Alzheimer's disease
Introduction
Introduction to Alzheimer's Alzheimer's disease (Alzheimers disease), also known as Alzheimers disease (AD), is a primary degenerative brain disease that occurs in old age and early age. It refers to a persistent high-grade neurological activity disorder. In the absence of disturbance of consciousness, memory, thinking, analysis and judgment, depending on obstacles in spatial recognition and emotions. Its characteristic pathological changes are atrophy of the cerebral cortex, accompanied by -amyloid (-AP) deposition, neurofibrillary tangles (NFT), a large number of memory neurons, and age spots. The formation of (senileplaque, SP). basic knowledge The proportion of illness: 0.02%-0.08% Susceptible people: the elderly Mode of infection: non-infectious Complications: aspiration pneumonia, acne, constipation, fracture
Cause
Causes of Alzheimer's disease
Brain degenerative diseases (45%):
There are many kinds of dementia caused by brain degenerative diseases. The most common one is Alzheimer's disease dementia. In the early stage of senile, it is also called Alzheimer's disease, and its onset is slow, which is progressive progressive dementia. There are also Pico disease, Tinton's chorea dementia, progressive supranuclear palsy, Parkinson's disease dementia, etc. These latter dementias are relatively rare.
Cerebrovascular disease (15%):
The most common form of multiple cerebral infarction dementia is caused by a series of multiple mild ischemic attacks, multiple accumulations caused by a substantial brain infarction, in addition to subcortical vascular dementia, acute episodes of cerebrovascular disease Dementia can rapidly develop into dementia after a series of cerebral hemorrhage and cerebral embolism, and a small number can also be caused by a large area of cerebral infarction. In short, cerebrovascular disease is also a common cause of senile dementia.
Genetic factors (25%):
Many studies at home and abroad have proved that the offspring of patients with Alzheimer's disease have more chances to develop the disease, but its genetic pattern is still unclear. Some people think it is dominant gene inheritance, while others think it is recessive gene inheritance. It is considered to be multi-gene autosomal recessive inheritance, and genetic effects can be restricted by environmental factors and mutations of genetic factors, so that its genetic effects are interrupted. Some studies also suggest that elderly people are non-genetic diseases, such as vascular dementia and heredity. Direct relationship.
1, endocrine disorders: such as hypothyroidism and parathyroid hypothyroidism may cause dementia.
2, nutrition and metabolic disorders: due to nutritional and metabolic disorders caused by brain tissue and its function damage caused by dementia, such as various organs caused by encephalopathy, such as renal encephalopathy, is chronic renal failure, uremia caused by the brain Ischemia, hypoxia, can lead to dementia, other such as hepatic encephalopathy, pulmonary encephalopathy, etc. can lead to dementia, severe nutritional deficiencies, such as vitamin B1, B12 and niacin, folic acid deficiency can lead to dementia, diabetes and high fat Hypertension can cause atherosclerosis in large and middle arteries, thickening of small blood vessels and microvascular basement membrane, which can cause cerebral infarction and cerebral hemorrhage, leading to vascular dementia.
3, tumor: malignant tumor caused by metabolic disorders can lead to dementia, brain tumors can also directly damage brain tissue leading to dementia.
4, drugs and other substances poisoning: alcoholism, chronic sprinkling poisoning caused by senile dementia is not uncommon, the middle is still not recognized by people, long-term exposure to aluminum, mercury, gold, silver, arsenic and lead, etc., poor protection, Caused by chronic poisoning can lead to dementia, carbon monoxide poisoning is also one of the common causes of acute dementia.
5. AIDS: AIDS is one of the causes of Alzheimer's disease. It is known that elderly people with progressive AIDS can develop progressive AIDS, and it has been shown that the central nervous system can directly infect human immunodeficiency virus (HIV).
6, syphilis: Treponema pallidum can invade the brain, produce mental and neurological symptoms, and finally lead to paralysis and increasing mental retardation and personality changes, the so-called paralytic dementia.
7, other: brain trauma, epileptic seizures, and normal stress hydrocephalus and other causes can cause Alzheimer's disease, in addition, the elderly long-term emotional depression, out of the group, widowed, illiterate, low language level, lack of physical and mental strength Exercise, etc., can also speed up the process of brain aging and induce Alzheimer's disease.
Prevention
Alzheimer's prevention
Prevention of Alzheimer's Disease Because of the different causes of dementia, the methods of prevention are different, mainly in the following aspects:
1. Improve the working environment.
2, avoid alcohol and quit smoking.
3, diet regulation: not only to prevent high-fat foods caused by elevated cholesterol, but also to take the necessary nutrients, such as protein, inorganic salts, amino acids and multivitamins, especially vitamins B1, B2 and B6, vitamin C and vitamins E is very important to the elderly.
4. Keep your spirits happy for longevity and mental health.
5. Arrange for life and study: When you are old, you must continue to learn new knowledge and maintain extensive contact with the society.
6. Before retiring, be mentally and mentally well prepared, rich in life content, wide-ranging interests and hobbies, can promote mental activity, and delay or alleviate the process of aging.
7. Regular physical examinations to treat physical illnesses early, pay attention to your body, and do not pay too much attention or worry.
8, regular outdoor activities: the elderly are suitable for more sustainable, more sports, such as walking, jogging, gymnastics, Tai Chi, Tai Chi sword and traditional dance.
The treatment of AD mainly uses acetylcholinesterase (AchE) and anti-inflammation, anti-oxidant and other symptomatic treatment drugs to temporarily relieve the cognitive decline of patients.
The Japan Association for the Prevention of Dementia recently invited experts in dementia medicine to develop eight key tips for preventing Alzheimer's disease:
First, a balanced diet, avoid excessive intake of salt and animal fat, one day salt intake should be controlled below 10 grams, eat less animal fat and sugar, protein, dietary fiber, vitamins, minerals, etc. should be balanced Ingestion.
Second, moderate exercise, maintaining the strength of the waist and feet, the movement of the hand is also very important, often doing some complicated and exquisite handwork will promote the vitality of the brain, cooking, writing diaries, playing musical instruments, painting, etc. have prevention of dementia effect.
Third, avoid excessive drinking, smoking, regular life, excessive drinking can lead to liver dysfunction, causing abnormal brain function. People who drink more than 0.3 liters a day are more likely to have cerebrovascular dementia than ordinary people. Smoking does not only cause cerebrovascular disease. Dementia is also an important cause of dangerous diseases such as myocardial infarction.
Fourth, prevention of arteriosclerosis, hypertension and obesity and other lifestyle-related diseases, early detection, early treatment.
Fifth, be careful not to fall, head injuries can lead to dementia, elderly people should use crutches when necessary, always maintain a high degree of interest and curiosity about things, can increase people's attention, prevent memory loss, the elderly should do more Some things of interest and participation in public welfare activities, social activities, etc. to strengthen the brain nerves.
Sixth, we must actively use the brain to prevent mental decline. Even when watching a TV series, you can express your feelings at any time to achieve the purpose of using your brain power. Reading and publishing, playing chess, writing diaries, writing letters, etc. are simple. A method that helps the brain.
Seventh, pay attention to people at any time, maintain good interpersonal relationships, and find their own survival value.
Eighth, keep a young heart and dress yourself properly.
Complication
Alzheimer's disease complications Complications, aspiration pneumonia, constipation fractures
1, excessive or insufficient diet, causing gastrointestinal discomfort, bleeding, and even perforation.
2. Water and electrolyte disorders.
3, due to difficulty swallowing, easy to have aspiration pneumonia or asphyxia.
4, long-term bed is prone to hemorrhoids, constipation or thrombosis, embolic disease.
5. Trauma or fracture.
6, large, urinary out of control, easy to cause urinary tract infections.
Symptom
Symptoms of Alzheimer's Dementia Common Symptoms Reduced daily living ability... Recent events, forgetting phenomenon, dullness, forgetfulness, large cognitive dysfunction, memory impairment, heart and brain insufficiency, mental disorder, forgetfulness, aphasia, ataxia
1, memory disorders, the first symptom of senile dementia is memory impairment, mainly for the recent memory of forgetfulness, such as the same content will be immediately forgotten if he tells him several times, just put the things you just left, and forget the position When the dishes have been let go, the salt has been released for a while, and the things that have just been bought are forgotten. The friends who have just been introduced have once again seen the scenes because they forgot their names, but for the past, The events that have been deeply impressed, such as the wars that have been experienced in the past, the political activities that have been participated in, the lost relatives, etc., have better memory, that is, the so-called long-term memory remains better, but with the development of the disease, the long-term Memory will also be lost, misunderstandings, fiction and delusions will occur. For example, what happened in the past is said to be happening now, and several unrelated things are strung together, Zhang Guan Li Dai, and even one piece will be mentioned from beginning to end. There are no things that have happened at all. When the memory barrier is the most serious, it is manifested as not knowing your own relatives, and even the self in the mirror or photo does not know.
2. The directional power of time and place is gradually lost. For example, I dont know what year, month, and day, today, I dont know where I am, I cant find a home when Im home.
3, the ability to calculate the obstacles, the speed of the calculation is significantly slower, can not complete a slightly more complex calculations, or often very obvious errors, even in the case of serious additions and subtractions can not be carried out, and even the concept of safety loss.
4. The decline in comprehension and judgment is manifested in the inability to correctly understand the things around, directly affecting the reasoning and judgment of things, and the inconsistencies between the primary and secondary, whether they are essential or non-essential, and therefore cannot Handle the problem correctly.
5, language barriers, light words, repeated content, chaotic, unclear, heavy questions are not asked, content is a thousand miles, unintelligible, or often self-talk, content fragmentation, or silence, loss of reading ability.
6, thinking emotional barriers, thinking often appear fragmentary, major events are ignored, trivial things are entangled, accompanied by emotional dullness, indifferent to people, gradually developed into completely absent but expressionless, or pediatric euphoria symptoms are prominent Some have hallucinations, such as auditory hallucinations, illusions, etc.; some appear fragmentary delusions, such as delusions, being stolen and delusional, exaggerating delusions.
7. Personality and personality change, most of which are selfish, subjective, or irritable, irrational, or anxious, suspicious, and some people appear to be unsociable, self-centered, not interested in things around, lack of enthusiasm, Compared with the pre-onset, it is judged as two people.
8, behavioral disorders, early manifestations of behavioral disorders based on forgetting, such as forgetting things, lost items, lost lost, etc., in the medium term, manifested as behavioral abnormalities related to thinking disorder and personality changes, such as staying up late, I wandered around, noisy; I dont know how to be warm and cold, I was dressed in disorder, even wearing clothes as a trousers, wearing a hat as a sock; not being hygienic, not discerning, even playing with me; not knowing respect, not being divided into men and women, even having sexual desire Propensity.
9, mobility disorders, slow movements, unstable walking, hemiplegia, even bedridden, incontinence, can not eat on their own, and ultimately die.
Examine
Alzheimer's examination
1. There was no significant change in laboratory tests.
2, EEG can see non-specific diffuse slow wave, wave rhythm slows, the amplitude becomes low; in severe cases, both sides can simultaneously issue a 0.5 c / s sharp wave, cerebral blood flow diagram, local cerebral cortex The cerebral blood flow is reduced and the cerebral oxygen metabolism rate is decreased.
3, brain CT scan or MRI often show varying degrees of ventricular enlargement and cortical atrophy, sulcal widening.
Diagnosis
Diagnostic identification of senile dementia
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory findings.
Differential diagnosis
1. Mild cognitive impairment: only memory impairment, no other cognitive impairment; some patients may be early manifestations of AD.
2, depression: early AD can be similar to depression, such as depression, lack of interest in various things, memory disorders, insomnia, fatigue or weakness.
