Question

a. what are some therapeutic procedures for Alzheimer's disease?

b. What are some laboratory tests for Alzheimer's disease?

Answer 1

Alzheimer's disease is one of the most common type of dementia among elderly people. There will be impairment in memory, thinking judgement and other mental functions. It is a progressive disease. There is intellectual deterioration which will interfere with the occupational or social performance of the individual, eventually progressing to affect his daily tasks. The deterioration will be happening in every areas of cognition like memory and language calculation, perception, judgement, abstraction or personality.

The abnormal changes in the brain like neurofibrillary plaques and neuritic tangles are responsible for bringing the deterioration in intellectual and cognitive functions. These plaques and tangles are pathologic characteristics of Alzheimer's disease.

a. Alzheimer's disease can not be cured with medications. But some medications will help to relieve some of the symptoms. That include Cholinesterase inhibitors and Memantine.

Cholinesterase inhibitors: This will inhibit the breakdown of acetylcholine which is a neurotransmitter, acting as a chemical messenger. Thus it will be helpful to make more Acetyl choline to be available for nerve impulse transmission. These drugs can also improve symptoms like agitation, depression etc.

Examples are Donepezil (Aricept), Rivastigmine(Exelon), Galantamine(Razadyne)

Some side effects can occur like Loss of appetite, nausea, diarrhea, sleep disturbances.

Memantine(Namenda) : This drug also helps to slow the progression of symptoms. It can be used for improving memory and attention. Mematine also can be used in combination with cholinesterase inhibitors. Side effects occur rarely including dizziness and confusion.

Low dose antipsychotic agents like Haloperidol can be given for agitation and confusion. Antidepressants are also given to manage depression.

Besides all these drugs we need to provide a safe, familiar and comfortable environment for the client. Decrease the environmental stimuli. Use effective communication strategies.

b. Laboratory test for Alzheimer's disease

No lab tests are available to diagnose Alzheimer's disease. But some tests or procedures can be used to detect the causes of dementia in Alzheimer's disease.We can collect personal and family history, conduct physical examination and some neuropsychological tests.

1. Blood tests : To detect thyroid disorders, vitamin deficiencies etc.

2. Brain imaging : This will help to detect tumours, stroke, evidences of trauma or brain atrophy. It may include the following procedures:

MRI (Magnetic Resonance Imaging ) : MRI give more anatomically detailed pictures than with CT.

CT(Computerized Tomography ) : It will help to detect intracranial bleeding, cerebral edema, infarctions, hydrocephalus, cerebral atrophy, space occupying lesions etc.

PET imaging (Positron emission tomography) : It helps to visualise the physiological function in the body areas.It helps to determine the amount of blood flow to specific body tissues, shows how does tissues use blood or nutrients, able to map specific receptors.

Fluorodeoxyglucose (FDG) PET scan, Amyloid PET imaging, Tau Pet imaging are different varieties coming under PET imaging.