Is Alzheimer's disease really just confusion?

Aunt Huang was smart and capable when she was young, but after retirement she stayed at home all day, depressed, forgetful, and often lost things. If she couldn't find something, she would suspect that someone around her had stolen it. She would often get angry over trivial matters, and was completely different from when she was young. Eight years later, she forgot about herself, couldn't take care of herself, and even played with her own feces. Only then did her family realize that she was in trouble and sought medical treatment, and the doctor diagnosed Aunt Huang with late-stage Alzheimer's dementia.

The latest data shows that there are 55 million dementia patients in the world, and a new case is diagnosed every three seconds, of which 60-80% are caused by Alzheimer's disease. There are currently about 10 million Alzheimer's disease patients in my country, and it is expected that by 2050, there will be more than 40 million, which will bring heavy care and economic burden to society. So what is Alzheimer's disease? How can we identify and prevent Alzheimer's disease?

What is Alzheimer's disease

Alzheimer's disease is a degenerative disease of the central nervous system that occurs in the elderly and pre-elderly, characterized by progressive cognitive dysfunction and behavioral impairment, leading to a significant decline in daily life, work ability and social interaction. It is mainly manifested by abnormal cognitive function and mental behavior, and is another major disease that causes disability and death in the elderly after cardiovascular and cerebrovascular diseases and malignant tumors.

What are the risk factors for Alzheimer's?

1. People with low education level

2. Hearing loss

3. Head trauma

4. People with high blood pressure

5. Obesity in middle age

6. Excessive drinking (drinking more than 21 U per week or long-term drinking)

7. Smoking

8. Depression in the elderly

9. Lack of physical activity

10. Reduced social contact

11. People with diabetes

12. Environmental factors: air pollution (NO2, PM2.5)

How is Alzheimer's disease treated?

There is currently no cure, and the disease is mainly treated with medication to slow disease progression, control symptom exacerbation, and rehabilitation training to improve and enhance physical function to make patients more comfortable.

How to identify the top ten danger signs of Alzheimer's disease and be alert to Alzheimer's disease?

Memory gradually declines, affecting daily activities (such as adding salt twice when cooking and forgetting to turn off the gas after cooking).

Difficulty handling familiar things and difficulty in performing daily household chores (such as not being able to use chopsticks when eating and the steps of cooking).

Difficulty expressing oneself (forgetting simple words, speaking or writing sentences that are incomprehensible).

Growing confusion about time, place, and people (can’t remember what year it is, what day of the week it is, what province I’m in).

Judgment ability gradually declines (wearing a cotton jacket under the scorching sun and thin clothes in the cold winter).

Decreased ability to comprehend or organize things (difficulty following a conversation or paying bills on time).

Often puts things in inappropriate places (puts the iron in the washing machine).

Emotional instability and behavior appear abnormal compared to before (such as rapid mood swings and becoming moody).

There is a change in personality, becoming suspicious, indifferent, anxious or rude.

Loss of motivation to do things (wasting time all day and no interest in previous hobbies).

Can Alzheimer's disease be prevented? The answer is yes. As long as you take the following preventive measures, you can easily stay away from Alzheimer's disease.

01 Receive education as early as possible and increase the opportunities for adults to receive education. 02 Prevent cerebrovascular diseases

Have regular physical examinations every year to check blood lipids, blood sugar, and blood pressure to prevent hypertension, high blood lipids, high blood sugar, arteriosclerosis, and stroke.

03Intelligence training

As the elderly age, their organs will gradually decline and their brain cells will no longer be active. They should participate in more mental activities, read more books, play chess, etc., to make their brain cells active and prevent diseases more effectively.

04 Take care of your mental state, maintain an optimistic mood, avoid long-term depression and depression, and avoid mental stimulation.

05 Cultivate the interests of the elderly, maintain interpersonal relationships, and participate in more social activities, such as birthday parties, holiday celebrations, etc.

06Physical Exercise

Perform aerobic exercise 2-3 times a week, each time lasting more than half an hour at moderate intensity, or 75 minutes per week at high intensity. You can do walking, cycling, Ba Duan Jin, Tai Chi exercises, etc. At the same time, you should also move your fingers as much as possible.

07Develop good sleeping habits.

08 Eat a healthy diet and pay attention to "three determinations, three highs, three lows and two taboos"

"Three determinations" means eating at regular times, in regular quantities and of regular quality; "three highs" means food high in protein, high in unsaturated fatty acids and high in vitamins; "three lows" means food low in fat, low in calories and low in salt; and "two quits" means quitting smoking and drinking.

09Preventing brain trauma

10. Treat hearing loss promptly

Use hearing aids to reduce hearing loss.

11. Avoid air pollution

12. Know the preclinical signs of disease

The patient feels that his or her subjective cognitive level has declined compared to before, such as a feeling of memory loss. He or she is very worried about this feeling, and it persists. The patient and family members who are familiar with the patient should work together to proactively go to the hospital's geriatrics, neurology, psychiatry/psychology, or memory clinic to seek neuropsychological scale screening, positron emission tomography PET, or Αβ examination.

What are the rehabilitation care for Alzheimer's disease? Daily life care

Guide and encourage patients to do simple things, give them opportunities to take care of themselves as much as possible, train them to take care of themselves, and help them restore their original optimal functional state. For patients who need assistance in self-care, take care of their daily life, such as dressing, eating, and sleeping.

Medication care

Accompany your patient throughout the medication process, observe adverse drug reactions after medication, and do a good job of drug management.

Intelligent rehabilitation training

Memory training, intellectual exercise, comprehension and expression ability training.

Safe care

The living environment should be safe and relatively fixed, with a dedicated person to accompany the patient. When going out, wear anti-lost equipment and keep the belongings safe. When the mental and behavioral symptoms worsen and the patient impulsively hurts others or destroys property, appropriate protective restraint and isolation should be given.

Psychological care

Accompany, care for, and enlighten the elderly, pay attention to maintaining the patients' self-esteem, and do not despise the elderly.

Carers Support Training Guide

Teach caregivers and other family members how to relax themselves, get enough rest, seek social support, make appropriate use of the resources of housekeeping service agencies, community health service agencies, hospitals and specialized agencies, and organize families with dementia patients to communicate, connect and provide emotional support.

In short, Alzheimer's disease is not scary, but it is neither senile confusion nor an inevitable symptom of aging, but a preventable and controllable disease. Let us work together to correctly identify the ten danger signs of Alzheimer's disease, prevent, detect, diagnose and treat it early, press the pause button on Alzheimer's disease, delay the development of the disease, preserve the patient's quality of life, and allow the patient to age gracefully.

References:

[1] Li Yajie, Wang Meijie, Cui Xiaomin, Li Bo. Interpretation of the 2020 Lancet Committee Guidelines on Dementia Prevention, Intervention and Care[J]. Journal of Nursing, 2021, 36(16): 39-43.

[2] Deng Zenan, Ma Qiuping, Wu Bin, et al. Summary of the best evidence for the management of mood disorders in patients with Alzheimer's disease[J]. Chinese Journal of Nursing, 2021, 56(11): 1714-1720.

Author: Yan Xuehua

Unit: Guangzhou Medical University Brain Hospital

Chief Judge: Wang Hong, Vice Chairman of the Science Popularization Working Committee of the Chinese Rehabilitation Medicine Association, Vice Dean of the School of Rehabilitation, Shanghai Health Medical College

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"