Wp/nth/Alzheimer's ill

< Wp‎ | nth

Alzheimer's disease or Alzheimer's ill is a neurodegenerative disease that usually starts slaw and progressively warsens.[1] It is the cause o 60–70% o cases o dementia.[1][2] The maist common early symptom is difficulty wi rememberin recent events.[3] As the disease advances, symptoms can include problems wi language, disorientation (includin gettin lost easy), mood swings, loss o motivation, sel-neglect, and behavioral issues.[1] As a parson's condition declines, they often withdraw frae their family and society.[4] Gradually, bodily functions is lost, ultimately leadin te deeth.[5] Though the speed o progression can vary, the typical life expectancy follaïn diagnosis is three te nine years.[6][7]

The cause ov Alzheimer's disease is poorly understuid.[4] There's mony environmental and genetic risk factors associated wiv its development. The strangest genetic risk factor is frev an allele ov APOE.[8][9] Other risk factors includes a history o heed injury, clinical depression, and high blood pressure.[3] The disease process is largely associated wi amyloid plaques, neurofibrillary tangles, and loss o neuronal connections i the brain.[5] A probable diagnosis is based on the history o the illness and cognitive testin wiv medical imagin and bluid tests te rule oot other possible causes.[10] Initial symptoms is often mistaen for normal brain agein.[4] The examination o brain tissue is needed for a definite diagnosis, but this can nobbut take place efter deeth.[5] Good nutrition, physical activity, and engagin socially are knawn te be o benefit generally in agein, and these may help in reducin the risk o cognitive decline and Alzheimer's; in 2019 clinical trials wes underway te leuk at these possibilities.[5] There's ne medications or supplements that hes been shown te decrease the risk.[11]

Ne treatments stops or revarses its progression, though some may temporarily improve symptoms.[1] Affected people increasinly relies on others for assistance, often placin a burden on the caregiver.[12] The pressures can include social, psychological, physical, and economic elements.[12] Exercise programs may be beneficial wi respect tiv activities o daily livin and can potentially improve ootcomes.[13] Behavioral problems or psychosis acause o dementia is often treated wi antipsychotics, but this isn't usually recommended, as there is little benefit and an increased risk ov early deeth.[14][15]

As o 2020, there wes approximately 50 million people warldwide wi Alzheimer's disease.[16] It maist often begins i people ower 65 year awd, though up te 10% of cases is early-onset affectin them i their 30s te mid-60s.[5][17] It affects aboot 6% o people 65 years and awder,[4] and women mair often nor men.[18] The disease is named efter German psychiatrist and pathologist Alois Alzheimer, whe first described it i 1906.[19] Alzheimer's financial burden on society is large, wiv an estimated global annual cost o Template:US$Template:Nbsptrillion.[16] Alzheimer's disease is currently ranked as the seventh leadin cause o deeth i the United States.[20]

Signs and symptomsEdit

The course ov Alzheimer's is generally described i three stages, wiv a progressive pattern o cognitive and functional impairment.[21][5] The three stages is described as early or mild, middle or moderate, and late or severe.[21][5] The disease is knawn te target the hippocampus, at is associated wi memory, and this is responsible for the first symptoms o memory impairment. As the disease progresses se dis the degree o memory impairment.[5]

First symptomsEdit

Stages ov atrophy iv Alzheimer's

The first symptoms is often mistaen for agein or stress.[22] Detailed neuropsychological testin can reveal mild cognitive difficulties up te eit years afore a parson fulfills the clinical criteria for diagnosis ov Alzheimer's disease.[23] These early symptoms can affect the maist complex activities o daily livin.[24] The maist noticeable deficit is short term memory loss, at shows up as difficulty rememberin recently lairned facts and an inability tiv acquire new information.[23]

Subtle problems wi the executive functions ov attentiveness, plannin, flexibility, and abstract thinkin, or impairments wi semantic memory (memory o meanins, and concept relationships) can be symptomatic o the early stages ov Alzheimer's disease an aa.[23] Apathy Depression can be seen at this stage forby, wiv apathy remainin the maist persistent symptom through-oot the course o the disease.[25][26] Mild cognitive impairment (MCI) is often fund te be a transitional stage atween normal agein and dementia. MCI can present wiv a variety o symptoms, and when memory loss is the predominant symptom, it is termed amnestic MCI and is frequently seen as a prodromal stage ov Alzheimer's disease.[27] Amnestic MCI hes a greeter than 90% likelihood o bein associated wiv Alzheimer's.[28]

Early stageEdit

I people wiv Alzheimer's disease, the increasin impairment o lairnin and memory eventually leads tiv a definitive diagnosis. Iv a smaa percentage, difficulties wi language, executive functions, perception (agnosia), or execution o movements (apraxia) is mair prominent nor memory problems.[29] Alzheimer's disease disn't affect aa memory capacities equally. Awder memories o the parson's life (episodic memory), facts lairned (semantic memory), and implicit memory (the memory o the body on hoo te de things, sic as usin a fork tiv eat or hoo te drink frev a glass) is affected tiv a lesser degree nor new facts or memories.[30][31]

Language problems is mainly characterised biv a shrinkin vocabulary and decreased word fluency, leadin tiv a general impoverishment ov oral and written language.[29][32] In this stage, the parson wiv Alzheimer's is usually capable o communicatin basic ideas adequately.[29][32][33] While performin fine motor tasks sic as writin, drawin, or dressin, çartain movement coordination and plannin difficulties (apraxia) may be present, but they often gan unnoticed.[29] As the disease progresses, people wiv Alzheimer's disease can often continue te perform mony tasks independently, but may need assistance or supervision wi the maist cognitively demandin activities.[29]

Middle stageEdit

Progressive deterioration eventually hinders independence, wi subjects bein unable te perform maist common activities o daily livin.[29] Speech difficulties becomes evident due tiv an inability tiv recall vocabulary, at leads te frequent incorrect word substitutions (paraphasias). Readin and writin skills is progressively lost an aa.[29][33] Complex motor sequences becomes less coordinated as time passes and Alzheimer's disease progresses, se the risk o faain increases.[29] Durin this phase, memory problems warsens, and the parsen may fail te recognise close relatives.[29] Lang-term memory, at wes previously intact, becomes impaired.[29]

Behavioral and neuropsychiatric changes becomes mair prevalent. Common manifestations is wanderin, irritability and emotional lability, leadin te cryin, ootbursts ov unpremeditated aggression, or resistance te caregivin.[29] Sundoonin can appear an aa.[34] Approximately 30% o people wiv Alzheimer's disease develops illusionary misidentifications and other delusional symptoms.[29] Subjects loses inseet o their disease process and limitations (anosognosia) an aa.[29] Urinary incontinence can develop.[29] These symptoms create stress for relatives and caregivers, at can be reduced by movin the parson frae the hame care tiv other long-term care facilities.[29][35]

Late stageEdit

A normal brain on the left and a late-stage Alzheimer's brain on the reet

Durin the final stage, knawn as the late-stage or severe stage, there is complete dependence on caregivers.[5][21][29] Language is reduced te simple phrases or even single words, eventually leadin te the complete loss o speech.[29][33] Despite the loss o verbal language abilities, people can often understand and return emotional signals. Though aggressiveness can still be present, extreme apathy and exhaustion is much mair common symptoms. People wiv Alzheimer's disease ultimately winnet can perform even the simplest tasks independently; muscle mass and mobility deteriorates te the point where they are bedridden and unable te feed themsels. The cause o deeth is usually an external factor, sic as infection o pressure ulcers or pneumonia, nut the disease itsel.[29] In some cases, there is a paradoxical lucidity immediately afore deeth, where there is an unexpected recovery o mental clarity.[36]

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  1. 1.0 1.1 1.2 1.3 "Dementia Fact sheet". World Health Organization (September 2020).
  2. Cite error: Invalid <ref> tag; no text was provided for refs named Simon2018p111
  3. 3.0 3.1 Cite error: Invalid <ref> tag; no text was provided for refs named Knopman2021
  4. 4.0 4.1 4.2 4.3 "Alzheimer's disease" (February 2009). BMJ 338: b158. doi:10.1136/bmj.b158. PMID 19196745. 
  5. 5.0 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 "Alzheimer's Disease Fact Sheet".
  6. "Alzheimer's disease" (January 2010). The New England Journal of Medicine 362 (4): 329–344. doi:10.1056/NEJMra0909142. PMID 20107219. 
  7. "Survival in dementia and predictors of mortality: a review" (November 2013). International Journal of Geriatric Psychiatry 28 (11): 1109–1124. doi:10.1002/gps.3946. PMID 23526458. 
  8. Cite error: Invalid <ref> tag; no text was provided for refs named Long
  9. "Study reveals how APOE4 gene may increase risk for dementia" (16 March 2021).
  10. "Dementia diagnosis and assessment". National Institute for Health and Care Excellence (NICE).
  11. Cite error: Invalid <ref> tag; no text was provided for refs named Hsu2017
  12. 12.0 12.1 "Systematic review of information and support interventions for caregivers of people with dementia" (July 2007). BMC Geriatrics 7: 18. doi:10.1186/1471-2318-7-18. PMID 17662119. 
  13. "Exercise programs for people with dementia" (April 2015). The Cochrane Database of Systematic Reviews 132 (4): CD006489. doi:10.1002/14651858.CD006489.pub4. PMID 25874613. 
  14. National Institute for Health and Clinical Excellence. "Low-dose antipsychotics in people with dementia". National Institute for Health and Care Excellence (NICE).
  15. "Information for Healthcare Professionals: Conventional Antipsychotics". US Food and Drug Administration (16 June 2008).
  16. 16.0 16.1 Cite error: Invalid <ref> tag; no text was provided for refs named Breijyeh2020
  17. "Early-onset Alzheimer's disease: nonamnestic subtypes and type 2 AD" (November 2012). Archives of Medical Research 43 (8): 677–685. doi:10.1016/j.arcmed.2012.11.009. PMID 23178565. 
  18. "Alzheimer's pathogenic mechanisms and underlying sex difference" (June 2021). Cell Mol Life Sci 78 (11): 4907–4920. doi:10.1007/s00018-021-03830-w. PMID 33844047. 
  19. Cite error: Invalid <ref> tag; no text was provided for refs named pmid9661992
  20. "Alzheimer's Disease Fact Sheet" (in en).
  21. 21.0 21.1 21.2 "Alzheimer's disease – Symptoms" (10 May 2018).
  22. "Recommendations for the diagnosis and management of Alzheimer's disease and other disorders associated with dementia: EFNS guideline" (January 2007). European Journal of Neurology 14 (1): e1-26. doi:10.1111/j.1468-1331.2006.01605.x. PMID 17222085. 
  23. 23.0 23.1 23.2 "Multiple cognitive deficits during the transition to Alzheimer's disease" (September 2004). Journal of Internal Medicine 256 (3): 195–204. doi:10.1111/j.1365-2796.2004.01386.x. PMID 15324363. 
  24. "Instrumental activities o daily living: a stepping-stone towards Alzheimer's disease diagnosis in subjects with mild cognitive impairment?" (2003). Acta Neurologica Scandinavica. Supplementum 179 (s179): 42–46. doi:10.1034/j.1600-0404.107.s179.8.x. PMID 12603250. 
  25. "Behavioral and psychological symptoms in Alzheimer's dementia and vascular dementia" (2019). Handbook of Clinical Neurology 165: 5–32. doi:10.1016/B978-0-444-64012-3.00002-2. PMID 31727229. 
  26. (2012) "Depression and Psychosis in Neurological Practice", Bradley's neurology in clinical practice, 6th, Philadelphia, PA: Elsevier/Saunders. ISBN 978-1-4377-0434-1. 
  27. "Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology" (January 2018). Neurology 90 (3): 126–135. doi:10.1212/WNL.0000000000004826. PMID 29282327. 
  28. Cite error: Invalid <ref> tag; no text was provided for refs named Atri2019
  29. 29.00 29.01 29.02 29.03 29.04 29.05 29.06 29.07 29.08 29.09 29.10 29.11 29.12 29.13 29.14 29.15 29.16 29.17 "Clinical features of Alzheimer's disease" (1999). European Archives of Psychiatry and Clinical Neuroscience 249 (6): 288–290. doi:10.1007/s004060050101. PMID 10653284. 
  30. "Memory deficits in Alzheimer's patients: a comprehensive review" (June 1992). Neuropsychology Review 3 (2): 119–169. doi:10.1007/BF01108841. PMID 1300219. 
  31. "Implicit memory performance of patients with Alzheimer's disease: a brief review" (1995). International Psychogeriatrics 7 (3): 385–392. doi:10.1017/S1041610295002134. PMID 8821346. 
  32. 32.0 32.1 "Language performance in Alzheimer's disease and mild cognitive impairment: a comparative review" (July 2008). Journal of Clinical and Experimental Neuropsychology 30 (5): 501–556. doi:10.1080/13803390701550128. PMID 18569251. 
  33. 33.0 33.1 33.2 "Effect of Alzheimer's disease on communication function" (September 1994). Journal of the South Carolina Medical Association 90 (9): 417–423. PMID 7967534. 
  34. "Sundowning and circadian rhythms in Alzheimer's disease" (May 2001). The American Journal of Psychiatry 158 (5): 704–711. doi:10.1176/appi.ajp.158.5.704. PMID 11329390. 
  35. "When home caregiving ends: a longitudinal study of outcomes for caregivers of relatives with dementia" (January 1995). Journal of the American Geriatrics Society 43 (1): 10–16. doi:10.1111/j.1532-5415.1995.tb06235.x. PMID 7806732. 
  36. "Paradoxical lucidity: A potential paradigm shift for the neurobiology and treatment of severe dementias" (August 2019). Alzheimers Dement 15 (8): 1107–1114. doi:10.1016/j.jalz.2019.04.002. PMID 31229433.