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Alzheimer’s Disease

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Dementia and Alzheimer’s Disease

Dementia is a syndrome caused by a disease of the brain, usually of a chronic or progressive nature, where there is an alteration of multiple superior cortical functions, including memory, thought, orientation, comprehension, calculus, learning ability, language and judgment. Conscience is not altered and alterations in the cognitive function are frequently joined, and occasionally preceded, by an impairment of emotional control, of social behavior or of motivation. In 2010 it was estimated that there were around 35.6 million people suffering from dementia, a figure that tends to rise with society’s progressive aging [1]. In addition to the patients’ personal deterioration and disability, the physical, psychological and socioeconomic impact on their relatives and on society’s financial and social resources must be taken into account.

Dr. Alois Alzheimer
Dr. Alois Alzheimer

There are many diseases which affect the brain, primarily or secondarily, and may cause dementia. The most important for its frequency and social impact is Alzheimer’s Disease, which causes around 60% of all dementias.. In Spain slightly more than 400.000 people are believed to suffer from this disease [2] and owing to the population’s increasing age, in 2030 this number could rise to 650.000. In economic terms, the yearly cost (for 2009) of dementia in our country was estimated to approach 14.000 million euros [3], of which about two thirds could be allocated to Alzheimer’s disease.

Less than 5% of Alzheimer’s cases are hereditary, linked to specific gene mutations. Many of these patients start showing symptoms before they are 60-65. Most cases (more than 95%) lack an evident cause and start late in life (from 60-65 years). It is known nowadays that Alzheimer’s disease may be active for years, even decades, before clinical symptoms begin to show and that the transition from a normal person to a dementia patient is gradual, with some intermediate stages (for instance, the so-called minor cognitive impairment) where the patients is n longer normal but still does not fit the pattern of dementia.

Alzheimer’s characteristic and essential symptom is the loss of episodic memory, appearing as the impossibility to retain new information. Atypical beginnings may occur with different symptoms to memory loss, but they are unusual. Other impairments start joining the progress of the disease (which is measured by years) such as difficulties in language expression and comprehension, loss of visuospatial abilities (for instance, to recognize images), of constructive abilities, of learned movement sequences (for example, to dress or to use common tolls such as cutlery or scissors) and of executive functions (such as problem solving, planning, strategy development and execution, response inhibitions)- Most patients also present psychological symptoms (for instance, depression, apathy..) and behavioral symptoms (such as aggressiveness, lack of inhibition). Cognitive changes alter day to day functions and the resulting disability increases with the disease’s progress to reach complete dependence on other for the maintenace of the most basic daily activities, such as hygiene and eating.

Diagnosis of dementia and, specifically, of Alzheimer’s disease is made by specialist doctors (usually neurologists, geriatrists and psychiatrists) who take into account the patients’ clinical profile and its evolution, neurological and complementary tests (such as blood tests, brain scan) and internationally acknowledged diagnostic methods.

Treatment of Alzheimer’s disease is currently administered in a selective form (not every patient benefits from treatment) with two types of medication: the non-competitive antagonists of N-methyl-D-aspartate and inhibitors of brain acetylcholinesterase, with partial success in improving cognitive, behavioral and functional aspects of the disease. There is also a wide range of non-pharmacological therapies, some of them with insufficiently proven effectiveness.

Nowadays a huge effort is being made by international research on every aspect related to Alzheimer’s disease. Although scientific progress appears slow it is also remarkable, and mechanisms which cause the disease are increasingly better understood. In the last few years there have been significant advances in specific diagnoses and consequently, important therapeutic improvements are also expected in the medium term.

References

  1. Dementia: A public health priority. World Health Organization 2012
  2. de Pedro-Cuesta J, Virues-Ortega J, Vega S, et al. Prevalence of dementia and major dementia subtypes in Spanish populations: A reanalysis of dementia prevalence surveys, 1990-2008. BMC Neurol 2009; 9: 55.
  3. Wimo A, Winblad B, Jönsson L. The worldwide societal costs of dementia: Estimates for 2009. Alzheimer & Dementia 2010; 6: 98-103.
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. 10.11.2017

Inauguración del VII Congreso Nacional de Alzheimer CEAFA

​Doña Sofía presidió la apertura de este encuentro, que durante tres jornadas reúne a cerca de 800 participantes con el objetivo de poner en común prácticas e informaciones sobre el alzhéimer y sus consecuencias, así como servir de punto de encuentro entre las personas que forman el tejido asociativo vinculado con el tratamiento de esta enfermedad.

The Alzheimer Project overcame society’s indiference."

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