| (Presenile dementia) |
| What is it? |
| A brain disorder characterized by gradual mental deterioration. A rapidly progressive form begins in adults around the ages of 36 to 45. A more gradual form, with slower development of symptoms, begins around ages 65 to 70. An estimated 5 to 10 percent of persons over 65 show some form of dementia. |
| Causes |
| Damage to or loss of brain cells for unknown reasons. |
| Signs and Symptoms |
| Early stages: |
| * Forgetfulness of recent events (loss of short term memory) |
| * Increasing difficulty performing common tasks, such as accustomed work, balancing a checkbook, or maintaining a household. |
| * Personality changes, including poor judgement. |
| Later stages: |
| * Difficulty performing simple tasks, such as choosing clothing, problem-solving. |
| * Failure to recognize familiar persons. |
| * Disinterest in personal hygiene or appearance. |
| * Difficulty feeding self. |
| * Belligerence and denial that anything is wrong. |
| * Loss of sexual and social inhibitions. |
| * Wandering away. |
| * Anxiety and insomnia. |
| Advanced stages: |
| * Complete loss of memory, speech and muscle function (including bladder and bowel control), necessitating total care and supervision. |
| * Extreme belligerence and hostility, or complete docility. |
| Risk Factors |
| * Family history of Alzheimer's disease |
| * Aging |
| Prevention |
| None known. |
| Diagnosis and Treatment |
| General Measures |
| * Caregivers are most important . Some of the patient's problem behaviour can be reduced by: |
| * Repetition: Patient with memory problem may benefit from frequent, simple reminders. |
| * Reassurance: A brief firm chat with a family member may help quell anxiety, verbal outbursts or agitation. |
| * Redirection: Distract the patient who is frustrated or agitated. A short walk or other diversion can be helpful. |
| * If a family member has this disease, don't take their hostility personally. |
| * Modify the home environment for safety. |
| * Have the patient wear an identification bracelet or neck tag, or clip identification onto clothing. |
| * If you care for a family member with this disease, try to obtain help so you can get away often. Don't feel guilty about needing a respite even if the patient resents it. |
| * Join a support group for families of Alzheimer's victims. Use adult day care where available. |
| * Beware of persons offering treatments for large sums of money. No legitimate treatment currently exists. |
| * Psychotherapy or counselling for family members. |
| * Nursing home care when home care becomes impossible. |
| Medication |
| * No medication is currently available to treat Alzheimer's disease, but many medications are being studied. Currently under investigation is tacrine, which has had mixed results to date. |
| * Some drugs are useful to control symptoms such as agitation. |
| * A follow-up with your family physician is very important. |
| Activity |
| As much as possible. As the condition progresses, all activity will eventually require supervision. |
| Diet |
| Choline and lecithin supplements are under study. Feeding assistance will eventually become necessary. |
| Possible Complications |
| * Decreased resistance to infections, especially pneumonia and meningitis. |
| * Seizures and coma (rare) |
| Prognosis |
| This condition is currently considered incurable and untreatable. It is usually fatal within an average of 7 to 10 years. Research into causes and treatment continues, so there is hope for eventual treatment and cure. |
