Alzheimer’s disease is synonymous
Synonyms: primary degenerative dementia, presenile and senile dementia = dementia, Alzheimer’s type
Definition of Alzheimer’s disease. An irreversible, progressive, degenerative disease of the brain with typical neurological changes (accumulation of senile plaques and tangles of thickened, spiral-shaped wriggling neurofibrils in the brain tissues), clinically – with loss of cognitive abilities (memory, thinking)
Epidemiology. The most frequent type of dementia in our country is more than 1 million patients, the increase in the number of cases due to the increase in life expectancy, as this is an age-related disease: the risk of developing in people over 65 is 2-6%, in people over 85 years old – 25-33% .
Etiopathogenesis of Alzheimer’s disease:
– Genetic factors: the 4th type of apolipoprotein E, presenilin-1. Changes in the 4th and 21st chromosomes in the presenile variant of Alzheimer’s disease; amyloid theory
– Pathological deposits: amyloid plaques, neurofibrillary tangles in the brain tissues -> nerve cell degeneration
– Increased production of amyloid beta-protein precursor; intracerebral deposition of hyperphosphorylated tau protein – Cholinergic deficiency (decrease in the level of acetylcholine, as well as serotonin and norepinephrine), an excess of glutamate
– Autoimmune process
– Cerebral adrenaline deficiency
Risk factors: age, 4th type of apolipoprotein E Decompensation of the main triggers may result, for example, change of residence, privacy, surgical intervention (anesthesia) and emotional stress.
Alzheimer’s disease classification:
• Early form (up to 65 years), late form (after 65 years)
• Inherited cases (only about 5%)
The main symptoms of Alzheimer’s disease are:
• In the beginning – protracted short-term memory disorders, abnormal thinking disorders, reduction of initiative and incentives
• Early symptoms of the non-cognitive sphere: discrete behavioral changes, passivity, emotional isolation, mood lability, loss of good faith and carelessness in everything, helplessness
• At the next stage, violations of cortical functions and neurological symptoms appear: amnesia, amnestic aphasia (word choice problems), acalculia (inability to count), apraxia, protopagnosis (inability to recognize faces); behavioral disorders (physical activity -> “runaway”); violation of perception, eating behavior; changes in the rhythm of day and night, symptoms of delirium
Important: At an early stage, one can observe a significant similarity of the clinical picture with the picture of depression (“depressive pseudodementia”). Significant problems of differential diagnosis: monitoring and treatment with antidepressants.