Alzheimer's Dementia - Medical Malpractice Lawyers

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Alzheimer's Dementia - Medical Malpractice

Alzheimer's dementia is the most common type of senile dementia, making up about fifty to eighty percent of cases. It is the loss of intellectual abilities and memory to the degree that it interferes with activities of daily living. It is a progressive disease that is ultimately fatal to whoever has it. Nerve cells of the brain degenerate and die, particularly in the amygdala and the hippocampus, although all areas of the brain are eventually affected.

The two major lesions seen in Alzheimer's disease brains include neurofibrillary tangles and amyloid deposits. These are only seen at the time of autopsy, however. The neurofibrillary tangles are intracellular accumulations of tau, a cytoskeletal protein. The amyloid is a precursor protein that builds up and collects into plaques.

Alzheimer's dementia is a loss of brain function that affects one's memory, behaviour and thinking. You will see impairment of the short term memory, difficulty with language, problems making decisions, impaired judgement and alterations in the personality.

The major risk factors for Alzheimer's dementia include being of an older age and having a family history for the disease, specifically a first degree relative. There are certain combinations of genes that seem to predispose a person for getting the disease.

Other risk factors for getting Alzheimer's disease include having high blood pressure, being female and having a prior history of head trauma.

There is early and late onset Alzheimer's disease. Early onset disease occurs before age 60 and is less common than late onset disease. Its progression tends to be faster than late onset disease. In late onset disease, people develop it after age 60. Both types may run in families.

The cause of Alzheimer's dementia is not clear but is believed to be partially hereditary and partially environmental. One must rule out other causes of dementia before calling the disease "Alzheimer's dementia". A brain biopsy is the only true way of diagnosing the disease but this is always done as a post mortem measure. In such cases, neurofibrillary tangles, amyloid plaques and senile plaques (dead nerve cells) can be seen under the microscope.

Symptoms of dementia include memory loss, language deficits, perception deficits, behaviour and personality changes and alterations in cognition. It usually begins with mild memory loss and progresses from there. This results in mild cognitive impairment which includes forgetting recent events or conversations, difficulty performing multiple tasks at once, difficulty in problem solving and doing tasks more slowly.

In severe Alzheimer's dementia, there is loss of understanding of language, problems recognizing loved ones and problems performing the activities of daily living, including dressing, bathing and eating. Incontinence and difficulty swallowing can also be a problem in severe Alzheimer's dementia.

Alzheimer's dementia is partly diagnosed with a complete history and physical examination, paying close attention to the mental status examination. Other things are ruled out, including vitamin deficiencies, thyroid disease, brain tumour, brain trauma, stroke, medication intoxication, chronic infection, severe depression and anaemia.

CT scan or MRI scan can be done to look for other signs of dementia, although you can see shrinkage of the brain in advanced disease. You cannot see neurofibrillary tangles or plaques on the CT scan or MRI scan.

There is no cure for Alzheimer's disease but doctors have medications that slow the progression of the disease. These include cholinergic medication that increase acetylcholine. The home can be modified to make it safer for the patient and families can learn how to manage the disease.

Medications for Alzheimer's disease include Aricept, Exelon and galantamine. All increase acetylcholine levels in the brain. Another medication, called Namenda, is used to treat Alzheimer's disease in a different way. Medications that contribute to Alzheimer's dementia will need to be discontinued. Supplementation with vitamin B9, vitamin B12 and vitamin E are sometimes used but do not seem to prevent the disease nor completely treat the disease.

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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here