Alzheimer's disease

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Alzheimer's disease
SynonymsAlzheimer disease, Alzheimer's
Alzheimer's disease brain comparison.jpg
Comparison o a normal aged harn (left) an the harn o a person wi Alzheimer's (richt). Chairactereestics that separate the twa are pyntit oot.
SpecialtyNeurology
SymptomsDifficulty in rememmerin recent events, problems wi leid, disorientaition, muid swings[1][2]
Uisual onsetOwer 65 year auld[3]
DurationLang term[2]
CausesPuirly unnerstuid[1]
Risk factorsGenetics, heid injures, depression, hypertension[1][4]
Diagnostic methodBased on symptoms an cognitive testing after rulin oot ither possible causes[5]
Seemilar condeetionsNormal agin[1]
MedicationAcetylcholinesterase inhibitors, NMDA receptor antagonists (smaw benefit)[6]
PrognosisLife expectancy 3–9 years[7]
Frequency29.8 million (2015)[2][8]
Daiths1.9 million (2015)[9]
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Alzheimer's disease (AD), an aw referred tae semply as Alzheimer's, is a chronic neurodegenerative disease that usually stairts slawly an worsens ower time.[1][2] It is the cause o 60–70% of cases o dementia.[1][2] The maist common early symptom is difficulty in rememmerin recent events (short-term memory loss).[1] As the disease advances, symptoms can include problems wi leide, disorientation (includin easily gettin lost), muid swings, loss o motivation, nae managin sel care, an behavioural issues.[1][2] As a person's condition declines, thay eften widraw frae faimily an society.[1] Gradually, bodily functions are lost, ultimately leadin tae daith.[10] Awtho the speed o progression can vary, the teepical life expectancy follaein diagnosis is three tae nine years.[7][11]

The cause o Alzheimer's disease is puirly unnerstuid.[1] Aboot 70% o the risk is believed tae be genetic wi mony genes uisually involved.[4] Ither risk factors include a history o heid injures, depression, or hypertension.[1] The disease process is associatit wi plaques an tangles in the harn.[4] A probable diagnosis is based on the history o the illness an cognitive testing wi medical eemagin an bluid tests tae rule oot ither possible causes.[5] Ineetial symptoms are eften mistaken for normal agein.[1] Examination o harn tishie is needit for a definite diagnosis.[4] Mental an pheesical exercise, an avoidin obesity mey decrease the risk o AD; houiver, evidence tae support these recommendations is nae strang.[4][12] Thare are na medications or supplements that hae been shawn tae decrease risk.[13]

Na treatments stap or reverse its progression, tho some mey temporarily impruive symptoms.[2] Affectit fowk increasingly rely on ithers for assistance, eften placin a burden on the caregiver; the pressurs can include social, psychological, pheesical, an economic elements.[14] Exercise programmes mey be beneficial wi respect tae activities o daily leevin an can potentially impruive ootcomes.[15] Behavioural problems or psychosis due tae dementia are eften treatit wi antipsychotics, but this is nae uisually recommendit, as thare is little benefit wi an increased risk o early daith.[16][17]

In 2015, thare war approximately 29.8 million fowk warldwide wi AD.[2][8] It maist eften begins in fowk ower 65 years o age, awtho 4% tae 5% o cases are early-onset Alzheimer's that begin afore this.[3] It affects aboot 6% o fowk 65 years an aulder.[1] In 2015, dementia resultit in aboot 1.9 million daiths.[9] It wis first descrived bi, and later named efter, German psychiatrist an pathologist Alois Alzheimer in 1906.[18] In developit kintras, AD is ane o the maist financially costly diseases.[19][20]

References[eedit | eedit soorce]

  1. a b c d e f g h i j k l m Burns A, Iliffe S (Februar 2009). "Alzheimer's disease". BMJ. 338: b158. doi:10.1136/bmj.b158. PMID 19196745.
  2. a b c d e f g h "Dementia Fact sheet". World Health Organization. 12 December 2017.
  3. a b Mendez MF (November 2012). "Early-onset Alzheimer's disease: nonamnestic subtypes and type 2 AD". Archives of Medical Research. 43 (8): 677–85. doi:10.1016/j.arcmed.2012.11.009. PMC 3532551. PMID 23178565.
  4. a b c d e Ballard C, Gauthier S, Corbett A, Brayne C, Aarsland D, Jones E (Mairch 2011). "Alzheimer's disease". Lancet. 377 (9770): 1019–31. doi:10.1016/S0140-6736(10)61349-9. PMID 21371747.
  5. a b "Dementia diagnosis and assessment" (PDF). National Institute for Health and Care Excellence (NICE). Archived frae the original (PDF) on 5 December 2014. Retrieved 30 November 2014. Unknown parameter |deadurl= ignored (help)
  6. Commission de la transparence. Médicaments de la maladie d'Alzheimer [Drugs for Alzheimer's disease: best avoided. No therapeutic advantage]. Prescrire International. June 2012;21(128):150. PMID 22822592.
  7. a b Querfurth HW, LaFerla FM (Januar 2010). "Alzheimer's disease". The New England Journal of Medicine. 362 (4): 329–44. doi:10.1056/NEJMra0909142. PMID 20107219.
  8. a b GBD 2015 Disease Injury Incidence Prevalence Collaborators (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
  9. a b GBD 2015 Mortality Causes of Death Collaborators (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–544. doi:10.1016/S0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
  10. "About Alzheimer's Disease: Symptoms". National Institute on Aging. Archived frae the original on 15 Januar 2012. Retrieved 28 December 2011. Unknown parameter |deadurl= ignored (help)
  11. Todd S, Barr S, Roberts M, Passmore AP (November 2013). "Survival in dementia and predictors of mortality: a review". International Journal of Geriatric Psychiatry. 28 (11): 1109–24. doi:10.1002/gps.3946. PMID 23526458.
  12. "So, What Can You Do?" (in Inglis). National Institute on Aging. 29 Julie 2016. Archived frae the original on 3 Apryle 2017. Unknown parameter |deadurl= ignored (help)
  13. Primary and secondary prevention trials in Alzheimer disease: looking back, moving forward. Current Alzheimer Research. 2017;14(4):426–40. doi:10.2174/1567205013666160930112125. PMID 27697063.
  14. Systematic Review of Information and Support Interventions for Caregivers of People with Dementia. BMC Geriatrics. 2007;7:18. doi:10.1186/1471-2318-7-18. PMID 17662119.
  15. Forbes D, Forbes SC, Blake CM, Thiessen EJ, Forbes S (Apryle 2015). "Exercise programs for people with dementia". The Cochrane Database of Systematic Reviews (Submitted manuscript). 132 (4): 195–96. doi:10.1002/14651858.CD006489.pub4. PMID 25874613.
  16. National Institute for Health and Clinical Excellence. "Low-dose antipsychotics in people with dementia". National Institute for Health and Care Excellence (NICE). Archived frae the original on 5 December 2014. Retrieved 29 November 2014. Unknown parameter |deadurl= ignored (help)
  17. "Information for Healthcare Professionals: Conventional Antipsychotics". US Food and Drug Administration. 16 Juin 2008. Archived frae the original on 29 November 2014. Retrieved 29 November 2014. Unknown parameter |deadurl= ignored (help)
  18. Evolution in the Conceptualization of Dementia and Alzheimer's Disease: Greco-Roman Period to the 1960s. Neurobiology of Aging. 1998;19(3):173–89. doi:10.1016/S0197-4580(98)00052-9. PMID 9661992.
  19. Impact économique de la démence (English: The Economical Impact of Dementia). Presse Médicale. 2005;34(1):35–41. French. doi:10.1016/s0755-4982(05)83882-5. PMID 15685097.
  20. Economic Considerations in Alzheimer's Disease. Pharmacotherapy. 1998;18(2 Pt 2):68–73; discussion 79–82. doi:10.1002/j.1875-9114.1998.tb03880.x. PMID 9543467.