Alzheimer's Disease: Brain Disease, Alzheimer's is
Alzheimer's disease, how to start?
The most common form of onset saw, forgetfulness. This is an extremely insidious progressive forgetfulness. Patients and their relatives, "Since when has this forgetfulness," he ask, "can not be said very clearly, that's the last one to two years, there was a little forgetfulness ... could not find stuff sometimes. Forgot to tell sometimes, we provided were old age, but after this We've found a little too began to forget that "you get the answer. "So, how did you notice an increase," he ask, "Very often the same questions again began to, for example, in half an hour asking the same question five times and never heard of before, like when he asked if each is doing. Sometimes it never happened, such as the events took place without a trace lost, for example, from a previous visit a few days completely forgotten: 'Son, where are you two weeks, why did not you come' he asks, or yesterday morning I called, 'Son, why call me since few days,' he says, "I get answers to the form. As you can see the problem here, I mean forgetfulness or aired a repeat one more time that goes beyond a few days later, to say the same thing over and over, or to ask the same thing as a truly remarkable forgetfulness. The main signs of the disease is evident by this time, forgetfulness or added to other mental dysfunction.
What type of corruption they are:
For example, deterioration in the determination of the time and place. What year is this, which aydayız, which often do not ask or can not answer questions like gündeyiz. Even in a place you know very well suddenly, "Where Do dönecektim right, left, Is, which inecektim stop, where I would go when I go home" venue, such as jamming. It also is accompanied by problems with language functions. Frequently used, well-known words, found, talking to a sudden stuttering, such as difficulties in understanding complicated phrases. Over time, he saw to it that can detect and understand the difficulties associated with, to plan, more complex functions, such as disruption of öngörebilme.
All of them consist of symptoms of Alzheimer's disease?
For ease of understanding and teaching the symptoms of this disease, we are gathered in three groups: Mental symptoms, behavioral symptoms and the symptoms of daily living functions. Groups that we call mental symptoms of forgetfulness, especially given the above examples of language function, visual functioning, attentional, there is deterioration in the perception of space and time.
Behavioral symptoms, personality change comes at the beginning. For example, a quiet man with a quick start angry or upset is usually mild-mannered it has become increasingly known as a man, into the draw. Tutturmaların addition, the charges, the emergence of appendages. Frequently a situation we see in our delusions (delusions), we call beliefs and the charges were false. For example, "I guess women working at home playing my stuff" or the family, against children, "you no longer want to get rid of me" or, "You want to settle my mirasıma, would like to take our property. You put instead of driving me crazy for him. Me, the old house would send "gibisinden accusations.
So Alzbeimer disease, a number of behavioral disorders or are emerging?
Often. Sometimes, however, under such accusations in the real lie, you should not forget that. Can be difficult to distinguish them from time to time but is able to realize most of the time people have escaped extreme of these claims. Another common example: The patient does not find the money stores, "have stolen," he says. Puts belongings somewhere, can not find, "Working women changing constantly replace it," he says. Behavioral symptoms in the majority of patients within the framework of hallucinations (dreams) may also occur. In this case, the patient sees or hears things that are not, "Do not you see where you are sitting on the people, who they are," he says, "The door is played, why açmıyorsunuz" he says. Rarely, both sees and hears, "There were people here, spoke to me," he says.
From time to time is another common behavioral problem that is agresyort acrimony. Alzheimer's disease usually occurs as a result of acrimony zıtlaşmalar. Alzheimer's patients is very rare hırçınlaşması rhyme or reason. For example, we hear often in a situation as follows: The patient will detect the wrong house, "This is not my home, I'll go to my house," he says, remembers childhood home, afternoon or night you want to go half. "Stop, Mom! Where are you going, my time at midnight," he trying to convince whether to keep the door, thrust-Meler-kakışmalar, sometimes verbal and sometimes physical aggression occurs.
Restlessness is doing, Alzheimer's Symptoms
What else can occur, such as behavioral problems ": In some patients wander around the house all day, then pass that room, rooms, cabinets open and turn it off, sometimes they put things away in a suitcase, they want to go, things bohçalayıp, package and they open again, sometimes can not resist in place or agitated are (irritability, restlessness). Sometimes an "excessive dependence" start state, closer, his wife may become over-dependent. For example, his wife, through the kitchen, the bedroom, the patient comes back, enters the bathroom, comes back. the behavioral symptoms of sleep disorders in a other varieties. dalamaz patient or never sleep, or wake up and take it from there in a short time, sometimes even travels're fast.
A third group mentioned indications? In the third group of symptoms of Alzheimer's disease, impairment of daily living functions. First bozulanlar, are works of the complex. If the patient is running, we see the work of his life began to go wrong. If you forget that the day before, or that received, forget the decisions or orders. Yet the concept of money as an early symptom deterioration and monetary accounts, the value and purchasing power of money tartamama may occur. Patient bank accounts, bills, follow-up, may have difficulty in preparing the tax return form. However, increasingly self-referential function in the deterioration of the person begins. Initially, what we see most often, problems with choosing clothes, summer-winter, for example, failing to do the dirty-clean separation of the patient inappropriate dress very thin or thick. I used the color harmony of a human, sloppy dress. Begins with basic daily functions are affected by the disease progresses, people. Bathing the patient reduces the incidence, says that more recent, personal cleanliness delay. In the later stages of the disease is no longer any function to its full sense can not become dependent on the income and the last stages. Advanced stages before the urine, stool incontinence cases can be clarified over time. Impairment of gait and the patient is unable to act alone, that is, become bedridden as the most recent stage.
What is the incidence of this disease in the world and our country?
Studies on this subject have been made in different countries of the world. Almost all of them close to each other, the resulting ratios. This rate is between 5 to 10 per cent over 65 years. This is quite a rare disease until the age of 60-65.
How rare?
Very rare. In general, familial form of the disease before the age emerges. Begin to rise in the incidence from the age of 65. Expiration of five years each as a unit over 65 years if we doubled the frequency of every five years is going. So much so that one third of the disease, such as over the age of 85. Illness in 100 people over the age of 65 from 5 to 10, while over 85 years of age, this number is 35.
The number of patients with Alzheimer's in 2050 will be folded into three
Do you have a study done in Turkey?
Yes. We, as our Department of Neurology, Istanbul Faculty of Medicine, was such a study, with the support of Alzheimer's Association. Kadikoy district of Istanbul on 70 years of age in this study were scanned yaşlımızı thousand.
Results like?
On the frequency of 70 found in about 10 percent. This figure is not reported in the world. If we apply this rate structure in Turkey, Turkey's influence turns out to be about 200-250 thousand of Alzheimer's disease. This is the current situation, this number will increase gradually, because our country with people living longer than ever, as the aging population has a relative. Developed countries in fact the problem is currently living in the most intense degree. Because their average life expectancy of around almost 90 years, so I currently have a large elderly population, Alzheimer's disease also occur more frequently with age, this problem is now increasingly intense live. Turkey is a country in ever-increasing elderly population. Ulaşmadık yet, but will reach the peak of the problem. Last year, in December 2050 in an article published in the renowned medical journal Lancet'da Alzheimer's disease in Turkey, around 700-800 thousand supposed to be.
Currently, Alzheimer's disease is thought to be around 20-25 million worldwide. 4 to 5 million of these, only the United States. The cost of treatment of the disease is also very high, for example, in the U.S. society, the cost per year is thought to be around 80 to 100 billion dollars.
We have how much?
We have such a figure is not known. "This is how the estimated cost of" If you ask a lot of factors are taken into consideration. Their main working-age patients and loss of productivity of labor, the labor loss of relatives of patients, medical diagnosis and treatment costs and nursing home costs. For him, this personal, familial and social dimension is also very important for the economy of the community next to a disease.
Alzheimer's and dementia is not destiny
Natural Should Dementia? Is the fate of Alzheimer's disease?
No. Alzheimer's disease or dementia is not a natural process, a process that increased with age. Dementia, old age is not a natural result of aging for each other bunamaz. Reverse look at, the dementia is always a pathological condition, there is always an underlying disease. Dementia is not normal in no time, no matter what age.
That is not no such thing as stand-alone dementia. Always something to lay under
Completely so, dementia is a disease always lies below, an "old-age dementia," There is no natural and inevitable consequence of aging is dementia. The frequency of dementia increases with age, people varıyorlar aware of it and say, "This situation emerges in old age, the frequency of occurrence in years ahead of how much he is growing up." Thus, a direct connection is established, and old age dementia is thought to be a natural result of aging. Although the extraction observation wrong: no matter what age, dementia is not natural. On the other hand most of the people of the world's oldest known bunamamış. Does not see the eyes, ears to hear, going down to walk, but under the bunamıyorlar missing. For him the greatest injustice to the person showing signs of dementia, "came the age of 90. Dementia in the natural" means.
If we do this injustice, it is natural to think, but can not find the cure?
Absolutely. This is the thinking that the greatest harm to the natural. Because doğalsa do not have to do something. "How is this even a part of old age, getting older, dementia is natural that" he does not search and the steps that you can not think of a reason.
However, there is not much to be done?
Very true. Dementia patients have a lot to be done. The first thing to do, put the correct diagnosis of treatment to apply to him. If you want a little talk about the process of diagnosis. Dementia due to Alzheimer's disease, how is it diagnosed? Diagnosis The first step in the process of talking with patients and their relatives. In this context, the functions of the patient near the patient's mental status before the start of symptoms, personality and behavioral characteristics we ask. Alzheimer's disease, a disease that develops slowly, resulting in a day is not a disease, so since when the symptoms were noticed, the emergence rate, or a sudden you begin to slow, how to develop, grow and not increased gradually, which first symptoms appeared, symptoms the order in question and the development process. For Alzheimer's disease is a typical cruise, slowly slowly starting to be the forefront of a growing forgetfulness.
That is a good examination of the patient history is extremely important in the diagnosis correct?
The number one weapon in our hands is to a good story in the diagnosis of dementias. In particular, patients' relatives. A good history taken (medical history) is important to us. In this context, to talk with the patient may not always help. Because diseases do not accept the majority of patients, when asked agree that they are a bit forgetful or say I have no problems. Therefore, patients' relatives to be more important than story. The symptoms began some time ago, has shown a slow increase in going sailing and mental performance, according to earlier in the case of a fall, the presence of dementia is strong evidence that passes through our hands.
In parallel, we examined the patient's mental functions. All mental functions according to age and educational level, we have a standardized way to measure the tests. Applying them, indeed, the patient's memory, the intention, there is a distortion of language and visual functions, mental functions, the place to be according to age and education, there is more bad and if so how serious this deterioration, which functions are impaired in the foreground and which are preserved , looking for answers to these questions. If we decide that the patient has a dementia diagnosis status of the second stage of the process is suffering a brain MR or computed tomography. However, on the one hand trying to do directly affects the brain tissue of another cause (a tumor, hematoma, blood vessel blockages), see if it is. On the other hand the brain cell loss in Alzheimer's and other degenerative diseases of the brain in certain areas and consequently the resulting tissue loss, shrinkage, shrinkage (atrophy) Do you, investigate it.
Atrophy of brain cell loss in the regions which are emerging?
For example, cell loss and brain shrinkage in Alzheimer's disease affects memory-related regions. While other regions of the brain is relatively good, due to loss of memory cells in areas related to the downsizing we see. MR or computed tomography of the brain than we do some laboratory tests. Here too the goal of hormonal disorders that can cause dementia, vitamin deficiencies, may affect the brain's normal functioning of bodily or metabolic diseases (high-sugar, urea, etc.) to investigate. In short, the diagnosis of Alzheimer's disease and other bunamalarda put in two phases. Do you have a table of the first stage, do not have dementia, to understand it. What lies under the table for the second stage of dementia, to investigate it.
The correct diagnosis, correct treatment is very important, is not it?
Extremely important. There are some dementias are limited to-do in terms of drug therapy, but a related dementia, for example if you have thyroid disease, it is possible to solve the foundation. If you have a dementia related to vitamin B-12, able to turn back. Into the brain tumor, hematoma, or if any, intervention must be able to solve the root of dementia. For him, the patient first suspected bunadığından necessarily have to go through the process of an accurate diagnosis. First, you need to determine under what lies in that it is possible for him to get in front of treatment.
That is the underlying cause, according to the treatment plan is done, and sometimes the root of the problem can be solved?
Completely so. Let's say that the problem lies in the patient's thyroid under bunamasının. Then the thing to do, to treat thyroid disease. Let's say that another brain tumor patient lies under the table of dementia. For example, the front part of brain tumors, without any other symptoms of dementia may be caused by the statement. If you detect tumors in the surgery table is lost if the patient's dementia. We bunamalara this type of "reversible dementias" call.
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