An estimated 5 to 10 percent of all mental deterioration in persons over the age of 65 is due to reversible conditions, such as depression, underlying physical disease (metabolic disorders, cardiovascular disease or pernicious anemia), excessive and inappropriate drug use, loss of social support or change in social environment. Therefore, it is important to diagnose Alzheimer’s disease to ensure that any mental impairment is not reversible.
In order to diagnose Alzheimer’s disease, a physician must:
- Take a detailed medical history
- Conduct physical and neurological examinations
- Consult Alzheimer’s diagnostic criteria
- Conduct laboratory examinations, such as urine tests, a CAT scan, magnetic resonance imaging (MRI) or positron emission tomography (PET) to detect structural abnormalities of the head and brain conduct a functional and mental status assessment test
- Do a complete inventory of any prescription and over-the-counter drugs the patient is taking.
Although there is currently no cure for Alzheimer’s disease, a great deal can be done to manage it. There are four approaches to managing the disease.
The approaches and solutions are to relieve behavioral symptoms associated with dementia, including depression, agitation and psychosis.
Medications, called cholinesterase inhibitors, such as tacrine (Cognex), donepezil (Aricept), rivastigmine (Exelon) or galantamine (Reminyl), enhance the effectiveness of acetylcholine (the chemical messenger found in the neurotransmitter system which coordinates memory and learning) by slowing its breakdown. Unfortunately, these medications only temporally improve the symptoms associated with Alzheimer’s. The effects of the drugs will fade as the deterioration of brain cells progresses.
To relieve cognitive dysfunction to improve memory, language, attention and orientation doctors may prescribe precursors, cholinesterase inhibitors and cholinergic receptor agents.
Slow the rate of illness progression, thereby preserving quality of life and independence.
Delay the time of onset of illness. Medications and therapies to combat these problems are still in the development and clinical trial stages. For instance, the research shows that vitamin E slows the progress of some consequences of Alzheimer’s for about 7 months, and scientists are investigating whether ginkgo biloba can delay or prevent dementia in older people, and if estrogen can prevent Alzheimer’s in women with a family history of the disease.
Researchers are looking at methods to enhance cerebral metabolism, stabilize membranes, promote neuronal sprouting, decrease inflammation, neurotoxins and excitatory amino acids, as well as alter metabolism of key proteins.
In addition to the pharmaceutical approaches, conservation methods also can be beneficial to the management of Alzheimer’s disease, such as:
- Eating a proper diet.
- Getting daily exercise.
- Continuing intellectual stimulation and social contact.
- Implementing memory aids, such as a prominent calendar, lists of daily tasks and labels on frequently used items that can help compensate for memory loss and confusion.
- Providing a comfortable and stimulating environment and always trying to give simple and easy to understand instructions.
- Participating in support groups.