Stay away from Alzheimer's disease and keep good memories

Alzheimer's disease, also known as senile dementia, is a progressive, chronic neurodegenerative disease. Clinical manifestations include memory impairment, aphasia, apraxia, agnosia, visual-spatial impairment, abstract thinking and calculation impairment, executive dysfunction, and personality and behavioral changes. Alzheimer's disease is the most common type of senile dementia, accounting for about 50-70% of senile dementia, and is also one of the most common chronic diseases in the elderly.

Data show that the prevalence of this disease doubles with every 6.1 years of age increase, and the prevalence of the elderly over 85 years old can be as high as 20-30%. At present, there are more than 10 million patients with Alzheimer's disease in my country, accounting for a quarter of the total number of cases in the world, and an average of 300,000 new cases are reported each year. Alzheimer's disease is the most common disease that causes the elderly to lose their ability to live in daily life, and it is also the fifth leading cause of death in the elderly. The disease not only brings great pain to patients, but also brings heavy pressure and burden to families and society. Although there is currently no specific drug to cure the disease, we can reduce the progression of the disease in patients through drug therapy combined with cognitive rehabilitation training.

What are the symptoms of Alzheimer's disease?

01 Pre-dementia stage

The main manifestations are mild memory impairment, decreased ability to learn and retain new knowledge, and mild impairment of attention, executive function, language, and visual-spatial abilities, but it does not affect basic daily living abilities.

02 Dementia Stage

(1) Mild

The main symptom is memory loss. The first thing that appears is that you often forget what you do in your daily life and the items you often use, such as not being able to find your way home after going out, forgetting that you just ate, forgetting to take medicine, forgetting appointments with friends, etc. As the disease progresses, you may forget things and people that happened a long time ago. You lack initiative in doing things, and the time spent on daily housework is prolonged. You are prone to boredom and other negative states when facing unfamiliar and complicated things.

(2) Moderate

Memory is significantly reduced, and both long-term and short-term memory are significantly impaired. The knowledge and skills that have been mastered are reduced, the calculation ability is reduced, and even epilepsy occurs. Obvious personality and behavior changes occur, and the child will lose his sense of shame (such as urinating and defecating in public). He can only partially take care of himself and needs help from others.

(3) Severe

The patient's cognitive functions were severely reduced and he was completely unable to take care of himself. He lost the ability to take care of himself (eating, dressing, going to the toilet, etc.), lost his language ability, lost his ability to communicate, cried and laughed at random, stayed in bed all day, his limbs became stiff and paralyzed, and he became incontinent. He eventually died of complications of systemic diseases.

Tips

In the pre-dementia stage, patients only show forgetfulness and repeat the same questions, but their overall cognitive function remains intact. At this time, many family members do not pay attention to it, mistakenly thinking that this is a normal manifestation of aging. The pre-dementia stage is the best time to conduct cognitive training. Early detection, early diagnosis, and early intervention can bring early benefits.

What are the treatments for Alzheimer's disease?

01Drug treatment

Commonly used Western medicines include cholinesterase inhibitors (donepezil, rivastigmine and galantamine), glutamate receptor antagonists (memantine), etc. In recent years, the original sodium mannitol capsules in my country have also been approved for the treatment of mild to moderate Alzheimer's disease. Atypical antipsychotics (olanzapine, risperidone and quetiapine) are recommended for the treatment of psychiatric and behavioral symptoms.

Traditional Chinese medicine for the treatment of dementia is also gaining more and more attention from the industry at home and abroad. Acupuncture, Qinggong Shoutao Pills, Ginkgo Biloba Leaf Extract, etc. may be beneficial in improving mild Alzheimer's disease.

02Cognitive rehabilitation training

Cognitive rehabilitation training is an effective supplement to drug treatment. It can prevent and delay the progression of Alzheimer's disease, improve or preserve the patient's cognitive function as much as possible, enhance independent self-care ability, reduce dependence on others, and improve the quality of life of the elderly.

01One -to-one traditional cognitive training

Systematic training is provided for attention, execution, memory, language, perception, orientation, calculation, logical reasoning and problem solving, such as associative memory, number sorting, map recognition, block arrangement, object classification, etc., from easy to difficult.

02Computer -Assisted Cognitive Training

Through various cognitive training programs with instant feedback from human-computer interaction, patients' cognitive functions are comprehensively evaluated and personalized trained.

03Virtual Reality Technology

By building realistic three-dimensional scenes (such as supermarkets, kitchens, and communities) to carry out cognitive training, patients' interest and participation in cognitive training are increased.

04Rehabilitation Robot

Dual-task training that combines physical movement and cognitive function provides cognitive intervention in multiple areas.

05Physical Exercise

Patients should do appropriate aerobic exercise, such as ball games, aerobics, walking, swimming, yoga, Tai Chi or Ba Duan Jin, which are beneficial to improve the activity level of the central nervous system and better exert brain function. However, it is necessary to do it within one's ability and persevere.

06Neuromodulation Technology

Transcranial magnetic stimulation, transcranial direct current stimulation, etc. improve the cognitive function of Alzheimer's patients by regulating the excitability of the cerebral cortex.

07Daily Activities Training

The main purpose is to train the patient to complete various activities in daily life (such as eating, going to the toilet, traveling, taking medicine, etc.), and let the patient complete them alone as much as possible. If the patient can complete the designated task alone, then ask the patient to shorten the time to complete the task as much as possible.

08Team activities or discussions

Improve patients' overall cognitive and social functioning through non-specific means such as music and dance, crafts, themed discussions, group games, revisiting the past, and social groups.

Tips

Alzheimer's patients can achieve more obvious training results if they train for at least 30 minutes each time, at least three times a week, and for a total training time of more than 20 hours.

Who is more likely to develop Alzheimer's disease?

The cause of this disease is still unknown, but the following points may increase the risk of disease.

01 Age Age is the biggest risk factor. The older you are, the more likely you are to get sick. In China, the incidence rate for people over 65 years old is 6.6%, and one in four people over 85 years old is sick.

02 Heredity In addition to age, the most obvious risk factor is heredity. People who carry the gene mutation that causes Alzheimer's disease usually develop the disease before the age of 65.

03 Family history: The incidence rate among first-degree family members (parents, siblings) of patients with Alzheimer's disease is 3.5 times higher than that of ordinary people.

04 Gender: The disease rate in women is 20-30% higher than that in men, which may be related to women's longer life expectancy and lower estrogen levels in old age.

05Chronic diseases: cardiovascular and cerebrovascular diseases, hypertension, hyperglycemia, high cholesterol, high homocysteine, etc.

06Weight The increased risk of Alzheimer's disease is closely related to obesity in middle age and weight loss in old age.

07 Unhealthy lifestyle: smoking and drinking, lack of exercise, living alone and lack of interpersonal communication, etc.

08Other factors: low education level, hearing loss, history of brain trauma, etc.

Tips

Although age, genetics, family history, gender and low education level are immutable risk factors, chronic diseases, weight, lifestyle and hearing are all controllable risk factors.

Preventing dementia starts with a healthy lifestyle

01Quit smoking and drinking, and eat healthy

02Maintain weight and reduce the "three highs"

03 Cultivate interests and hobbies and maintain an optimistic mood

04 Strengthen physical exercise and engage in more social interactions

05 Wear hearing aids as early as possible to improve hearing

Author: Feng Liang and Gao Caiping, Tongji University Affiliated Yangzhi Rehabilitation Hospital

Chief Judge: Zhai Hua, Vice Chairman of the Science Popularization Working Committee of the Chinese Rehabilitation Medicine Association, Secretary of the Party Committee of Yangzhi Rehabilitation Hospital Affiliated to Tongji University

Illustration: Li Chuan, Editor: Zhu Jiaye, Department of Rehabilitation Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine

The popular science content of this platform has been funded by the China Association for Science and Technology's Science Popularization Department's 2022 National Science Literacy Action Project "National Society Science Popularization Capacity Improvement Project-Rehabilitation Science Popularization Service Capacity Improvement Action Plan"