Saturday, April 10, 2010

Dementia of the alzheimer type.

A slow and gradual deterioration of brain cells of a human is called dementia. The patient affected by dementia is unable to function normally. There are various causes for a person to get affected by dementia; it could be a brain injury this could be categorized as fixed cognitive impairment. The brain injury may cause irreversible but a fixed impairment. There is another way that dementia affects is slow progressive dementia.

Dementia which begins gradually and worsens progressively over several years, this is usually caused by neurodegenerative disease. In this condition generally the neurons of the brain gradually and slowly lose function and this is irreversible. Dementia leads to memory loss, loss of familiarity to the surroundings, repetition of actions and many other disfunctions. The patient with dementia does not behave as normal person anymore and to recognize that he/she is affected by dementia in the initial stage is quite difficult. If the symptoms occur for more than six months or so then it is possible to diagnose dementia.

The hormone melatonin (treating dementia).

The hormone melatonin, released by the pineal gland and considered important in regulating sleeping behaviour, has been cited as a beneficial supplement for patients with sleep disturbances.

Sleep disorders and disruptive nocturnal behaviour associated with dementia present a significant clinical problem. A characteristic pattern of sleep disturbance referred to as 'sundowning' has been described. This shows itself in increased arousal and activity, usually in the late afternoon, evening or night and is a cause of increased stress for carers.

There is considerable theoretical evidence to support the use of melatonin as a treatment for sleep disturbance associated with dementia. Melatonin is a hormone implicated in the control of the sleep-wake cycle. It is stimulated during darkness and suppressed by light. While the effects of melatonin have been extensively studied in animals, there is growing evidence that melatonin is also involved in the regulation and control of sleep and waking patterns in humans. Dementia appears to disturb these patterns.

One small but well conducted study evaluated the effect of bright light therapy in combination with melatonin or a placebo on restless behaviour. Bright light therapy was found to help restless behaviour, but the addition of melatonin negated the effect. Further research in the use of bright light therapy is necessary. A review found evidence to support the use of light therapy from four small studies, but again with calls for replication of the findings.

Therapy for alzheimer's disease.

Dietary supplements
Good diet is essential for health. The use of vitamins and other supplements is often considered CAM even though it may not technically be so.

Antioxidants
There is growing evidence demonstrating the effectiveness of these compounds, which are found naturally in fruit and vegetables, in preventing the development of Alzheimer's disease. Reviews of the existing work in this area have been done and several antioxidants have shown positive effects: in particular, vitamin E, selegiline and idebenone.

One study examined vitamin E (2,000 units daily), selegiline (10mg daily) and a combination of the two in Alzheimer's disease, for a two-year period. The results were positive, although there is some controversy over the way they were reported. There seemed to be fewer falls in the group taking vitamin E. The authors recommend replication of the study to confirm their positive results. A large study investigating the possible prevention of dementia in patients with mild memory problems by taking vitamin E daily is currently underway. A study of idebenone found it to have a positive effect in Alzheimer's disease, with a dose-dependent effect (a better effect with a greater dose). It was also found to be safe. Positive effect and safety remained good after two years on the supplement.

General nutrition
Weight loss in patients with Alzheimer's disease is a recognised problem. It seems to be due to lack of attention to proper nourishment rather than part of the disease process. Dietary supplementation can produce a significant increase in body weight amongst patients with dementia, as found in patients on a hospital ward. Nutritional awareness is important for elderly people in general: one study of 96 healthy individuals aged 65 or over found that dietary supplementation of vitamins and trace elements improved mental function.

Aromatherapy and Massage (treating dementia).

Aromatherapy is the therapeutic use of essential oils derived from plants. The oils are generally:

•Applied directly to the skin, often accompanied by massage
•Heated in an oil burner to produce a pleasant odour
•Placed in a bath.
The oils are concentrated and should be used according to instructions - they should be diluted before being applied to the skin, for example.

Research funded by the Mental Health Foundation in 2000 highlighted the potential benefits of aromatherapy, specifically the use of melissa officinalis, or lemon balm, in the treatment of Alzheimer's disease. Researchers at Newcastle University's Medicinal Plant Research Centre believe that lemon balm may help prevent the loss of the key brain chemical acetylcholine. The loss of this chemical is one of the changes associated with Alzheimer's. Lemon balm may then work in the same way as the first generation of drugs for Alzheimer's disease, Aricept and Exelon.

This research suggests that aromatherapy may have a more specific role in the treatment of Alzheimer's than aiding relaxation. It highlights the need for further research.

In 2002, a paper by Alistair Burns in the British Medical Journal added weight to the potential benefits of aromatherapy for people with dementia, used as an alternative to neuroleptic drugs.

There are many different types and schools of massage in existence, but common to them all is the tactile manipulation of the body's soft tissue using the direct contact of the practitioner.

There is some evidence that aromatherapy - either alone or in combination with massage - is effective in helping people with dementia to relax. One trial compared aromatherapy and massage, aromatherapy and conversation, and massage only. It found that excessive 'wandering' could be reduced by aromatherapy and massage in combination.

Another study investigated lavender oil on a hospital ward, and showed a reduction in agitated behaviour. The benefits of aromatherapy and massage and expressive physical touch (which generally includes gentle massage) have also been reported, although one review of a number of studies reported inconclusive findings.

Herbal medicine (dementia help).

Treatments that have been shown to be useful for people with dementia
Herbal medicine
Herbal medicine is the use of plants to restore or maintain health. Phytomedicine is a term often used to denote a more scientific approach to herbal medicine, where, for example, products are standardised and concentrated to contain specified amounts of the identified active substances in the herbal products. More rigorous research is also usually undertaken.

There is variation in the quality and, therefore, the levels of the active constituents of herbal products. Herbal medicines are generally regulated as foodstuffs or dietary supplements in the UK. As such, there is the potential for self-medication, as they can be bought over the counter from most health food shops. If you are interested in selfmedication, consult your doctor first and buy a recognised brand by a leading manufacturer.

Silymarin

Silymarin is an extract of milk thistle (silybum marianum L), a tall herb with prickly leaves and a milky sap. Native to the Mediterranean region of Europe, it is now naturalised in California and the eastern USA.

Silymarin is alleged to help the functioning of the liver. It may reduce the side-effects experienced with Tacrine (a conventional drug used to treat dementia, not available in the UK) that may cause liver problems. One study found that 420mg of Silymarin a day seemed to reduce the number of cases of liver toxicity in those taking it and found that the drug was well tolerated.

Choto-san

'Kanpo' is a Japanese variant of Chinese traditional medicine. The 'Kanpo' mixture Choto-san, which contains 11 medicinal plants, has been the subject of investigation. A research study found an improvement over 12 weeks in patients with vascular dementia taking Choto-san. Further research on this preparation seems warranted.

Kami-Umtan-To

Another Kanpo mixture, Kami-Umtan-To (KUT), which contains 13 different plants, has also been investigated. The KUT review reports that a clinical trial found a slower decline in the group given this preparation.

Yizhi capsule

The Chinese traditional herbal medicine Yizhi capsule (YZC) has also been the subject of investigation. Two studies used patients with vascular dementia. However, although both reported positive results, the studies were not of a high standard. Further research into this preparation also seems warranted.

Caring for the elderly (demetia).

As Alzheimer’s disease progresses, patients regularly lose the facility to express themselves, accelerating their feelings of isolation and discouragement. Communication problems can cause the inappropriate and agressive behaviors that can characterize Alzheimer’s patients. This may cause caregivers to feel concerned and depressed over their inability to speak with their family and friends. Learning easy techniques for conversing with Alzheimer’s patients can make this less difficult and thus improve the connection between caregivers and patients. To better communicate with Alzheimer’s patients, caregivers must first understand some of the challenges their family and friends face with the disease.

Because of their shortened attention spans, Alzheimer’s patients frequently become distracted and lose their train of thought. A boring conversation partner or a loud environment may impede their ability to have a productive dialogue.

Poor short term memory frequently causes them to repeat things they’ve already said. They may also forget what they were already told, annoying their conversation partner. It also takes much longer for them to verbalise what they are thinking, and they may not be able to grasp certain words. Finally, patients who are hard of hearing or legally blind, which are communication roadblocks in their own right, could find communication doubly annoying. When communicating with Alzheimer’s patients, it is useful for caregivers to keep these reservations in mind in order to communicate with their loved one from a place of compassion instead of impatience or tension.

While the restrictions that Alzheimer’s patients face in communicating are great, using some straightforward creative listening strategies can knock down plenty of the barriers between patient and caregiver. First, when conversing with Alzheimer’s patients, it is vital to keep in mind that they need to express themselves and may do so with their nonverbal expressions of emotion and behaviors as much as with their words.

These styles of communication shouldn’t be overlooked. Likewise, caregivers must listen nonverbally too with eye contact, a smile, or even through giving hugs.

Interrupting or disagreeing, which are obstacles to conversation in ordinary circumstances, can be especially exasperating for an Alzheimer’s patient, leading to disruptive behaviors. Caregivers must be patient and permit their loved ones additional time to communicate. Ultimately, it is vital to translate statements made by Alzheimer’s patients as both literal expressions and expressions of emotion.

Caregivers can also employ varied systems to boost their probabilities of being accepted by Alzheimer’s patients. They should create rapport first by introducing themselves and using the patient’s name. They should concentrate on fundamentals – talking slowly and clearly for short periods. If they have instructions to supply, they should break them down into manageable chunks that will not stress the patient’s attention span or memory.

Instead of using questions that need further reasoning from patients, they should ask yes or no questions. Instead of asking “How do you feel?,” instead ask “Are you feeling tired?” This recommendation runs counter to normal communication, but nonverbal communication and oral replies requiring simple words can speed communication with Alzheimer’s patients. Most significantly, caregivers should express themselves with love and concern rather than disappointment or impatience when talking with Alzheimer’s patients.

Dementia senile.

Alzheimer’s disease is an extremely upsetting form of dementia which can be characterized in numerous ways. It’s a progressive illness which worsens over time and is devastating to both the patient and their loved ones. Alzheimer’s disease can initially be subtle in its onset with just occasional lapses in memory and thought processes spotted by relatives and close friends.

Because Alzheimer’s is mostly found in older people, these “lapses” are often put down to age-related changes. On the other side of the coin, many older people have been misdiagnosed with Alzheimer’s disease when they have only age-related forgetfulness. In the earlier stages of Alzheimer’s disease, one of the classic symptoms is forgetting recent events or the names of people they know well. Solving math problems or a puzzle becomes too difficult for them. This may lead to frustration on the part of the individual who may realize there’s something wrong with them.

As the illness advances, these symptoms continuously worsen until ultimately the friends and family of the victim realize that something is seriously wrong. At this time, the patient may still be in complete denial. This makes it much tougher to get them to find help. In due course the issues related to Alzheimer’s disease become so bad they affect the person’s activities and daily living tasks. They may become so ill that they can no longer care for themselves. Even something as basic as cleaning their teeth, fastening buttons or tying shoelaces becomes too hard.

Eventually the person cannot think clearly at all. They do not recognize familiar faces or names. If english is their second language they lose their capability to communicate or understand it. They will also lose the facility to read and write. They frequently become totally uninterested in food, and caregivers will find it a nightmare making sure they’re kept well nourished. Eventually they may endure a radical personality change where they become agressive, use foul language and wander away from home. They may finally lose the power to walk. This is the stage where if they are still at home, the caregivers need to ask whether it might be fairer to both themselves and the Alzheimer’s patient for them to be cared for in a nursing facility.

At the time of writing, scientists haven’t yet discovered what really causes Alzheimer’s disease, though there is a lot of supposition. It is assumed that there’s possibly a mixture of factors. This would also account for why it’s so tricky to get a cure. It is also assumed that genetic factors can have a part to play.

It is said by a number of researchers that genetics plays a vital part in whether an individual will develop Alzheimers disease or not. It has been showed clearly that early onset Alzheimer’s disease (occurring between the ages of 30-60) is an inherited illness. So it’s a logical conclusion to reach. Although serious strides have been made into the study of Alzheimer’s disease, there’s sadly still a long way to go before a cure is discovered. Researchers still must study environment, health and diet before they can reach any positive conclusions. Now much of what’s “known” about Alzheimer’s disease is simply theory and guess work.