Alzheimer’s Disease Treatment
Treatment of Alzheimer's disease in Israel carried out by specialists of the neurological department of the country's leading private hospital: Herzliya Medical Center. The clinic utilizes the latest developments in science around the world in the early diagnosis of the disease symptoms, as well as unique methods to prevent the progressive disorder (delay its onset) of intellectual functions and their rehabilitation.
What is Alzheimer’s Disease?
Alzheimer's disease - a severe chronic neurodegenerative disease characterized by progressive atrophy of neurons in the brain, thereby shrinking of the brain. The consequence of these changes and the death of nerve cells is the loss of memory, disturbance of intellectual functions, loss of social skills, and a range of mental disorders, affecting not only the ability to work, but also the possibility of patients to perform routine daily activities. Alzheimer's disease is the leading type of dementia predominantly seen in old age – it is important to note that it is not part of the normal aging process. Although Alzheimer’s disease affects mainly people over the age of 65 years of age (late-onset Alzheimer’s), there has been a trend of increased morbidity of people below the age of 65 years old (early-onset Alzheimer's). Early-onset Alzheimer’s patients commonly develop myoclonus, a condition that involves muscle twitching and spasms. Familial Alzheimer’s is another type of Alzheimer’s that is linked with specific genes, this type is extremely rare.
Causes of Alzheimer's Disease
Scientists continue to study all of the causes of Alzheimer's disease. There are two main theories to explain the development of the disease:
- Genetic peculiarities and hereditary mutations (mutations of apolipoprotein E-e4 - APOE e4)
- Abnormalities of metabolic processes, particularly between neurons (brain nerve cells), accompanied by changes in protein metabolism: A buildup of beta-amyloid (amyloid plaques), these accumulate between neurons and form insoluble plaques. Neurofibrillary tangles are insoluble, twisted proteins (comprising mainly of tau protein) and are found in neurons.
The hallmark of Alzheimer’s is the presence of the abovementioned plaques and tangles that are only visible post-mortem. It is believed that these pathological processes are responsible for the degradation of neurons, severely affecting mental ability – which is visible in the symptoms of Alzheimer’s disease.
Alzheimer's Risk Factors
Identified risk factors that increase the likelihood of developing the disease include:
- Age - risk significantly increased over 65 years of age
- Family history of the disease
- Genetics – possession of APOE-e4
- Familial Alzheimer’s and early-onset Alzheimer's disease – although rare, is a result of possession of a mutation of APP, PSEN-1 and PSEN-2 proteins
- Women are affected more than men
- Severe head trauma in the past
- Heart-head connection - diseases accompanied by cerebral ischemia (cerebral atherosclerosis, diabetes, lipid metabolism, hypertension)
- Physical inactivity (reduced mobility)
- Alcohol and drug addiction
Prevent Alzheimer's Disease
Specialists have examined factors that reduce the likelihood of degenerative changes in the brain, such as an active lifestyle, a high level of formal education, "training" of cognitive functions by means of systematic solutions of mathematical and/ or verbal tasks, playing musical instruments, as well as high social activity. In addition, maintaining good cardiovascular health, stopping to smoke and drink alcohol
Signs and Symptoms of Alzheimer's
The gradual development of the symptoms of Alzheimer's disease often complicates timely diagnosis. Additional problems also arise from the fact that many patients try to ignore (or avoid) the initial manifestations of the disease. The most common sign of Alzheimer’s disease is one’s inability to retain newly learned information this is because Alzheimer’s develops in the part of the brain that affects learning. Over time, symptoms worsen, increasingly affecting the individual in their daily activities. Other major symptoms of Alzheimer's disease include:
- Memory disorders, forgetting familiar words, events, etc.
- Repetitive statements or questions
- Disorientation in time and space, confusion regarding life events
- Reduced concentration
- Loss of abstract thinking (in advanced stages of the disease as a function of broken concrete thinking)
- Loss of verbal skills (speaking and writing), difficulty in communicating up to the total loss of communicability
- Impaired ability to learn new skills
- Failure to plan and perform common tasks (in severe cases of Alzheimer's disease - a total loss of domestic skills, including personal hygiene)
- Changes in behavior and mentality (depressed mood, depression, anxiety, unstable mood, apathy, agitation, delirium, hallucinations, impaired phases of wakefulness and sleep)
- Unfounded suspicion about family and friends, common objects or people unrecognizable
- Rejection of fluids and food
- Involuntary urination and defecation, as a manifestation of the deep defeat the basic functions of the brain
Stages of Alzheimer’s Disease
Three main stages of Alzheimer’s exist; it is important to note that the symptoms overlap and so may be hard to distinguish the level of mental impairment. The stages are briefly described:
- Mild Alzheimer's disease (early-stage) – mild memory loss, forgetting names
- Moderate Alzheimer's disease (middle-stage) – this stage can last a few years, progressive memory loss, clearly noticeable mood changes
- Severe Alzheimer's disease (late-stage) – severe memory loss, poor communication, requires full time care
Diagnosis of Alzheimer's Disease
With a view to the diagnosis of Alzheimer's disease, the specialist clinic at HMC apply effective clinical and psychiatric tests, defining abnormal characteristics of intellectual abilities. A particularly important task is the differential diagnosis of the disease with other organic brain damage, as well as metabolic disorders that can cause a similar clinical picture.
Neurologists’ clinic at Herzliya Medical Center will conduct all the necessary laboratory tests and, if necessary, using the following diagnostic methods:
- Computer (CT) and magnetic resonance (MR) tomography scan of the brain. These are specialized diagnostic protocols for early Alzheimer's disease
- Positron emission tomography (PET-CT), which determines the level of metabolic activity of brain structures
Early diagnosis is critical in guiding the optimum treatment plan. There is no cure for Alzheimer’s, but early diagnosis can guarantee a better management of the disease, ease a patient’s anxieties and offer supportive services to the patient and their family, as well as providing further options in terms of future planning, participating in clinical trials and more.
Treatment of Alzheimer's Disease
Specialists at HMC develop individual treatment programs for patients with Alzheimer's disease. Complex therapy includes:
- The use of modern drugs to prevent the progression of degenerative changes of neurons, such as memantine (Namenda), donepezil (Aricept), galantamine (Razadyne) and rivastigmine (Exelon)
- Sedation and normalization phases of wakefulness and sleep
- Treatment for depression and anxiety
- Diet therapy and normalization of food
- Physiotherapy and occupational therapy for the preservation and restoration of motor function
- Train memory and thinking
A professional approach to the treatment of Alzheimer's disease is applied at Herzliya Medical Center in the Department of Neurology allowing patients to not only maintain independence, but also to return to a full and active lifestyle.