Alzheimer’s Disease

Causes of Alzheimer’s Disease

Scientists believe that for most people, Alzheimer’s disease is caused by a combination of genetic, lifestyle and environmental factors that affect the brain over time.

Less than 1 percent of the time, Alzheimer’s is caused by specific genetic changes that virtually guarantee a person will develop the disease. These rare occurrences usually result in disease onset in middle age.

The exact causes of Alzheimer’s disease aren’t fully understood, but at its core are problems with brain proteins that fail to function normally, disrupt the work of brain cells (neurons) and unleash a series of toxic events.

Other causes

Neurons are damaged, lose connections to each other and eventually die.

The damage most often starts in the region of the brain that controls memory, but the process begins years before the first symptoms.

The loss of neurons spreads in a somewhat predictable pattern to other regions of the brains. By the late stage of the disease, the brain has shrunk significantly.

Researchers are focused on the role of two proteins:

Plaques:

Beta-amyloid is a leftover fragment of a larger protein. When these fragments cluster together, they appear to have a toxic effect on neurons and to disrupt cell-to-cell communication.

These clusters form larger deposits called amyloid plaques, which also include other cellular debris.

Tangles:

Tau proteins play a part in a neuron’s internal support and transport system to carry nutrients also other essential materials.

In Alzheimer’s disease, tau proteins change shape and organize themselves into structures called neurofibrillary tangles. The tangles disrupt the transport system and are toxic to cells. [2]

Risk Factors of Alzheimer’s disease

Age i.e.:

• Increasing age is the greatest known risk factor for Alzheimer’s disease.
• Alzheimer’s is not a part of normal aging, but as you grow older the likelihood of developing Alzheimer’s disease increases.

Family history and genetics i.e.:

• Your risk of developing Alzheimer’s is somewhat higher if a first-degree relative – your parent or sibling has the disease.
• Most genetic mechanisms of Alzheimer’s among families remain largely unexplained, similarly the genetic factors are likely complex.
• One better understood genetic factor is a form of the apolipoprotein E gene (APOE).
• A variation of the gene, APOE e4, increases the risk of Alzheimer’s disease, but not everyone with this variation of the gene develops the disease.
• Scientists have identified rare changes (mutations) in three genes that virtually guarantee a person who inherits one of them will develop Alzheimer’s. But these mutations account for less than 1 percent of people with Alzheimer’s disease.

Down syndrome i.e.:

• Many people with Down syndrome develop Alzheimer’s disease.
• This is likely related to having three copies of chromosome 21 and subsequently three copies of the gene for the protein that leads to the creation of beta-amyloid.
• Signs and symptoms of Alzheimer’s tend to appear 10 to 20 years earlier in people with Down syndrome than they do for the general population.

Sex i.e.:

There appears to be little difference in risk between people of all genders, but, overall, there are more women with the disease because they generally live longer than men.

Mild cognitive impairment i.e.:

• Mild cognitive impairment (MCI) is a decline in memory or other thinking skills that is greater than what would be expected for a person’s age, but the decline doesn’t prevent a person from functioning in social or work environments.
• People who have MCI have a significant risk of developing dementia.
• When the primary MCI deficit is memory, the condition is more likely to progress to dementia due to Alzheimer’s disease.
• A diagnosis of MCI enables the person to focus on healthy lifestyle changes, develop strategies to compensate for memory loss and schedule regular doctor appointments to monitor symptoms.

Past head trauma i.e.:

People who have had a severe head trauma have a greater risk of Alzheimer’s disease.

Poor sleep patterns i.e.:

Research has shown that poor sleep patterns, such as difficulty falling asleep or staying asleep, are associated with an increased risk of Alzheimer’s disease.

Lifestyle and heart health i.e.:

Research has shown that the same risk factors associated with heart disease may also increase the risk of Alzheimer’s disease.

These include i.e.:

• Lack of exercise
• Obesity
• Either Smoking or exposure to secondhand smoke or both
• High blood pressure
• High cholesterol
• Poorly controlled type 2 diabetes

These factors can all be modified. Therefore, changing lifestyle habits can to some degree alter your risk.

Lifelong learning and social engagement i.e.:

Studies have found an association between lifelong involvement in mentally and socially stimulating activities and a reduced risk of Alzheimer’s disease.

Low education levels less than a high school education appear to be a risk factor for Alzheimer’s disease. [2]

Pathophysiology

Types of Alzheimer’s:

• Early-Onset,
• Late-Onset, and
• Familial.[5]

1. Reduced ability to take in and remember new information, which can lead, for example, to:

• Repetitive questions or conversations
• Misplacing personal belongings
• Forgetting events or appointments
• Getting lost on a familiar route

2. Impairments to reasoning, complex tasking, and exercising judgment, for example:

• Poor understanding of safety risks
• Inability to manage finances
• Poor decision-making ability
• Inability to plan complex or sequential activities

3. Impaired visuospatial abilities that are not, for example, due to eye sight problems. These could be:

• Inability to recognize faces or common objects or to find objects in direct view
• Inability to use simple tools, for example, to orient clothing to the body

4. Impaired speaking, reading and writing, for example:

• Difficulty thinking of common words while speaking, hesitations
• Speech, spelling, and writing errors

5. Changes in personality and behavior, for example:

• Out of character mood changes, including agitation, apathy, social withdrawal or a lack of interest, motivation, or initiative
• Loss of empathy
• Compulsive, obsessive, or socially unacceptable behavior [1]

Changes in personality and behavior

Brain changes that occur in Alzheimer’s disease can affect moods and behaviors. Problems may include the following:

• Depression
• Apathy
• Social withdrawal
• Mood swings
• Distrust in others
• Irritability and aggressiveness
• Changes in sleeping habits
• Wandering
• Loss of inhibitions
• Delusions, such as believing something has been stolen [2]

Clinical Examination

A complete physical examination with a detailed neurological exam and mental status examination is needed to evaluate the disease stage and rule out other conditions. Comprehensive clinical assessment can provide reasonable diagnostic accuracy in most patients. A detailed neurological examination is essential to rule out other conditions. In Alzheimer’s disease, the neurological exam is usually normal. The physical exam is normal except for anosmia.

Anosmia is also found in patients with Parkinson’s disease, dementia with Lewy bodies, and TBI with or without dementia, but not in those with VCI or depression. In the advanced stages of Alzheimer’s disease, patients do not have lateralized signs. They eventually become mute, fail to respond to verbal requests, remain confined to bed, and frequently slip into a persistent vegetative state. A mental status examination should assess concentration, attention, recent and remote memory, language, visuospatial functioning, praxis, and executive functioning.

Mental status examination

Brief standard examinations like the mini-mental status examination are less sensitive and specific, although they can be used for screening.

All follow-up visits should include a full mental status examination to evaluate disease progression and the development of neuropsychiatric symptoms.[7]

Investigation

Lab tests:

• Blood tests may help your doctor rule out other potential causes of memory loss and confusion, such as a thyroid disorder or vitamin deficiencies.

Mental status and neuropsychological testing:

• Your doctor may conduct a brief mental status test or a more extensive set of tests to assess memory and other thinking skills.
• Longer forms of neuropsychological testing may provide additional details about mental function compared with people of a similar age and education level.
• These tests are also important for establishing a starting point to track the progression of symptoms in the future.

Brain imaging:

Images of the brain are now used chiefly to pinpoint visible abnormalities related to conditions other than Alzheimer’s disease such as strokes, trauma or tumors, that may cause cognitive change.

New imaging applications currently used primarily in major medical centers or in clinical trials — may enable doctors to detect specific brain changes caused by Alzheimer’s.

Imaging of brain structures include the following:

• Magnetic resonance imaging (MRI): MRI uses radio waves and a strong magnetic field to produce detailed images of the brain. MRI scans are used primarily to rule out other conditions. While they may show brain shrinkage, the information doesn’t currently add significant value to making a diagnosis.
• Computerized tomography (CT): CT scan, a specialized X-ray technology, produces cross-sectional images (slices) of your brain. It’s currently used chiefly to rule out tumors, strokes and head injuries.

Imaging of disease processes can be performed with Positron emission tomography (PET).

During a PET scan, a low-level radioactive tracer is injected into the blood to reveal a particular feature in the brain.

PET imaging may include the following:

• Fluorodeoxyglucose (FDG) PET scans show areas of the brain in which nutrients are poorly metabolized. Identifying patterns of degeneration areas of low metabolism can help distinguish between Alzheimer’s disease and other types of dementia.
• Amyloid PET imaging can measure the burden of amyloid deposits in the brain. This imaging is primarily used in research but may be used if a person has unusual or very early onset of dementia symptoms.
• Tau Pet imaging, which measures the burden of neurofibrillary tangles in the brain, is only used in research.

In special circumstances, such as rapidly progressive dementia or very early onset dementia, other tests may be used to measure abnormal beta-amyloid or tau in the cerebrospinal fluid.

[7]

Diagnosis

A key component of a diagnostic assessment is self-reporting about symptoms, as well as the information that a close family member or friend can provide about symptoms and their impact on daily life.

Laboratory and imaging tests can rule out other potential causes or help the doctor better characterize the disease causing dementia symptoms.

Tests:

A diagnostic work-up would likely include the following tests:

Physical and neurological examination:

Your doctor will perform a physical examination and likely assess overall neurological health by testing the following:

• Reflexes
• Muscle tone and strength
• Ability to get up from a chair and walk across the room
• Sense of sight and hearing
• Coordination
• Balance

[2]

Differential diagnosis of Alzheimer

• Pseudodementia,
• Lewy body dementia,
• Vascular dementia, and frontotemporal lobar degeneration.

Other disorders to consider and rule out when evaluating for Alzheimer’s disease include

• age-associated memory impairment,
• alcohol or drug abuse,
• vitamin-B12 deficiency,
• patients on dialysis,
• thyroid problems, and
• polypharmacy.[7]

Treatment

Drugs:

Current Alzheimer’s medications can help for a time with memory symptoms and other cognitive changes.

Two types of drugs are currently used to treat cognitive symptoms:

Cholinesterase inhibitors:

• These drugs work by boosting levels of cell-to-cell communication by preserving a chemical messenger that is depleted in the brain by Alzheimer’s disease. The improvement is modest.
• Cholinesterase inhibitors may also improve neuropsychiatric symptoms, such as agitation or depression.
• Commonly prescribed cholinesterase inhibitors include donepezil (Aricept), galantamine (Razadyne) and rivastigmine (Exelon).
• The main side effects of these drugs include diarrhea, nausea, loss of appetite and sleep disturbances.
• In people with cardiac conduction disorders, serious side effects may include cardiac arrhythmia.

Memantine (Namenda):

• This drug works in another brain cell communication network and slows the progression of symptoms with moderate to severe Alzheimer’s disease.
• It’s sometimes used in combination with a cholinesterase inhibitor.
• Relatively rare side effects include dizziness and confusion.

Sometimes other medications such as antidepressants may be prescribed to help control the behavioral symptoms associated with Alzheimer’s disease.

Creating a safe and supportive environment:

Adapting the living situation to the needs of a person with Alzheimer’s disease is an important part of any treatment plan.

For someone with Alzheimer’s, establishing and strengthening routine habits and minimizing memory-demanding tasks can make life much easier.

You can take these steps to support a person’s sense of well-being and continued ability to function:

• Always keep keys, wallets, mobile phones and other valuables in the same place at home, so they don’t become lost.
• Keep medications in a secure location. Use a daily checklist to keep track of dosages.
• Arrange for finances to be on automatic payment and automatic deposit.
• Carry a mobile phone with location capability so that a caregiver can track its location.
• Program important phone numbers into the phone.
• Make sure regular appointments are on the same day at the same time as much as possible.
• Use a calendar or whiteboard in the home to track daily schedules. Additionally, Build the habit of checking off completed items.

other steps

• Remove excess furniture, clutter also throw rugs.
• In general, Install sturdy handrails on stairways and in bathrooms.
• Ensure that shoes and slippers are comfortable and provide good traction.
• Reduce the number of mirrors because People with Alzheimer’s may find images in mirrors confusing or frightening.
• Make sure that the person with Alzheimer’s either carries identification or wears a medical alert bracelet.
• Keep photographs and other meaningful objects around the house. [2]

Homeopathic Treatment of Alzheimer’s Disease

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines selected after a full individualizing examination and case-analysis.

Which includes

• The medical history of the patient,
• Physical and mental constitution,
• Family history,
• Presenting symptoms,
• Underlying pathology,
• Possible causative factors etc.

A miasmatic tendency (predisposition/susceptibility) also often taken into account for the treatment of chronic conditions.

What Homoeopathic doctors do?

A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’?

The disease diagnosis is important but in homeopathy, the cause of disease not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness also looked for. Now a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.

The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can greatly improve with homeopathic medicines.

Homeopathic Medicines for Alzheimer’s Disease:

The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications also taken into account for selecting a remedy, potency and repetition of dose by Homeopathic doctor.

So, here we describe homeopathic medicine only for reference and education purpose. Do not take medicines without consulting registered homeopathic doctor (BHMS or M.D. Homeopath).

Recommended Homeopathic Treatment for Alzheimer’s disease:

• The popularly recommended homeopathic remedies for Alzheimer’s disease are Anacardium, Cannabis Indica, Medorrhinum, Ignatia and Kali Phos.
• Anacardium is a suitable remedy for marked forgetfulness. Additionally, Sudden diminution of memory of what a person has just seen, just listened to or names of people surrounding him appears.
• Cannabis Indica is the appropriate choice for short-term memory loss in persons with Alzheimer’s disease.
• Medorrhinum ranks high as a cure for memory loss for the names of well-known persons and places.
• Last medicines Ignatia and Kali Phos are wonderful remedies to deal with depression in Alzheimer’s patients.

1. Homeopathic medicines for Alzheimer’s disease with marked forgetfulness:

Effective homeopathic medicines for Alzheimer’s disease with marked forgetfulness are Anacardium and Alumina.

Anacardium:

• Anacardium is a good choice when the person is very forgetful.
• He forgets what he has seen and suddenly forgets names of people surrounding him.
• Memory progressively gets bad.
• Along with forgetfulness, the person also shows irritability, anxiety, anger with violent behavior and use of foul language.

Alumina:

• It is also a valuable selection for forgetfulness in Alzheimer’s disease.
• Alumina is selected when memory is weak or entirely lost.
• The person has cloudiness in the mind, he is slow to answer and lacks judgement power.
• Absent mindedness also prevails.
• He also makes mistakes while writing and speaking.

 2. Homeopathic medicines for Alzheimer’s disease with short term memory loss:

Cannabis Indica:

• Cannabis Indica is one of the best homeopathic remedies for Alzheimer’s disease with short-term memory loss.
• It is indicated where a person forgets frequently while he is doing a specific task or soon after doing it.
• He forgets what he has just done, or what has just happened, or what he has just said or read.
• He also forgets what he is about to do, what he is about to write.
• Forgets frequently while talking.
• While speaking a sentence, he forgets what he is about to say, forgets the words in his mouth.
• Sudden loss of ideas and speech also appears. He begins a sentence but cannot finish it.
• There is inability to recall ideas even after exerting the mind to do so.

 3. Homeopathic medicines for Alzheimer’s disease with loss of memory for names of well-known persons and places:

Medorrhinum:

• Medorrhinum is among the top-grade homeopathic remedies for Alzheimer’s disease where a person shows loss of memory for names of well-known persons and places.
• Surprisingly, He forgets names of close friends and family members.
• Eventually, In extreme cases, he even forgets his own name.
• Medorrhinum is also indicated when a person finds it difficult to carry on a conversation.
• He gets lost while conversing and a question has to be repeated.
• He is unable to collect ideas also gives incorrect replies.

 4. Homeopathic medicines for Alzheimer’s disease with difficulty while reading and writing from memory weakness:

The prominently indicate homeopathic remedies for Alzheimer’s disease with weak memory posing a difficulty in reading and writing are i.e. Lac Caninum and Nux Moschata.

Lac Caninum:

• Lac Caninum is helpful when the person is forgetful while writing.
• He makes use of wrong words while writing, doesn’t remember appropriate words.
• He makes spelling mistakes, omit letters in words.
• While reading or writing, he is unable to concentrate.
• Person needing Lac Caninum seems hopeless about recovery.
• The person is sure that the disease is incurable also recovery is impossible.

Nux Moschata:

• Nux Moschata is prescribing for sudden vanishing of thoughts while reading or writing.
• Person uses wrong words either in reading or in writing.
• Moreover, He frequently makes a wrong selection of words.
• He may also show marked drowsiness, absent- mindedness and indifferent behavior accompanying the above symptoms.

 5. Homeopathic medicines for Alzheimer’s disease to deal with accompanying depression and emotional imbalance:

The most appropriate homeopathic remedies for Alzheimer’s disease to deal with depression and emotional imbalance are i.e. Ignatia, Kali Phos and Aurum Met.

Ignatia:

• Ignatia is the best choice when a person experiences sadness, weeping spells, and desire to be alone.
• It is also indicated for mood swings.

Kali Phos:

• It can help when a person has marked exhaustion, fatigue, lassitude, and weariness along with Alzheimer’s disease.
• Kali Phos is also indicated for gloominess, despondency, sadness, and a dull mind accompanying Alzheimer’s disease.

Aurum Met:

• Aurum Met is useful when depression with suicidal tendencies persists in Alzheimer’s disease.
• A person requiring Aurum Met also feels he is worthless and of little importance, he feels life is a burden.
• Even the slightest contradiction is unbearable and leads to acute anger outbursts in such persons. [4]

Diet and Regimen of Alzheimer’s Disease

Healthy lifestyle choices promote good overall health and may play a role in maintaining cognitive health.

Exercise:

• Regular exercise is an important part of a treatment plan.
• Activities such as a daily walk can help improve mood and maintain the health of joints, muscles and the heart.
• Exercise can also promote restful sleep and prevent constipation.
• People with Alzheimer’s who develop trouble walking may still be able to use a stationary bike or participate in chair exercises.

Nutrition:

People with Alzheimer’s may forget to eat, lose interest in preparing meals or not eat a healthy combination of foods.

They may also forget to drink enough, leading to dehydration and constipation.

Offer the following:

Healthy options:

• Buy healthy food options that the person with Alzheimer’s disease likes also can eat.

Water and other healthy beverages:

• Try to ensure that a person with Alzheimer’s drinks several glasses of liquids every day.
• Avoid beverages with caffeine, which can increase restlessness, interfere with sleep and trigger a frequent need to urinate.

High-calorie, healthy shakes and smoothies:

• You can supplement milkshakes with protein powders or make smoothies featuring favorite ingredients.
• This may be particularly important when eating becomes more difficult.

Social engagement and activities:

Social interactions and activities can support the abilities and skills that are preserved. Doing things that are meaningful and enjoyable are important for the overall well-being of a person with Alzheimer’s disease.

These might include:

• Listening to music or dancing
• Reading or listening to books
• Gardening or crafts
• Social events at senior or memory care centers
• Planned activities with children

Coping and support:

• People with Alzheimer’s disease experience a mixture of emotions — confusion, frustration, anger, fear, uncertainty, grief and depression.
• If you’re caring for someone with Alzheimer’s, you can help them cope with the disease by being there to listen, reassuring the person that life can still enjoy, providing support, and doing your best to help the person retain dignity and self-respect.
• A calm and stable home environment can help reduce behavior problems.
• New situations, noise, large groups of people, being rush or press to remember, or being asked to do complicated tasks can cause anxiety.

Caring for the caregiver:

• Caring for a person with Alzheimer’s disease is physically and emotionally demanding.
• Feelings of anger and guilt, stress and discouragement, worry and grief, and social isolation are common.
• Care giving can even take a toll on the caregiver’s physical health.
• Paying attention to your own needs and well-being is one of the most important things you can do for yourself and for the person with Alzheimer’s.
• Many people with Alzheimer’s and their families benefit from counseling or local support services.
• Contact your local Alzheimer’s Association affiliate to connect with support groups, doctors, occupational therapists, resources and referrals, home care agencies, residential care facilities, a telephone help line, and educational seminars. [2]

Frequently Asked Questions

What is Alzheimer’s disease?

Alzheimer’s disease is a neurological disorder in which the death of brain cells causes memory loss and cognitive decline.

Homeopathic Medicines used by Homeopathic Doctors in treatment of Alzheimer’s disease?

• Anacardium
• Alumina
• Cannabis Indica
• Medorrhinum
• Lac Caninum
• Nux Moschata
• Ignatia
• Aurum Met

What are the symptoms of Alzheimer’s disease?

• Repetitive questions or conversations
• Forgetting events or appointments
• Poor understanding of safety risks
• Inability to manage finances
• Poor decision-making ability
• Inability to recognize faces or common objects
• Difficulty thinking
• Loss of empathy

What are causes of Alzheimer’s disease?

• Genetic, lifestyle and environmental factors
• Brain proteins that fail to function normally
• Neurons are damaged
• Brain has shrunk significantly
• Plaques
• Tangles