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Introduction

Alzheimer's disease (also known as Alzheimer or AD) is a progressive degenerative brain disease, and the most common type of dementia. People affected by AD have progressive and frequent memory loss. With time they may become withdrawn and develop trouble in thinking, planning, working, interacting socially or looking after themselves.

Normal Aging & Memory

The human brain contains over two billion neurons, and other than sensory analysis and execution of motor acts, it performs the unique and exceedingly complex & intricate function of accumulating knowledge that adds to the experience of an individual. This constitutes the intellect (cognitive ability) of a person and is person specific, develops with age, and is refined with education and exposure. In normal aging, the loss of intellectual faculties is not significant and people can live independent and productive lives.

Almost everyone experiences memory problems occasionally. However, memory loss is considered significant if the memory impairment is frequent and severe enough to interfere with work or daily routine.

Dementias are a group of neurological disorders that lead to decline in the cognitive abilities/intellect & interfere with a person's ability to work and interact socially. There are various types of dementias that have different biological mechanisms, affect different regions of the brain, present in different ways and require different treatment. Some of these dementias are even reversible. Therefore, evaluation by a neurologist is important to identify the particular type of dementia as the treatment and prognosis of each dementia varies.

What are the types of dementia?

  • Neurodegenerative dementias like Alzheimer's disease, Parkinson's disease & Frontal Temporal dementia
  • Vascular dementias (following strokes)
  • Normal Pressure Hydrocephalus
  • Head injury
  • Brain injury following cardiac arrest
  • Infections like Creutzfeldt-Jakob Disease (Mad Cow Disease)
  • Metal disorders like Wilson's Disease and Neurodegeneration from Brain Iron Accumulation (NBIA)

Risk Factors

How does Alzheimer Develop?

Alzheimer is associated with deposition of abnormal proteins in the brain, brain cell death and brain shrinkage. The exact causes and risk factors of Alzheimer are subject of active research.

Who can Develop Alzheimer?

Alzheimer usually develops in people over the age of 65 years. The risk of developing Alzheimer increases with age. It affects both men and women. A rare genetic form of the disease, called, early-onset Alzheimer, develops between 30-60 years of age.

Diagnosis

How is Alzheimer diagnosed?

Step 1: Cognitive Assessment to detect the type of memory and cognitive impairment
Step 2: Tests to find the cause of memory loss

What are the tests to diagnose Alzheimer?

Cognitive Assessment

The brain is highly organised and each part supports a special ability like memory, planning, emotional processing, facial recognition and others. Cognitive assessment involves answering questions and solving puzzles to identify which brain regions or networks are working sub-optimally. Cognitive assessment, therefore, helps diagnose the type of dementia as well as grade its severity and judge treatment response.

Laboratory

There may be a need for specialised tests like metabolic markers, vitamin levels, endocrine assessment, cerebrospinal fluid examination, and infection and tumour markers as advised by the specialist doctor.

3 Tesla MRI

Specialised MRI protocols like morphometric MR, volumetric MR, Diffusion Tensor Imaging (DTI), Functional MRI and MR angiography can help elucidate brain networks and help diagnose AD early and monitor the disease. These techniques also help identify other conditions mimicking AD.

PET Scan

This is a recent advance in diagnosing AD and other dementias. PET scan records the activity of various brain regions by using a specialised imaging technique.

Electroencephalogram (EEG)

EEG is a recording of brain rhythms by placing electrodes (stickers like in an ECG) on the scalp. This helps identify the stage of AD as well as exclude other dementias.

Treatment

At present there is no cure for AD but there are drugs available to alleviate symptoms. These drugs can improve cognitive abilities, and delay functional decline to an extent. Medical treatments include drugs that alter levels of chemical involved in transmitting signals between brain cells. Effective medical treatments are available for behavioural problems, such as depression, agitation and aggression. These problems are common in people with AD, and can be very distressing especially to the caregivers.

The Onset of AD Can Be Prevented By:

  • Education
  • Maintaining Active Lifestyle (Physical / Mental)
  • Healthy eating habits
  • Regular health checks, to maintain normal Blood Pressure, Blood Sugar, Cholesterol and Body Weight, Avoiding smoking & excessive alcohol intake

Dos & Don'ts

A brain healthy lifestyle involves

  • Regular Exercise
  • Healthy Diet
  • Mental Stimulation
  • Quality Sleep
  • Stress Management
  • An Active Social Life

Why KDAH?

Alzheimer's clinic

Our Alzheimer and Memory Clinic is a specialist clinic for people with neurological problems resulting in memory loss, confusion, difficulty in speech and understanding, change in personality, aggressive behavior, hallucinations or depression.

The clinic offers a comprehensive screening and care program for AD and other memory disorders, including neurology consultation, physical and cognitive rehabilitation, and psychotherapy. Since cognitive and behavioral problems affect the family along with the patient, we also offer family counseling services, help target rehabilitative goals and equip the family for KH supported long term home care.

The mission of the Clinic is to join hands with the patient and their family to alleviate suffering by offering the best in medical care by combining the latest scientific know-how, medical technology and personalized attention.

Why get checked for Alzheimer?

Early diagnosis of AD can maximise benefit from the available treatments and also allow the patient to take part in decisions about living options, medical treatment, financial and legal matters. The patient and the caregivers can also participate in building the right care team and social support network.

Please note

Most people with memory problems do not have AD. There are many types of dementia and correct diagnosis is essential for proper prognostication and to institute appropriate treatment.

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