Tuesday, 21st November 2017
BEAUTY Article
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This Month's Magazine
A common health problem with the elderly “Alzheimer’s disease”

A common health problem with the elderly “Alzheimer’s disease”

A patient suffering from AlzheimerÂ’s disease has a deficit that represents a significant decline in functioning, which must be severe enough to interfere with his work and his social life.

Older individuals can suffer the occasional difficulty in retrieving items from their memory (usually manifested as “word-finding” complaint); they can experience a slowing in their rate of information processing.

By contrast, dementia is an acquired persistent and progressive impairment of the intellectual function with a compromise in the multiple cognitive domains, one of which being memory.

A patient suffering from AlzheimerÂ’s disease has a deficit that represents a significant decline in functioning, which must be severe enough to interfere with his work and his social life.

Intellectual impairment in older patients is frequently the result of two other medical syndromes depression and delirium, each of these coexisting with “dementia”.

By comparison to younger patients suffering with this disorder, geriatric patients with depression are far more likely to have somatic complaints and are less likely to report their depressed moods and their feelings of guilt. The older patient is more likely to express his “delusions” in general about his life and that which is around him.

We should note that “Delirium” is an acute fluctuating disturbance of consciousness associated with a change in condition or the development of perceptual disturbance. These syndromes can coexist with Alzheimer’s or an underlying dementia.

Alzheimer’s disease typically presents itself with early problems in memory and “Visio spatial” difficulties, for example: becoming lost in familiar surrounds and the inability to copy a geometric line on a piece of paper.

Meanwhile, personality changes and behaviour difficulties such as wondering - agitation –inappropriate sexual behaviour may develop as the disease progresses.

To have a correct diagnosis what is needed is a neurological examination. This is essential with the emphasis on an assessment of the mental status. It is also important to note that drug effects can result in” diminished mental behaviour” in older patients, so a thorough examination in fundamental.


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Laboratory studies for most patients are intended to uncover treatable causes of cognitive impairment and should include a complete blood count:     

Electrolytes Calcium 
Creatine Glucose
HIV test  TSH and vitamin b levels 
Liver functionality    RPR

A CT scan or MRI scan can be of substantial help in showing focal neurological signs or symptoms.
Soon after a diagnosis is made the patientÂ’s family should be made aware of the problem and should program a care support. Education and counselling can prevent or delay the necessity for a nursing home placement.  As you can understand a medical evaluation is must with this disease.

Risk factors for” Alzheimer’s”

  • Old age
  • Family history
  • Higher risk for the female gender


Clinical features of dementia:

  • Language impairment: initially just word finding with later difficulty to follow a conversation and finally leading to mutism.
  • Apraxia: inability to perform previously learned tasks, such as cutting a loaf of bread - with the distraction of the intact sensory and the motor functionality. 
  • Agnosia: inability to recognise an object. 
  • Impaired executive function: poor abstraction, mental flexibility, planning and judgement.

 



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