Alzheimer's dementia

More quality of life again

Alzheimer's disease generally starts insidiously and occurs more commonly in older people. Often, the initial memory gaps, orientation and speech problems are not taken seriously, are attributed to the normal ageing process or are just ignored. If the symptoms occur more frequently, many of those affected try to hide their problems from their family or employer due to feelings of fear or shame. It is important, however, to start treatment as early as possible.

Our specialists at Schoen Clinic have many years of experience in treating Alzheimer's disease. With various approaches to treatment, we pursue the goal of alleviating your symptoms and slowing down the progress of dementia.

Causes & symptoms

What is Alzheimer's disease?

Alzheimer's is the most common form of dementia. It is a neuro-degenerative conditions that causes problems with the memory, orientation and the ability to think and judge. These problems occur due to the increasing loss of nerve cells and prevention of the transfer and processing of information between those nerve cells.
The risk of Alzheimer's increases as we get older, especially from the age of 80 onwards. The memory lapses continue to get worse, which is why people who are affected by this condition should have reviews at least every six months.

Causes: How does Alzheimer's develop?

Scientists are still not fully certain why brain cells die off. There is a lot of evidence, however, to indicate that a whole raft of genetic and environmental risk factors are involved. Alzheimer's patients are all found to have protein deposits between and inside their brain cells. The role of this protein, however, is still debated.
One thing is certain: the extent of the disease is still determined by messenger substances that transfer the signals from one nerve cell to the next. If the concentration of these messenger substances changes, the transfer of impulses between the nerve cells in the memory system no longer functions correctly.

Symptoms: Signs of Alzheimer's

Early-stage symptoms
The earliest symptom of dementia is generally when new information can no longer be reliably stored in the memory. Since we all experience difficulties with this as we grow older, mild forgetfulness does not necessarily mean dementia.

The following symptoms, however, may indicate the presence of the condition:
  • Frequent forgetting of recent events
  • Difficulties carrying out habitual activities
  • Problems finding the right words during speech
  • Difficulties finding one's way around in unfamiliar environments
  • Dwindling interest in work, hobbies and friends
  • Loss of control over financial affairs
  • Mood fluctuations that have not occurred previously, persistent anxiety, irritability and mistrust
Middle-stage symptoms
The ability to remember events that occurred further back in time also gradually diminishes. Disorientation increasingly affects details relating to the individual's life history. The planning and coordination of movements are also affected: simple activities, such as buttoning up a shirt or using the TV, become increasingly difficult. Spatial orientation is also gradually lost. As a result of this lack of orientation, anxiety and uncertainty can increase. Objects are left in unusual places, which means they are no longer immediately able to be found. Patients need to ask for more help to cope with their everyday lives.

Late-stage symptoms

Severe memory gaps occur, and patients can often only speak a few words. Bladder and bowel control, as well as posture, can be lost. Patients are no longer able to walk unaided and become bed-bound. They need to be looked after at home.

Diagnostics

Diagnosis: How we diagnose Alzheimer's?

If you think you may have Alzheimer's disease, you and your relatives should visit a specialist in neurology or psychiatry. The doctor will then ask you about the progress of your symptoms so far, such as when you first noticed something was wrong. Using a systematic psychological or psychiatric examination technique, your awareness, orientation, attentiveness, ability to remember things, sensory delusions and mood will be documented. Blood tests and possibly a sample of your cerebrospinal fluid will be taken to rule out any other possible causes for your symptoms. These include hormonal disorders, vitamin deficiencies, metabolic disorders and chronic infectious diseases.

Revealing treatable causes with imaging methods

We are able to uncover some of the rare, potentially treatable causes of dementia using CT or MRI scans. During these scans, sectional images are generated of your brain. More modern methods are also able to visualise the flow of blood through the brain and make the activity of certain parts of the brain visible. Repeated examinations will generally show any progression of brain shrinkage.

Psychometric testing to confirm the diagnosis

To ensure a reliable diagnosis, we also use psychometric testing. This involves questions, tasks or practical work to objectively document your mental capacity or any shortfalls at an early stage. The severity of your brain capacity problems can be roughly determined using the ten-minute Mini Mental State Test (MMST). This looks at your orientation, memory, attentiveness, calculation skills, speech and logical thinking, for example. In late-stage Alzheimer's especially, the tests also take into account cognitive, affective and motor aspects.