Alzheimer’s Disease and Non-Alzheimer’s Dementia

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Alzheimer's disease is the most common cause of severe mental deterioration (dementia) in the elderly. It has been estimated that 30% to 50% of people over 85 years old suffer from this condition. Its cause is not known. However, microscopic examination of the brains of people who have died of Alzheimer’s shows loss of cells in the thinking part of the brain, particularly cells that release a chemical called acetylcholine.Alzheimer's begins with subtle symptoms, such as loss of memory for names and recent events. It progresses from difficulty learning new information to a few eccentric behaviors to depression, loss of spontaneity, and anxiety. Over the course of the disease, the person gradually loses the ability to carry out the activities of everyday life. Disorientation, asking questions repeatedly, and an inability to recognize friends are characteristics of moderately severe Alzheimer's. Eventually, virtually all mental functions fail.Similar symptoms may be caused by conditions other than Alzheimer's disease, such as multiple small strokes (called multi-infarct or vascular dementia), severe alcoholism, and certain more rare causes. It is very important to begin with an examination to discover what is causing the symptoms of mental decline. Various easily treatable conditions, such as depression, can mimic the symptoms of dementia.Four drugs have shown at least modest benefit for Alzheimer's disease or non-Alzheimer's dementia: Reminyl, Exelon, Aricept, and Cognex. These medications usually produce a modest improvement in mild to moderate Alzheimer's disease by increasing the duration of action of acetylcholine. However, they can cause sometimes severe side effects due to the exaggeration of acetylcholine's action in other parts of the body.

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