Overview: Alzheimer’s disease is a chronic, degenerative and progressive disease of the brain characterized by a loss of neurons and synapses and is currently ranked as the 7th leading cause of death in the United States. According to the Alzheimer’s Association, an estimated 5.8 million Americans currently have Alzheimer’s disease and the number is expected to triple by the year 2050.
Diagnosis: There is no specific test or tool to diagnose Alzheimer’s disease. The diagnosis is made by a detailed history taken from the patient (in earlier stages) and the family. There has to be a history of change in cognition, behavior or functionality.
Diagnostic Criteria for Alzheimer’s Disease: The initial clinical manifestation of Alzheimer’s disease is usually short-term memory loss in 90% of patients. Short-term memory includes two types, episodic and semantic. Symptoms of episodic memory loss include losing track of personal belongings, repeatedly asking the same questions, repeating the same story over and over, or failing to remember things that happened as recently as yesterday. Symptoms of semantic memory loss may include difficulty finding words or names during a conversation, or forgetting the names of family members and friends. This stage is called mild cognitive impairment (MCI). For years, short-term memory loss (MCI) was defined as “benign short-term memory loss of the elderly.” Unfortunately, this condition is not benign in every aging individual. About 50% of these individuals will eventually develop additional cognitive deficits that result in dementia (most likely Alzheimer’s) over the course of the next 3 years. As the disease progresses, multiple cognitive domains are involved: Apraxia, agnosia, aphasia and anomia and disturbance of executive function.
Apraxia is defined as an inability to perform motor tasks despite the integrity of the motor system. Examples of motor tasks include combing hair, using eating utensils or using tools that the patient was very familiar with in the past. Agnosia is defined as an inability to perform sensory tasks despite the integrity of the sensory system. Examples of agnosia include a fork being mistaken for a spoon or the failure to recognize body parts or color. Diseased individuals are often unable to recognize their own disease, and when confronted about their behavior, may make remarks such as “I’m perfectly normal, my daughter is crazy.” Aphasia and anomia are defined as progressive deterioration of language that gets worse over time, especially in the advanced stages. Occasionally, loss of language is seen in earlier stages of the disease. Speech may be fluent, but the patient is unable to understand spoken language (Aphasia) or name familiar objects (Anomia). Disturbance of executive function includes impairments in planning, judgment, insight, orientation, the use of math skills, etc. These cognitive deficits cause significant impairment in social functioning and common, daily activities such as writing checks, paying bills, making appointments, shopping, traveling, cooking, getting lost or disoriented while driving, etc.
Alzheimer’s is gradual in onset and is marked by a continual decline in cognition and function. As the disease progresses, behavior becomes increasingly problematic. Patients may wander, become apathetic and depressed, and may display psychotic manifestations such as agitation, delusions, and visual hallucinations. In more advanced stages of Alzheimer’s disease, patients are left mute and bedridden. These symptoms cannot be attributed to any other central nervous system disorder, systemic illness or substance-induced condition. Additionally, they do not occur exclusively in conjunction with delirium, which is usually seen with acute medical illness or hospitalization.
Interested in learning more about Alzheimer’s research? Please call 561-296-3855. The Premiere Research Institute in West Palm Beach regularly conducts clinical research studies in the field of Alzheimer’s Disease. To find out more about these studies click here or sign up for their newsletter to keep informed about the newest treatments, articles, and research that are being conducted in the field of Alzheimer’s.