Alzheimer Dementia in Dubai
You fear having Alzheimer’s Dementia? You are suffering from memory loss? You have difficulties to concentrate? Don´t be afraid. To forget things doesn’t mean you are already suffering from Alzheimer Dementia. But what is Alzheimer Dementia actually?
Alzheimer´s Dementia is a chronic disease of the brain which starts slowly with mild symptoms. One symptom alone is not enough to justify the diagnosis. To forget some things some time does not make an Alzheimer´s Dementia. With ongoing age it is totally normal that your memory becomes worse. When you are 60 years it is more difficult to memorize information than with 50, and with 70 it is more difficult than with 60. That means you forget always a bit more becoming older in a natural way. It is very individual how much and how fast this process is ongoing. This depends on your gens, your general health situation, your environment you live in and your education. In scientific papers is was found that people with high education, university degrees or a sophisticated job, so called “brain workers”, get Alzheimer´s disease more seldom and later than people who work more physically. Our brain has a lot of resources to compensate deficiencies. And a well-trained brain does it better than a “lazy” brain.
There is not only one disease causing dementia. There are different kinds of dementia diseases like Alzheimer, vascular dementia or Lewy Body Disease Dementia. The syndromes of dementia can also be caused by other diseases like stroke, Parkinson, Hydrocephalus, brain tumor and others. It is the task of a neurologist to find out whether a person is suffering from dementia and if so, which kind. The most common dementia disease is the Alzheimer´s disease. Second most common form of dementia is the vascular dementia or a combination of Alzheimer’s Dementia and Vascular Dementia.
In early stages of Alzheimer´s Dementia patients are not only suffering from decline of memory but also other symptoms. People seem to be depressed because they realize their increasing problems. They feel tired, exhausted and try to avoid intellectual demanding tasks. Already in early stages of Dementia people are changing their behaviour. They are losing interest in things which were important for them before, like their job or hobbies. Patients suffering from dementia are avoiding social contacts, they want to be alone or only with very close persons like family members. The surrounding feels that something is wrong. First it is yet too little to talk or to worry about. There are always excuses to explain the changes. Then when the difficulties become more evident people feel unsecure how to talk about. Alzheimers Disease is stigmatized and for both sides it is difficult to face the facts. For the suffering person the same as for the family members or friends.
It is important to have a clear diagnosis to either stop worrying or to take action. However, in early stages it can be difficult to differentiate between forgetfulness of age and an early stage of a dementia disease. There are special cognitive tests a neurologist can apply to find out whether the memory alteration is still in age range or not. If there are symptoms of an alteration more than “what is allowed”, further investigations have to be done.
Other diseases like depression, burn out syndrome caused by too much stress, physically exhaustion and other corporal diseases have to be excluded. But how to find out whether a person is suffering from dementia?
First of all go to your neurologist and talk to him about your problems. Already by talking to a patient the doctor gets a first impression. He doesn´t only hear the complaints themselves. Important are also the duration and the progression of the problems. The way how a person speaks, the signs of memory disturbances in conversation, indication of aphasia, disturbance of time or local orientation, all this might already show first straits of a beginning dementia. The doctor also watches the spontaneous behaviour to form his opinion weather it is adapted to the situation or not. It is also important to listen to family members or other close persons. Maybe they have more information the patient eventually already forgot. Or they have another view of the changes the patient did undergo.
Next step are different cognitive tests. For example the worldwide used MMSE (Mini Mental State Examination), a psychometric test to prove orientation, retentiveness, alertness, speech, memory and other function. The neurological examination gives information about the different systems of the brain, peripheral nerves and muscles. Reflexes, speech, gait and locomotor system sensibility, vision, balance and the cranial nerves are checked. It is important to look whether there are any signs which could give an advice for another disease than dementia causing the problems. Blood tests, more seldom examination of the CSF (cerebrospinal fluid) were done. The CSF is the liquid the brain and the spine are covered with all over. In this CSF special peptides can be found which indicate an Alzheimer Disease (Tau-peptide, A beta-peptide).
EEG (electroencephalography) is an examination which does not hurt, comparable to the ECG (electrocardiogram) of the heart. It gives a good overview of the global cerebral function. Other electrophysiological test like AEP (acoustic evoked potentials) or SEP (sensible evoked potentials) can give more information about a lesion in the nervous system to exclude another disease. Also ultrasonic investigations of the cerebral blood flow are part of the diagnostic procedures. The neurologist will send the patient to the imaging of the brain by MRI or CT. In early stages of dementia there are no specific signs for the disease. In more progressed stages you can find signs of atrophy in special parts of the brain (in the temporal area hippocampussklerosis). But the most important reason for the imaging in early stages is again to exclude other diseases which have to be treated in a different way and which might be healed.
Therapy of Alzheimer disease is possible. With medication it is achievable to decelerate the progress of the disease, to stabilize the memory, concentration and basic life skills. In Alzheimer Disease nerve cells and nerve cell connections decay which cannot get restored. In consequence of the decay of the nerve cells the messenger substance Acetylcholine decreases. A special kind of medication, the so called “cholinesterase inhibitors”, compensates partly the deficit. By this the information processing improves again. There are other substances which influence the cerebral metabolism in a different way which might also have stabilizing effects on the cognitive functions. Coexisting symptoms like depression, sleeping disorders, anxiety or restlessness have to be treated with other drugs beside the special dementia medication.
Very important is the right contact and handling with the affected person. Lots of patience and sympathy, a quiet surrounding and good information for understanding the disease and the behaviour of the patient are absolutely essential. It is difficult and very exhausting to care for somebody in a more advanced stage when the person needs help in daily activities, in personal hygiene, in nutrition and needs observation the whole day. The family should use all the help and frontline services they could get or attend support groups.
© GNC, German Neuroscience Center Dubai (Neurology, Psychiatry, Psychology, Counseling, Dubai, UAE)