Alzheimer's Disease Essay

4193 words - 17 pages

Alzheimer's Disease Alzheimer’s Disease (AD) is a progressive degenerative disease of
unknown aetiology, as first described by Alois Alzheimer (1907).
According to Shoenberg et. al (1987), it is the commonest cause of
dementia in the elderly with an incidence ranging from 2.5 to 5 per
thousand. Furthermore, this incidence has grown in recent years as a
result people generally living longer. The disease is incurable at
present but there are drug treatments that delay the symptoms in the
early stages. Therefore, there is a real need for early
identification of the disease, so that a treatment program can be
administered.

In the later stages of AD, there are typical neurological signs of the
disease. These are plaques and tangles in the hippocampal region of
the brain. However, it may be a while into the disease before these
can be detected by diagnostic tools such as CT, MRI and fMRI. In
addition, reliance on these tools can lead to a false diagnosis of AD,
where some form of vascular dementia is actually the cause. In fact,
according to Brazzelli et al. (1994), there is no unequivocal
instrumental test to establish the presence of the disease.
Therefore, it is also common practice to establish the
neuropsychological symptoms of AD. Numerous studies have been
conducted into the neuropsychiatric symptoms of AD so that diagnosis
can be as accurate as possible.

According to Venneri, Turnbull and Sala (1996) the low contribution of
neurological and neuroradiological examination to the diagnosis of AD
in its early stages raises severe diagnostic problems. This is
because up to 30 per cent of dementias may be curable (e.g. depressive
psuedodementia, normotensive hydrocephalus) and the possible diagnosis
of AD needs to be excluded for these to be treated. According to the
ICD-10 other causes of dementia (such as CVD, Parkinsons, Corea, and
Hydrocephalus) must be excluded before making a diagnosis of AD. The
ICD-10 diagnostic criterion for AD is verbal and non-verbal memory
decline, decline of all other cognitive abilities, objective
evaluation, environmental awareness, emotional weakness, irritability,
apathy and disorders of behaviour. A history of these symptoms
proceeding at least 6 months must also be present. However, this is
not the case with the DSM-IV. The DSM-IV criteria starts the same as
the ICD-10 with memory impairment, then states one or more cognitive
deficits (aphasia, apraxia, agnosia) must be present. On top of this,
there must also be deficits in executive functions, deficits
interfering with working and social activities, gradual changes
compared with previous evaluations and slow progressive decline. As
with the ICD-10, the DSM-IV also states that other...

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