30 November 2010

Dementia and Its Parts - 2

Alzheimer's Disease (AD) is often difficult to separate from others at the start. The exact causes are still unknown. This is being studied very intensively and some of the
suspected causes include diseased genes, abnormal protein buildup in the brain, and environmental toxins. Now there is a link to diabetes and some identified proteins and a possible link to lack of insulin production by the brain.

The brain changes that occur with AD are the neurons (nerve cells) in the brain that affect memory, thinking, and judgment are damaged. This interrupts the passage of messages between cells by chemicals called neurotransmitters. One specific neurotransmitter is absent in people with AD. The cortex (thinking center) of the brain shrinks (atrophies). This causes a decrease on surface area, which plays a role in how well a person can think and function.

The spaces in the center of the brain (ventricles) become enlarged and the neurons develop specific changes that are key indicators of the disease as seen on autopsy after death. These nerve cell changes are called neurotic plaques (abnormal patches) and neurofibrillary (nerve fiber) tangles. The Diabetic Guy writes about this here.

There is no single test for AD. The Alzheimer's Association has a list of ten warning signs of Alzheimer's. Read them here. AD can only be positively diagnosed by examining a small piece of brain tissue after death (autopsy). The number and concentration of plaques and tangles in the short-term memory center of the brain confirm diagnosis. At present there is no specific medical treatment for AD.

A little history, please. Dr. Alois Alzheimer detected signs of the brain disease that is now named after him. Like so many doctors, he thought many patients had mental health problems or mental illness. During the autopsy, he found dense deposits outside and around the brain nerve cells in the brain of a patient. The deposits are now called neurotic plaques and the tangles inside the cells are twisted nerve fibers.

Today this still a lot to be learned about AD, but progress is being made with more and more information being made available every year. This has been a hard topic for me to face and still concerns me. I am starting to study it more carefully, as my risks are greater for several of the reasons. Age, having diabetes and several other indicators all raise concerns.

This is part two of three parts.

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