Introduction:
Alzheimer’s disease is a progressive cerebral condition leading to memory impairment and cognitive disabilities. It is a progressive disorder that affects a person’s memory, language skills, and thinking abilities and causes an incapability to execute routine tasks of daily living. The symptoms of the disease are managed with the use of medications.
What Are the Causes of Alzheimer’s Disease?
Alzheimer’s disease is a complex disorder with no exact cause. Risk factors include:
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Age: Old-aged individuals aged 60 to 70 years are commonly affected. As age increases, the risk of developing Alzheimer’s disease increases.
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Genetic Factors: Mutations in the genes like APP, PSEN1, and PSEN2 increase the risk of Alzheimer’s disease.
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Environmental Factors: Certain environmental and personal factors like head injury after a trauma or exposure to toxins are considered risk factors for developing Alzheimer’s disease.
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Lifestyle Factors: Factors like poor nutrition, lack of exercise and a balanced diet, and chronic stress combined with a sedentary lifestyle can increase the risk of Alzheimer’s disease.
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Underlying Medical Conditions: Other comorbidities like diabetes mellitus, hypertension, or coronary artery disease can increase the risk of developing the disease. This may be due to diminished cerebral blood flow, leading to inadequate oxygen delivery.
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Sleep Disturbances: Changes in sleep patterns and insomnia can increase the incidence of Alzheimer’s disease.
What Happens in Alzheimer’s Disease?
In Alzheimer's disease, there is an abnormal aggregation of amyloid and tau protein, thus resulting in amyloid plaques and neurofibrillary tangles. This causes loss of neurons and synaptic junctions, thus resulting in degeneration. This initially starts with areas of the brain corresponding to memory and language and progresses to other areas in the later stages.
What Are the Symptoms of Alzheimer’s Disease?
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Memory Loss: The most common symptom and the earliest manifestation of Alzheimer’s disease is loss of memory. In the early stages, short-term memory loss occurs. In the advanced stages, there is a loss of long-term memories.
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Loss of Executive Functions: Individuals with Alzheimer’s disease encounter challenges in doing routine tasks, planning things, managing finances, and handling objects.
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Loss of Language Skills: Communication skills will be affected, thus resulting in slurred speech.
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Mood Changes: Alzheimer’s disease can cause individuals to become more stressed, irritable, or agitated.
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Disorientation: People with Alzheimer’s disease feel disoriented about people, places, and time. They remain confused about their surroundings. In the later stages of Alzheimer’s disease, patients may not be able to perform any task independently, and they lose interest in doing any activity.
How Is Alzheimer’s Disease Diagnosed?
A comprehensive evaluation of personal and medical history, physical examination, and investigations diagnose Alzheimer’s disease.
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Personal history reveals the symptoms experienced by the patient.
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Cognitive testing like the Montreal Cognitive Assessment (MoCA) assesses the patient’s memory, communication, and other cognitive functions.
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Radiographic investigations like Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and Positron Emission Tomography (PET) are used to locate and assess the level of degeneration in the brain.
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Neuropsychological testing can help track changes in cognitive functions over time.
How is Alzheimer’s Disease Treated?
There is no complete cure for the disease. However, medical intervention is done to implement strategies that can handle the symptoms and slow down disease advancement. The following ways are used to manage the condition.
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Medications: Drugs like acetylcholinesterase inhibitors are prescribed.
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Lifestyle Modifications: Physical activity, diet modification, and stress management can help reduce the condition's progression.
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Cognitive and Behavioral Therapies: Cognitive rehabilitation or reminiscence therapy is indicated. Such therapies can help people to improve their cognitive functions and maintain their sense of independence. They also help people with coping strategies to manage the disease.
How Does Alzheimer’s Drug Increase the Risk of Hospitalization?
The most common drug prescribed for Alzheimer’s disease is acetylcholinesterase Inhibitors. They act by increasing the level of a neurotransmitter called acetylcholine in the brain. Acetylcholine is essential for memory and cognitive functions.
Individuals with Alzheimer’s disease show reduced levels of acetylcholine. Hence, the cholinesterase inhibitor class of drugs helps increase acetylcholine levels. Side effects of cholinesterase Inhibitors include:
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Nausea.
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Vomiting.
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Diarrhea.
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Headache.
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Dizziness.
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Stomach pain.
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Psychological symptoms like aggression.
The administration of cholinesterase Inhibitors also has the following complications.
Rhabdomyolysis:
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This condition causes the breakdown of muscle fibers and the release of contents into the bloodstream. This results in the release of myoglobin into the blood, leading to severe kidney damage.
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This can also cause fatigue, inflammation of the muscles, and pain in the affected regions.
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Rhabdomyolysis is also caused by the interaction between cholinesterase inhibitors and statins (drugs used to reduce cholesterol levels in the body).
Brain Shrinkage: Recent studies show an increased risk of brain shrinkage due to administering cholinesterase inhibitors. Acetylcholinesterase inhibitors also increased the rate of hippocampal and brain atrophy. This may be due to an abnormal increase in the levels of acetylcholine in the body. Acetylcholine increases brain activity, thus resulting in greater brain shrinkage.
While acetylcholinesterase Inhibitors can be effective in managing the cognitive symptoms of Alzheimer's disease, it is crucial to be aware of the potential hazards linked to these medications and to carefully consider the individual's specific situation when making treatment decisions.
What Are the Other Causes of Hospitalization in Individuals With Alzheimer’s Disease?
Individuals with Alzheimer's disease are at a higher risk for hospitalization compared to the general population. The causes of hospitalization in individuals with Alzheimer's disease can vary, but some common reasons include:
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Infections: Individuals with Alzheimer's disease are more prone to infections as a consequence of compromised immune systems and other medical conditions. Infections affecting the lungs (pneumonia), urinary tract, and sepsis are common causes of hospitalization in individuals with Alzheimer's disease.
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Falls and Injuries: Individuals with Alzheimer's disease have an increased incidence of injuries due to impaired balance, mobility, and coordination. Tumbles can result in severe wounds, broken bones, head injuries, and internal bleeding, which may require hospitalization.
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Behavioral and Psychological Symptoms: Behavioral and psychological symptoms of dementia, such as agitation, aggression, and wandering, can lead to hospitalization in individuals with Alzheimer's disease. Environmental factors, medication changes, or underlying medical conditions may trigger these symptoms.
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Medical Emergencies: Individuals with Alzheimer's disease may experience medical emergencies such as seizures, strokes, and heart attacks, which may require hospitalization.
Conclusion:
It is important for caregivers and healthcare providers to monitor individuals with Alzheimer's disease closely and to address any medical issues promptly to prevent hospitalization when possible. Proactive approaches like periodic medical examinations and proficient supervision of medications can mitigate the likelihood of hospital admission in individuals with Alzheimer's ailment.
