Alzheimers disease |
Alzheimers disease
Is a progressive neurodegenerative disease resulting in decline in congnitive functions and behavioural disturbances.It is the most common cause of cognitive impairment in elderly personsc/f:
1. Insidious onset disease
2. There is a gradual decline in activities of daily living which ultimetly leads to profound disability and depandance on others
3. The patient has disturbed memory,language n visual skills:
a)there is an impaired ability to learn new things and recall previously learnt information
b)a decline in language function n increased difficulty with names n understanding what is being said
c)an impaired ability to carry out motor activities,despite intact motor function
d)failure to recognise or identify objects despite intact sensory function
4. Other features include behavioural problems,psychotic symptoms n depression.Persecutory delusions occur in nealy 50% of patients
5. It is important to differentiate b/w alyheimers disease n other treatable causes of demantia
laboratory investigations-
1. There r carried out to exclude a treatable cause of dementia
2. Common investigations r blood chemistry,a complete blood count,tests for syphilis n thyroid functions,a CT head is usually done to exclude an intracranial pathology.An MRI may be necessary to detect presence of white ischaemic lesions
management
cognitive deficits
1. Cholinesterase inhibitors provide modest improvement in symptoms n reduction in the rate of cognitive decline.These drugs include donepezil,rivastigming,galantamine n tacrine
2. Other agents include vit E n NSAIDS though their exact role is not clear
co morbid conditions
optimal management should be provided for any co morbid conditions including visual or hearing deficits,dental problems n other common medical illnesses
behavioural problems
treatment of associated behavioural problems by non pharmacological n pharmacological interventions should be prescribed
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