Forgetfulness and lack of concentration - many older people see it as a harbinger of Alzheimer's disease. Thankfully, in most cases this is not true. Nevertheless, one should take the trouble to take a closer look at the causes. Lost the key, forget the friend's phone number - what's behind it? The fear of diagnosing Alzheimer's causes many to not even be examined. Only when the symptoms are clear and the suffering of the patient or relatives is great, a doctor is consulted. For this reason, Alzheimer's dementia is still detected today only in the middle stage.
Is another disease the trigger?
Behind the morbid loss of mental power and the associated more limited everyday coping can be a physical illness stuck, z. B. of the heart, liver, kidneys or lungs. Illnesses of the brain (Parkinson's disease, stroke, brain tumor, encephalitis, head injury) can also be considered triggers. The symptoms may be caused by medication, alcohol, great stress, poor sleep, bad diet or drugs. Sometimes hides behind a supposed dementia but also a mental illness such. B. depression.
Age forgetfulness or dementia?
|Talks rather for a benign age forgetfulness||Talks more for dementia|
|Onset of symptoms over the age of 60 years.||Onset of symptoms under the age of 60 years.|
|Only temporary occurrence of forgetfulness.||The forgetfulness continues and even gets worse over months.|
|The difficulties (laying glasses, keys, etc., forgetting names) are only occasional.||The misplacing or forgetting pile up, especially for important items that you usually pay attention to (purse, checkbook, ID).|
|Through intense reflection or concentration, the person concerned usually recovers the forgotten.||The person concerned forgets entire areas of experience and memory contents and can not remember it despite intense reflection later.|
|The affected person knows how to help with certain memory aids (eg sticky notes).||Even sticky notes and memos are no use anymore.|
|The person concerned can follow verbal or written instructions.||The person concerned can not follow verbal or written instructions.|
First contact person is the family doctor
First stop in a questionable Alzheimer's disease should be the family doctor. He usually knows the patient for many years and can therefore best fit changes in mental and functional abilities or behavioral problems. At the beginning, the family doctor will conduct a detailed conversation with the patient. First, with the help of certain questions and tasks, he will examine whether there is actually a pathological disorder of concentration and memory, or whether it is a normal age-related loss of performance. In order not to overlook any of these many and mostly treatable disorders, the physician will, inter alia, perform laboratory tests, write an ECG to examine the heart function and examine the lungs (chest X-ray, lung function). When is the specialist asked? In the diagnosis of Alzheimer's suspicion frequently arise questions that require a consultation of the specialist in neurology and psychiatry. He is z. For example, they are asked when it comes to distinguishing between dementia and depression or to determine the type of dementia present.
Is there a depression behind it?
Even in patients with depression, the mental performance often appears lowered, it is also called pseudo-dementia. The distinction is important because of the different treatment approaches and for the success of therapy is crucial.
|Typical features a depression||Typical features of dementia|
|The failure phenomena progress rapidly at the beginning.||The deficits increase gradually during the entire duration of the disease.|
|The patient laments the loss of certain mental abilities.||The patient usually does not complain about the loss of certain mental abilities.|
|The patient does not try to stay efficient.||The patient tries to compensate for deficits, eg with reminders|
|The mood is constantly depressed.||The mood fluctuates.|
|The memory weakness for current and distant events is equally pronounced.||The memory weakness for current events is more pronounced than far back.|
For sufferers: memory clinics or memory consultation hours
In almost all major cities, there are facilities that specialize in the diagnosis and treatment of dementia diseases - so-called memory consultations, memory outpatient clinics or even memory clinics. During the memory consultation, neurologists, psychiatrists, internists, geriatrists and / or psychologists work to thoroughly examine the patient in order to clarify the exact cause of the memory disorder.
The team summarizes and evaluates the individual results in the "Diagnosis Conference". The doctor in charge discusses the diagnosis in a detailed consultation with the patient and his relatives and discusses the treatment options. Many memory clinics also offer family support groups or discussion groups.
Therapy of Alzheimer's disease
Modern medicines (so-called anti-dementia drugs) can slow down the progression of Alzheimer's disease. The memory and the ability to concentrate are improved. The patient is able to perform activities of daily life, such as talking on the phone, getting dressed, eating independently again. The autonomy and quality of life of Alzheimer's patients will be preserved as long as possible. The drugs are substances that have an effect on the messenger substances such as glutamate or acetylcholine in the central nervous system. Approved is memantine (protects against increased glutamate concentration) and acetylcholinesterase inhibitors (stop the acetylcholine deficiency).
Widely used is the use of Memantine
Memantine is approved for the treatment of moderate to severe Alzheimer's dementia in Germany. Memantine prevents the harmful effects of glutamate in Alzheimer's patients. Patients become more mentally active, everyday life skills are improved. Dementia-induced behavioral disorders such as aggressiveness and mood swings are also positively affected. For patients in need of care, there are also improvements: the patients are more flexible in making beds, they can better fulfill their personal hygiene, put on their own clothes, recognize people again, can better understand the contents of a conversation and also respond better. Memantine not only leads to mental and physical improvements, but also to a significant reduction in the time taken to care.
Acetylcholinesterase inhibitors prevent the enzymatic degradation of acetylcholine and thus reduce the messenger substance deficit. In the meantime, various acetylcholinesterase inhibitors are available, eg donepezil, rivastigmine or galantamine. The acetylcholinesterase inhibitors can cause side effects, which are primarily gastrointestinal complaints. It can also cause insomnia and headache.