Alzheimer's Disease

Signs & symptoms

阿尔茨海默病的症状包括:

• Loss of abstract thinking. Someone with Alzheimer's disease may lose the ability to draw conclusions and solve problems. 平衡支票簿可能会变得很困难, for example, 因为病人忘记了怎么处理这些数字.

• Disorientation. 患有阿尔茨海默病的人可能会在他们居住的街道上迷路, 忘记他们在哪里以及他们是如何到达那里的, and not know how to get back home.

• Lack of initiative. 患有这种疾病的人可能会变得被动或没有动力, 在电视机前一坐就是几个小时, 睡得比平时多，不去做平时的活动.
• Language problems. People with Alzheimer's disease often forget simple words or substitute words with inappropriate ones. An Alzheimer's patient who can't find his or her toothbrush may ask for "that thing for my mouth."
• Misplacing items. 我们都很容易时不时地把钱包或钥匙放错地方, 但阿尔茨海默病患者会把东西放在不寻常的地方, 比如冰箱里的熨斗或者糖碗里的手表.
• Mood swings. Rapid mood swings — from calm to tears to anger — for no apparent reason is another common symptom.
• Personality changes. Personalities tend to change with age, 但患有阿尔茨海默病的人可能会有严重的性格改变, becoming extremely confused, suspicious, 害怕或依赖家庭成员的.
• Poor judgment. A loss of judgment is a common symptom. 病人穿衣服可以不顾天气, wearing several shirts or blouses on a warm day or very little clothing in cold weather. Others may give away large amounts of money to telemarketers or pay for home repairs or products they don't need.

Diagnosis

没有单一的诊断测试可以诊断阿尔茨海默病. 这个过程包括几项测试，可能需要一天以上的时间. These tests make it possible to diagnosis Alzheimer's with an accuracy of about 90 percent.

There are two abnormal structures in the brain associated with Alzheimer's disease — amyloid plaques and neurofibrillary tangles:

• Amyloid plaques. Amyloid plaques are sticky clumps or patches of protein surrounded by the debris of dying nerve cells in the brain.
• Neurofibrillary tangles. These are the damaged remains of protein called tau, which are required for normal brain function. In Alzheimer's, threads of tau protein become twisted, 研究人员认为哪些可能会损害神经元并导致它们死亡.

研究为神经元细胞死亡的原因提供了线索, but scientists have not identified the role plaques and tangles play in the disease and if they're the key factors.

Evaluation

At the UCSF Memory and Aging Center, an assessment will involve neurologists, radiologists, pharmacists, nurses and other health professionals. 评估可能包括一系列测量记忆的测试, reasoning, 视觉运动协调和语言技能. 此外，评估可能包括:

• Brain scans. These tests will be performed to detect other possible causes of dementia such as stroke.
• Interviews. 与患者和另一位与患者关系密切的人进行面谈, such as a relative, spouse or close friend who can provide examples of memory loss and functional decline.
• Laboratory tests. Lab tests, such as blood and urine tests, may provide information about problems other than Alzheimer's that could cause dementia.
• Medical history. 关于精神或身体状况的信息, 处方药和非处方药的使用, 家族病史也会被收集.
• Mental status. An evaluation will be conducted to assess sense of time and place; ability to remember, understand and communicate; and ability to do simple math problems.
• Physical exam. 评估患者的营养状况、血压和脉搏. Tests of sensation, balance and other functions of the nervous system also will be conducted.
• Psychiatric evaluation. An assessment of mood and other emotional factors that could cause dementia-like symptoms or may accompany Alzheimer's disease will be performed.

Treatments

Several medications are approved to manage the disease or slow the rate of decline. Some patients improve with medication and experience a temporary improvement soon after taking medication, 但改善和稳定的时期各不相同. Despite treatment, it appears that Alzheimer's disease progresses in the long term.

In addition to drugs, 有氧运动和负重运动可以提高能量水平, 减少冷漠，提高整体幸福感. 因为缺乏动力可能是个问题, a personal trainer can be helpful to ensure participation in an exercise program.

One treatment that holds promise for the future is a vaccine that targets the beta-amyloid protein. 在老鼠身上进行的疫苗研究令人鼓舞. 涉及人类的研究还处于早期阶段.

Health care professionals, 有了越来越灵敏的诊断技能, are using advanced imaging and medical technology to identify specific dementia disorders. 这改善并扩大了治疗的选择.

A reversible form of dementia is detected in 10 to 20 percent of suspected Alzheimer's disease cases. 这些情况通常是由电解质失衡引起的, thyroid disorders, trauma to the head, vitamin deficiencies, 精神疾病，如严重的抑郁症, medications such as Valium, or alcohol and drug abuse.

Caring for someone with Alzheimer's disease can be physically and emotionally challenging. Often, the caregiver assumes tasks such as household finances and cooking that were previously shared or the responsibility of the patient. 记忆力的逐渐丧失会损害对家庭成员的识别能力, 导致情感疏离和分离.

A wide range of support services are available for dementia patients and their caregivers.