As international Alzheimer’s Month is observed in September, Dr Kim Laxton, a psychiatrist at Akeso Clinic highlights important Signs, symptoms, diagnosis, treatment methods.
Life expectancy is between 5 and 10 years after the onset of the initial symptoms of Alzheimer’s Disorder (AD)
Signs and symptoms:
In the early stages of the disease the patient often does not realise the memory concerns, and a family member is usually the first to notice subtle changes in the patient’s ability to function.
Over time the person may begin to display changes in their behaviour and personality. Wandering in the neighbourhood and during the night, as well as aggressive outbursts, become significant concerns for the family.
Essentially, over time, the patient requires increasing assistance from others to be able to perform simple activities of daily life, such as bathing, toileting and feeding.
The illness renders the patient dependent on others. In the early stages, they might feel confused, irritable and even depressed. Slowly but surely, previously basic tasks become more difficult. The patient may feel cumbersome and vulnerable.
Over time the patient may lose insight and struggle to function within their environment without the head knowledge that there is a decline in functioning. However, it is believed that, despite the deteriorating mental capacity of the patient, there is a deep sense of loss that parts of oneself are declining.
The diagnosis of AD is essentially a clinical one.
Diagnosis and treatment
A doctor, predominantly a neurologist, geriatrician and/or psychiatrist, will take a thorough history, perform a physical examination and administer bedside screening questionnaires, one being the Folstein’s Mini-Mental State Examination (MMSE).
It is important that the doctor treat any underlying medical and/or psychiatric illness that could potentially mimic the symptoms of Alzheimer’s Dementia, such as a major depressive disorder.
Blood investigations routinely performed are those for thyroid function, vitamin B12, syphilis and HIV screening. This forms an important part of the workup as certain illnesses, such as hypothyroidism, can be treated, thus improving the patient’s overall cognitive functioning.
The doctor may request that the patient has radiological investigations – such as a CT and/or MRI-Brain which may assist in excluding other neurological illnesses – to stage the disease, especially in the latter part of the dementing process.
The treatment of AD does not cure the illness but it may slow the progression of the disease. There are currently clinical trials underway in Johannesburg that are attempting to screen patients and intervene early in those who are susceptible to the disease and are in the earliest clinical stages of the illness. However, the inclusion criteria are very specific; both the patient and their support structure are interviewed and assessed methodically and regularly, prior to medication trial being administered.
Source: News24
