Alzheimer’s Disease

Alzheimer’s Disease – General Information

Alzheimer’s Disease – Symptoms

Initial symptoms like these progress from apparently simple and sometimes fluctuating temporary amnesia and difficulty in orientation of oneself in space like as in a car lane while driving, to some more convincing short-term memory losses and difficulty going through familiar areas like one's neighborhood. As the disease goes in progress to a middle stage, diseased patients could still perform tasks on their own (like using the bathroom), although they may need some assistance with more difficult activities (like paying bills). As the disease progresses there is a deficiency in well-known skills and in recognizing of objects and persons. In an advanced stage of this disease, deterioration of movement and locomotion system, leading to bed fastness, feeding inability, and incontinence, will be noticed if death from some cause which is external (e.g. pneumonia or spontaneous heart attach) does not occur.

Alzheimer’s Disease – Treatment

For now, there is no solution for Alzheimer's disease. Currently available drugs offer some symptomatic benefits in the cases of some patients but they do not stop or slow disease progression. A consensus statement was published by The American Association for Geriatric Psychiatry in 2006 on Alzheimer's treatment.

Acetylcholinesterase inhibitors:

There is an activity reduction of the neurons which are cholynergic in Alzheimer’s disease. Acetylcholinesterase inhibitors can reduce the acetylcholine’s (ACh) breakdown rate and thus increase concentration of ACh in your brain (hence fighting the lessening of ACh which is caused by the cholinergin neurons’ death). Acetylcholinesterase-inhibitors seem to moderate some symptoms but they can’t change the course of the dementing process. Examples currently on the market may include donepezil (Aricept), rivastigmine (Exelon) and galantamine. The three products can come in oral form which must be taken twice a day. Rivastigmine can also be available as a one-per-day transdermal patch.

There are questions about the efficiency of cholinesterase inhibitors. Recent articles have criticized studies’ design that is and will be reporting benefit from drugs like these, concluding that they may have a doubtful clinical utility, are expensive, and also have many side effects. The pharmaceutical companies, and also some physicians who are independent, dispute the sayings of these articles.

Ginkgo Biloba

Examining 52 studies on Ginkgo for "cognitive impairment and dementia," treatment, in a review by Cochrane he states that "there is promising evidence of improvement in cognition and function associated with Ginkgo." This review actually says that the two controlled randomized studies which focused on Alzheimer's disease both revealed significant improvement in areas like these. Some other AAGP review didn’t recommend Ginkgo, but it did not warn people against using it. A big, randomized study of clinical facts in the US which is called the GEM study and examines some effects of Ginkgo of preventing dementia is now in progress. Results can be expected in early 2008 or hopefully late 2007.

NMDA antagonists

Recent proof of glutamatergic neuronal excitotoxicity involvement in Alzheimer's disease has led to creating and introducing memantine. Memantine is a new NMDA receptor antagonist, which has been evidenced to be efficient clinically in moderate terms. Memantine can be found in drugstores as Axura, Ebixa, Akatinol and Namenda.

Pshychosocial interventions

Rehabilitation strategies and cognitive/behavior interventions may be utilized as adjunct to pharmacological treatment, especially in mid to advanced stages of Alzheimer’s disease. Treatment ways include psychotherapy, counseling (if functioning of the cognitive is adequate), reminiscent therapy, orientation of reality therapy, and reinforcements of behavior, and also cognitive rehabilitation training.