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Alzheimer’s disease:
There’s no lifestyle factor that’s been conclusively shown to reduce your risk of Alzheimer’s disease. However, some evidence suggests that the same factors that put you at risk of heart disease may also increase the chance that you’ll develop Alzheimer’s. Examples include: Lack of exercise

Smoking
High blood pressure
High blood cholesterol
Poorly controlled diabetes
A diet lacking in fruits and vegetables
Lack of social engagement
These risk factors are also linked to vascular dementia, a type of dementia caused by damaged blood vessels in the brain. Working with your health care team on a plan to control these factors will help protect your heart — and may also help reduce your risk of Alzheimer’s disease and vascular dementia. Lifelong learning and social engagement

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Studies have found an association between lifelong involvement in mentally and socially stimulating activities and reduced risk of Alzheimer’s disease. Factors that may reduce your risk of Alzheimer’s include: Higher levels of formal education

A stimulating job
Mentally challenging leisure activities, such as reading, playing games or playing a musical instrument Frequent social interactions
Scientists can’t yet explain this link. One theory is that using your brain develops more cell-to-cell connections, which protects your brain against the impact of Alzheimer-related changes. Another theory is that it may be harder to measure cognitive decline in people who exercise their minds frequently or who have more education. Still another explanation is that people with Alzheimer’s disease may be less inclined to seek out stimulating activities years before their disease can be diagnosed.

Signs:

1. Memory loss that disrupts daily life. One of the most common signs of Alzheimer’s, especially in the early stages, is forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over; relying on memory aides (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own. What’s typical? Sometimes forgetting names or appointments, but remembering them later. 2. Difficulty completing familiar tasks at home, at work or at leisure. People with Alzheimer’s often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favourite game. What’s typical? Occasionally needing help to use the settings on a microwave or to record a television show. 3. Confusion with time or place. People with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there. What’s typical? Getting confused about the day of the week but figuring it out later. 4. Changes in mood and personality. The mood and personalities of people with Alzheimer’s can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone. What’s typical? Developing very specific ways of doing things and becoming irritable when a routine is disrupted. 5. Withdrawal from work or social activities. A person with Alzheimer’s may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favourite sports team or remembering how to complete a favourite hobby. They may also avoid being social because of the changes they have experienced. What’s typical? Sometimes feeling weary of work, family and social obligations. 6. Decreased or poor judgment. People with Alzheimer’s may experience changes in judgment or decision making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean. What’s typical? Making a bad decision once in a while.

P3- clinical measurements/investigations
Doctors can nearly always determine whether you have dementia, and they can often identify whether your dementia is due to Alzheimer’s disease. Alzheimer’s disease can be diagnosed with complete accuracy only after death, when microscopic examination of the brain reveals the characteristic plaques and tangles. To help distinguish Alzheimer’s disease from other causes of memory loss, doctors now typically rely on the following types of tests. Physical and neurological exam

Your doctor will perform a physical exam, and is likely to check your overall neurological health by testing your: Reflexes
Muscle tone and strength
Ability to get up from a chair and walk across the room
Sense of sight and hearing
Coordination
Balance
Lab tests
Blood tests may help your doctor rule out other potential causes of memory loss and confusion, such as thyroid disorders or vitamin deficiencies. Mental status testing
Your doctor may conduct a brief mental status test to assess your memory and other thinking skills. Short forms of mental status testing can be done in about 10 minutes. Neuropsychological testing

Your doctor may recommend a more extensive assessment of your thinking and memory. Longer forms of neuropsychological testing, which can take several hours to complete, may provide additional details about your mental function compared with others’ of a similar age and education level. This type of testing may be especially helpful if your doctor thinks you may have a very early stage of Alzheimer’s disease or another dementia. These tests may also help identify patterns of change associated with different types of dementia and can help doctors estimate your ability to safely manage important activities, such as financial and medical decision making. Brain imaging

Images of the brain are now used chiefly to pinpoint visible abnormalities
related to conditions other than Alzheimer’s disease — such as strokes, trauma or tumors — that may cause cognitive change. New imaging applications — currently used primarily in major medical centers or in clinical trials — may enable doctors to detect specific brain changes caused by Alzheimer’s. Brain-imaging technologies include:

Computerized tomography (CT). For a CT scan, you’ll lie on a narrow table that slides into a small chamber. X-rays pass through your body from various angles, and a computer uses this information to create cross-sectional images (slices) of your brain. It’s currently used chiefly to rule out tumors, strokes and head injuries. Magnetic resonance imaging (MRI). An MRI uses radio waves and a strong magnetic field to produce detailed images of your brain. You lie on a narrow table that slides into a tube-shaped MRI machine, which makes loud banging noises while it produces images. MRIs are painless, but some people feel claustrophobic inside the machine and are disturbed by the noise. MRIs are currently used primarily to rule out other conditions that may account for cognitive symptoms. In the future, they may be used to measure the volume of your brain tissue and whether shrinkage in brain regions implicated in Alzheimer’s disease has occurred. Positron emission tomography (PET). During a PET scan, you’ll be injected in a vein with a low-level radioactive tracer. You’ll lie on a table while an overhead scanner tracks the tracer’s flow through your brain. The tracer may be a special form of glucose (sugar) that shows overall activity in various brain regions. This can show which parts of your brain aren’t functioning well. New PET techniques may be able to detect your brain level of plaques — one hallmark abnormality linked to Alzheimer’s. Future diagnostic tests

Researchers are working with doctors to develop new diagnostic tools to help definitively diagnose Alzheimer’s. Another important goal is to detect the disease before it causes the symptoms targeted by current diagnostic techniques — at the stage when Alzheimer’s may be most treatable as new drugs are discovered. This stage is called preclinical Alzheimer’s disease. New tools under investigation include: Additional approaches to brain imaging

More-sensitive tests of mental abilities
Measurement of key proteins or protein patterns in blood or spinal fluid (biomarkers) In addition to helping diagnose Alzheimer’s at an earlier stage, biomarkers and new imaging techniques may also be helpful for monitoring how effective future treatments are.

( http://www.mayoclinic.com/health/alzheimers-disease/DS00161/DSECTION=tests-and-diagnosis )

How the progress of the disorder affected the individual?

Alzheimer’s disease typically develops slowly and gradually gets worse over the course of several years. It eventually affects most areas of your brain, including those important in memory, thinking, judgment, language, problem-solving, personality and movement. There are five stages associated with Alzheimer’s disease: preclinical Alzheimer’s disease, mild cognitive impairment, mild dementia due to Alzheimer’s, moderate dementia due to Alzheimer’s and severe dementia due to Alzheimer’s. Dementia describes a group of symptoms affecting intellectual and social abilities severely enough to interfere with daily functioning. These stages can help you and your family understand what to expect and plan for the future. It’s important to realize that Alzheimer’s stages are rough guides based on averages and generalizations. The disease is a continuous process. Your experience with Alzheimer’s, the symptoms you develop and when they appear may vary. Preclinical Alzheimer’s disease

Alzheimer’s disease begins long before any symptoms become apparent. This stage is called preclinical Alzheimer’s disease. You won’t notice symptoms during this stage, nor will those around you. This stage of Alzheimer’s can last for years, possibly even decades. Although you won’t notice any changes, new imaging technologies can now identify deposits of a substance called amyloid beta that have been associated with Alzheimer’s disease. The ability to identify these early deposits may be especially important as new treatments are developed for Alzheimer’s disease. Mild cognitive impairment
(MCI) due to Alzheimer’s disease

People with mild cognitive impairment have mild changes in their memory and thinking ability. These changes aren’t significant enough to affect work or relationships yet. People with MCI may have memory lapses when it comes to information that is usually easily remembered, such as conversations, recent events or appointments. People with MCI may also have trouble judging the amount of time needed for a task, or they may have difficulty correctly judging the number or sequence of steps needed to complete a task. The ability to make sound decisions can become harder for people with MCI. Not everyone with mild cognitive impairment has Alzheimer’s disease. In some cases, MCI is due to depression or a temporary medical complication. The same procedures used to identify preclinical Alzheimer’s disease can help determine whether MCI is due to Alzheimer’s disease or something else. Mild dementia due to Alzheimer’s disease

Alzheimer’s disease is often diagnosed in the mild dementia stage, when it becomes clear to family and doctors that a person is having significant trouble with memory and thinking. In the mild Alzheimer’s stage, people may experience:

– Memory loss for recent events. Individuals may have an especially hard time remembering newly learned information and repeatedly ask the same question. Difficulty with problem-solving, complex tasks and sound judgments. Planning a family event or balancing a checkbook may become overwhelming. Many people experience lapses in judgment, such as when making financial decisions. Changes in personality. People may become subdued or withdrawn — especially in socially challenging situations — or show uncharacteristic irritability or anger. Decreased attention span and reduced motivation to complete tasks also are common. Difficulty organizing and expressing thoughts. Finding the right words to describe objects or clearly express ideas becomes increasingly challenging. Getting lost or misplacing belongings. Individuals have increasing trouble finding their way around, even in familiar places. It’s also common to lose or misplace things, including valuable items. Alzheimer’s stages: How the disease progresses

Moderate dementia due to Alzheimer’s disease
During the moderate stage of Alzheimer’s, people grow more confused and forgetful and begin to need help with daily activities and self-care. People with moderate Alzheimer’s disease may:

Show increasingly poor judgment and deepening confusion. Individuals lose track of where they are, the day of the week or the season. They often lose the ability to recognize their own belongings and may inadvertently take things that don’t belong to them. They may confuse family members or close friends with one another, or mistake strangers for family. They often wander, possibly in search of surroundings that feel more familiar and “right.” These difficulties make it unsafe to leave those in the moderate Alzheimer’s stage on their own. Experience even greater memory loss. People may forget details of their personal history, such as their address or phone number, or where they attended school. They repeat favorite stories or make up stories to fill gaps in memory. Need help with some daily activities. Assistance may be required with choosing proper clothing for the occasion or the weather and with bathing, grooming, using the bathroom and other self-care. Some individuals occasionally lose control of their urine or bowel movements.

Undergo significant changes in personality and behavior. It’s not unusual for people with moderate Alzheimer’s to develop unfounded suspicions — for example, to become convinced that friends, family or professional caregivers are stealing from them or that a spouse is having an affair. Others may see or hear things that aren’t really there. Individuals often grow restless or agitated, especially late in the day. People may have outbursts of aggressive physical behavior. Severe dementia due to Alzheimer’s disease

In the severe (late) stage of Alzheimer’s, mental function continues to decline and the disease has a growing impact on movement and physical capabilities. In severe Alzheimer’s, people generally:

Lose the ability to communicate coherently. An individual can no longer converse or speak coherently, although he or she may occasionally say words or phrases. Require daily assistance with personal care.

This includes total assistance with eating, dressing, using the bathroom and all other daily self-care tasks. Experience a decline in physical abilities. A person may become unable to walk without assistance, then unable to sit or hold up his or her head without support. Muscles may become rigid and reflexes abnormal. Eventually, a person loses the ability to swallow and to control bladder and bowel functions. Rate of progression through Alzheimer’s stages

The rate of progression for Alzheimer’s disease varies widely. On average, people with Alzheimer’s disease live eight to 10 years after diagnosis, but some survive as long as 25 years. Pneumonia is a common cause of death because impaired swallowing allows food or beverages to enter the lungs, where an infection can begin. Other common causes of death include complications from urinary tract infections and falls.

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