For a few weeks or months, memory tests, blood tests and a scanner are performed to rule out alternative diagnoses. It has been possible to bring the accuracy of the diagnosis to 85%, but the definitive one must be done with tests on brain tissue obtained at autopsy.
Currently there are new diagnostic techniques in development based on the processing of electroencephalographic signals. Once the AD is diagnosed. The average life is approximately 7 to 10 years, although there are cases in which the terminal stage is reached before, between 4 and 5 years, but there are also cases that have survived up to 21 years.
At present there is no curative treatment, the objectives are:
Reduce the impact of the disease (although this is difficult to achieve);
Slow down the progress of cognitive decline;
Support family members and other caregivers;
Modify the home environment so that the best posible for caregivers;
Modify the home environment so that daily activities can be better performed;
All the existing treatments are palliative, they try to reduce the progression of the disease;
The treatment can be divided into Pharmacological, Psychosocial and care.
The efficacy of anticholinesterase drugs has been proven and it is also demonstrated that there are other drugs that improve some symptoms such as: anxiolytics, hypnotics, neuroleptics and antidepressants. Antipsychotic drugs are indicated to reduce aggression and psychosis.
There is evidence that the stimulation of cognitive abilities help to delay the loss of functions and abilities, these treatments include art therapy, music therapy and pet-assisted therapies, physical exercise and any recreational activity.
Since Alzheimer’s has no cure, over time the patient falls into a state of inability to self-care to take care of himself, so that care by third parties is a vital measure. The best management of the patient can avoid dental and oral diseases, pressure ulcers, hygiene, respiratory and urinary infections. In the final stage of the disease, care focuses on maintaining the quality of life until death.
Other treatments are being experienced such as:
Regenerative Medicine. – is to inject into the brain of the patient embryonic stem cells or adults to try to stop cognitive decline, have already conducted experiments with humans with positive results.
Pacemaker brains. – The device is part of a treatment called deep brain stimulation.
There are positive hopes for a new vaccine against Alzheimer’s.
With this work one realizes that over the years, as we get older, we can acquire diseases such as Alzheimer’s, very silent but so dangerous that cannot be cured, only controlled. Thanks to this work, we know many of the symptoms, that it is possible that people close to us, even a member of our family, could suffer and ultimately we are all prone to suffer this devastating disease. The aging of humanity is the most important demographic phenomenon and its social, economic, cultural and political repercussions are so transcendent that they constitute one of the most important challenges that our civilization has on the horizon. Today, we are all worried about our old age. We are terrified to become dependent without having the means to cope with it with dignity. We do not want to be a burden for others, especially for our loved ones, but at the same time we sense that it will be difficult for us to reach old people without needing the help of others. That is what we have seen in our parents, what we see in other adults, other friends, in our neighbors, in other people we know. That future scares us because we know that neither our society nor we are even prepared to face it. Will it change in the future? That depends on each one of us but, above all, on those who have greater responsibility in the evolution of our world.