Alzheimer’s disease
NATIONAL JOURNAL OF HOMOEOPATHY 2003 Nov / Dec VOL V NO 6.
Dr CH Asrani
General Write-Up:
Dr C H Asrani begins with the General write up pf Alzheimer’s disease.
Alzheimer’s disease is a progressive, neurological disorder that attacks the
brain and results in cognitive problems, such as memory loss, impaired thinking
and strange behavior.
Overview of Alzheimer’s disease (for lack of Indian data we shall look at
American statistics):
- Approximately 4 million Americans have Alzheimer’s disease.
- One in 10 persons over 65, and nearly half of those over 85 have Alzheimer’s disease
- A person with Alzheimer’s disease lives an average of 8 years and as many as 20 years or more from the onset of symptoms.
- Alzheimer’s disease is the 4th leading cause of death in the United States.
- More than 7 out of 10 people with Alzheimer’s disease live at home.
Alzheimer’s disease is not just memory loss. People with Alzheimer’s disease experience a decline in cognitive abilities such as thinking and understanding as well as changes in behavior. The following 10 "warning signs" aid in the diagnosis of Alzheimer’s disease:
- Memory loss that affects job skills.
- Difficulty performing familiar tasks.
- Problems with language.
- Disorientation to time and place.
- Poor or decreased judgment.
- Problems with abstract thinking.
- Misplaced things.
- Changes in mood and behavior.
- Changes in personality.
- Loss of initiative.
Evaluation of patients with suspected Alzheimer’s disease:
- Detailed history
- Physical examination
- Neurological and mental status assessments
- Blood and urine tests
- ECG
- CT or MRI imaging of brain
Treatment
The medical and social management of Alzheimer’s disease is expensive and stressful to both the patient and the caregiver. In addition to treating the symptoms, difficult issues regarding the location and type of health care for the patient must be addressed. In India, family and friends provide almost 75 percent of home care for Alzheimer’s patients, at some point in the illness, home care may no longer be possible, with more and more families turning nuclear families.
The major challenge in managing Alzheimer’s disease is behavioral symptoms. Some patients become anxious or aggressive, while others repeat certain questions or gestures. Some of the most common problematic behaviors are:
- Agitation
- Aggression
- Suspiciousness/paranoia
- Delusions / Hallucinations
- Insomnia
- Wandering
Nonpharmacological (supportive) Treatments
- Family education and counseling: It is important that caregivers learn what to expect when caring for someone with Alzheimer’s disease. It is very easy to feel ‘he is doing it on purpose to harass me!’
- Modifying the environment: Each personality responds differently to their immediate environment. Lighting, color, and the noise level can all impact behaviors. The goal is to modify the environment in a way to reduce confusion, disorientation and agitation.
- Planning activities : Proper planning of activities (ie personal hygiene as well as creative leisure activities) can play an important role in providing both stability and independence to the Alzheimer’s patient. They can also help relieve depression, agitation and wandering.
He was a successful lawyer working well in to his early 70’s. A very active lifestyle. waking up at 6am everyday and going to bed at 10 pm. Apart from his official work, he was very social, outgoing and truly enjoyed his social responsibilities. He was deeply religious and took part in various religious functions as well.
One noticed an abrupt shift in behavior when one day he could not recognize his own daughter. Just minutes later, he acknowledged that it is amazing how he could have forgotten his own child. Later,similar incidents not only happened frequently but he did not seem to care about them or even remember anything. If pushed or if the family insisted that this person is your daughter /sister, wife etc he only got suspicious and aggressive.
A MRI was done which showed multiple infarcts in the Brain.
