I can’t remember…

By Dr. Mario Romero Blanco

Alzheimer’s disease causes problems with memory, thinking and behaviour, and is a type of dementia. Symptoms get worse over time and usually develop slowly; eventually symptoms get so severe that they interfere with daily tasks. This is the most common form of dementia and accounts for 50% to 80% of dementia cases.

Dementia is a general term for memory loss and other intellectual abilities, serious enough to interfere with daily life.

Alzheimer’s is not a normal part of ageing, although the greatest known risk factor is increasing age – the majority of people with Alzheimer’s are 65 and older.

Alzheimer’s is not just a disease of old age. Early onset of Alzheimer’s appears in up to 5% of people in their 40s or 50s (also known as younger-onset).

Symptoms of Alzheimer’s

Just like the rest of our body, as we age, our brain changes. Most of us eventually notice some slowed thinking and occasional problems with remembering certain things. A sign that brain cells are failing may be serious memory loss, confusion and other major changes in the way our minds work.

The most common early symptom of Alzheimer’s is difficulty remembering newly learned information as Alzheimer’s begins in the part of the brain that affects learning. With the advance ofAlzheimer’s through the brain it leads to increasingly severe symptoms, including disorientation; deepening confusion about events, time and place; mood and behaviour changes, unfounded suspicions about family, friends and professional caregivers; difficulty speaking, swallowing and walking, and more serious memory loss and behaviour changes.

Signs of dementia may be more obvious to family members or friends. People with memory loss or other possible signs of Alzheimer’s may find it hard to recognise they have a problem.

The possibility of one day developing Alzheimer’s disease causes great distress and concern especially when one feels that there are already signs of memory loss. Fortunately, a large percentage of these complaints are benign and have different causes.

New criteria for the diagnosis of Alzheimer’s disease have recently been published, which make it possible to identify the disease in the early stages (before the onset of dementia).

We hope we will in the very near future be able to reach a diagnosis at the stage where the patient only has symptoms of memory loss, when he is independent in daily activities. Initiating treatment with preventative drugs in the early stages of the disease, once these drugs are available, will provide the patient with a diagnosis whereby he can then decide his future while he is still capable of doing so.

The following criteria are necessary to establish the diagnosis of probable Alzheimer’s, in its early stages.

1. Various recent episodes of memory loss must be diagnosed by the neurologist or neuropsychologist with necessary specific tests.

2. Other causes of memory loss must be excluded by a cranial CT scan and blood analysis.

3. The next step is a lumber puncture, in order to analyse the cerebrospinal fluid and determine the levels of β-amyloid and tau protein.

A patient that has decreased β-amyloid protein and an increased result in the tau protein could be diagnosed as having a high probability of having Alzheimer’s disease.

Alternatively, if the results of these two proteins are normal, it is unlikely that the patient’s symptoms of memory loss are due to this disease.

“Early diagnosis and intervention methods are improving dramatically, and treatment options and sources of support available can improve quality of life,” says Dr Mario Romero Blanco, Neurologist at Hospital Particular do Algarve.

||[email protected]

Dr Mario Romero Blanco is a Neurologist at Hospital Particular do Algarve