Slides for presentation on 22 March 2013 AMK-Thye Hua Kwan Hospital: Depression in Elderly

Slides for presentation at SPH: Forgetfulness and Alzheimer’s Disease

Alzheimer’s Disease

Alzheimer’s Disease is the most form of dementia whereby there is progressive failure of the brain. It is caused by toxic substances which accumulates in the brain with time called plaques and tangles. These toxic substances causes nerve damage and cell death in the brain

Symptoms of Dementia

Progressive loss of memory, particularly recent memories
Difficulty performing everyday tasks, eg. operating the television or marketing
Difficulty in communication – inability to remember words and to use them properly
Forgetting what place the person is or what time it is
Losing things and getting lost in familiar places
Changes in personality

Progression of Alzheimer’s Disease (AD)

Alzheimer’s Dementia is a progressive disease. In the early stage, symptoms are mild and may be dismissed by sufferers and family members. Forgetfulness and loss of memory is commonly one of the early symptoms to manifest. The individual can continue to be independent in the early stage of AD. However, he may be distressed and frustrated with his declining abilities. At this stage, the issue of making a will should be explored.

In the middle stage, the symptoms become more serious and the sufferer will require assistance with their Activities of Daily Living (ADL) such as toileting, bathing, washing and eating. They will need to be prompted to perform such activities. They may start to forget the names of the people around them or confuse their identities. They are often repetitive and may ask the same thing over and over again as they lose their memory. They can be confused and may develop hallucinations or delusions, often believing that others have stolen the things they have misplaced.

In the late stage, sufferers of AD loses their ability to communicate and can become immobile. They become totally dependent and require nursing care from others. They may be irritable and there may be angry outburst as the patients can no longer understand what are going on around them. Eventually, they may succumb to lung infections or serious bed sores due to prolonged immobility.

Treatment of AD

Drugs are available to treat AD. These increases the neurochemicals which are lacking due to nerve cell death. However, anti-dementia drugs do not cure or stop the progression of dementia in AD. Nevertheless, they can help to improve the symptoms, slow down the progress of dementia and most importantly improve the quality of life of the sufferers. These anti-dementia drugs have also been shown in studies to prevent the elderly suffering from AD from having to be admitted to a nursing home.

Other psychological strategies can be useful and these include:

Reality orientation whereby information about the environment to orientate a person with dementia to their surroundings using aids and prompts is given and
Reminiscence therapy whereby multimedia memory aids are used to promote memory and recall by reviewing past events