The development
of multiple cognitive deficits such as manifested by both, Impaired
memory, long or short-term, can't learn new information or can't recall
information previously learned and is distinguished by:
one (or more) of the following cognitive disturbances:
Aphasia (language
disturbance).
Apraxia (impaired ability to carry out motor activities despite
intact motor function).
Agnosia (failure to recognize or identify objects despite intact
sensory function).
Disturbance in executive functioning (i.e., planning, organizing,
sequencing, abstracting)
The cognitive
deficits above each cause significant impairment in social or occupational
functioning and represent a significant decline from a previous level
of functioning.
The decline in mental functioning begins gradually and worsens steadily.
The cognitive deficits above are not due to any of the following:
Other central
nervous system conditions that cause progressive deficits in memory
and cognition (e.g., cerebrovascular disease,
Parkinson's disease, Huntington's disease, subdural hematoma,
normal-pressure hydrocephalus, brain
tumor).
Systemic conditions that are known to cause dementia
(e.g., hypothyroidism, vitamin B-12 or folic acid deficiency, niacin
deficiency, hypercalcemia, neurosyphilis, HIV infection).
Substance-induced conditions.
They aren't better explained by another Axis I disorder such as a
Depressive
Disorder or Schizophrenia.
Associated
Features:
Learning Problem
Dysarthria or Involuntary Movement
Hypoactivity
Psychosis
Depressed
Mood
Somatic
or Sexual Dysfunction
Hyperactivity
Addiction
Sexually
Deviant Behavior
Odd
or Eccentric or Suspicious Personality
Anxious or Fearful or Dependent
Personality
Dramatic or Erratic or Antisocial
Personality
Differential
Diagnosis:
Some disorders have similar or even overlapping symptoms. The clinician,
therefore, in his diagnostic attempt has to differentiate against
the following disorders which need to be ruled out to establish a
precise diagnosis.
Normal Process
of Ageing;
Delirium;
Schizophrenia;
Major Depressive Episode;
Factitious Disorder with Psychological
Symptoms.
Cause:
Alzheimer's Disease
is defined by the National Institute on Ageing as progressive, irreversible
declines in memory, performance of routine tasks, time and space orientation,
language and communication skills, abstract thinking, and the ability
to learn and carry out mathematical calculations. Other symptoms include
personality changes and impaired judgment. Although a direct cause
of Alzheimer's is not known certain common factors are found in the
clinical picture of suffers. These include; prior personality organisation
of the individual and stressfulness of their life situation.
Treatment:
Although there
is no cure for Alzheimer's, and various psychotherapies appear to
be ineffective, there are ways to treat some of the symptoms of the
disease:
Use of medications
to treat cognitive decline and memory loss.
Appropriate activities such as exercise, recreation, and adult day
care services appear to assist in the management of the patient.
Caregiving
[ See Caregiving
Issues Section ] :
At times, a person
may display behavior problems such as wandering, paranoia, suspiciousness,
combativeness or resistance to maintaining personal hygiene. These
behavioral problems can seem overwhelming to the caregiver. Suggest
strategies to assist in daily care giving tasks can consist of:
Enrolment in
the Alzheimer's Association's Safe Return Program, an identification
program for memory impaired adults.
Modifying the
person's environment in order to reduce confusion caused by over
stimulation such as reducing noise and bright lights.
Explaining a
task before you do it by such as saying, "I am going to help
you put on your shirt."
Providing a
predictable routine at home with structured time for meals, bathing,
exercise, and bedtime.
Providing reassurance
to the confused patient without challenging their accusations or
misperceptions and by redirecting their attention
If it appears
that the above situational strategies are not successful a combination
of situational activities combine with drug therapy to manage symptoms
of depression, restlessness, hallucinations, hostility and agitation
may be required
Pharmacotherapy
[ See Psychopharmacology
Section ] :
Cognex (tacrine
hydrochloride)
Aricept (donepexil
hydrochloride)
