Knowledge point one
Alzheimer's disease can be divided into preclinical, mild cognitive impairment, and dementia. Most people's impression of Alzheimer's disease is often a symptom of a patient who has progressed to a dementia phase, and the early symptoms are often confused with normal aging and are ignored by the patient or his family. The World Health Organization clearly elaborated the 10 early warning signs of dementia in the "World Alzheimer's Disease Report 2021" and emphasized that dementia is not normal aging!
1. Memory loss. Especially forgetting about recent events, quickly forgetting what just happened.
2. Unable to complete work that would otherwise be familiar. For example, drivers often take the wrong road; bank employees can't count the bills; chefs don't know how to stir-fry vegetables.
3. Language expression disorders. It is often "unsatisfactory" and even explains simple words in a "substitution" way, such as "something used to write" instead of "pen".
4. The concept of time and place has declined. Sometimes I can't figure out the year, day or night, and it feels a little strange around my home.
5. Impaired or decreased judgment. Such as lending money to strangers, buying things repeatedly.
6. Difficult to plan affairs reasonably. It can be extremely difficult to complete complex mental tasks. If you make a mistake in dealing with each month's bill, it will also be difficult to break even.
7. Frequent misplacing of items. Such as fruit in the closet, socks on the table.
8. Changes in mood or behavior. Mood changes quickly, and people will suddenly cry or get angry and curse; there may also be unusual behaviors, such as spitting on the ground, taking items from the store without giving money, etc.
9. There are difficulties in understanding visual spatial information. For example, crossing the street and seeing the wrong traffic lights.
10. Decreased interest in work or social activities. Become unsocial, lose interest in their original hobbies, and withdraw from social activities.
Knowledge point two
The clinical diagnosis of Alzheimer's disease is a complex process, and the relevant tests include screening, comprehensive cognitive assessment, behavioral assessment and functional assessment based on scale evaluation, structural imaging and functional imaging-based brain imaging, and laboratory tests such as cerebrospinal fluid examination, blood tests, and gene sequencing.
The NIA-AA diagnostic criteria are the "core criteria" for the clinical diagnosis of Alzheimer's disease. This criterion is based on cognitive or behavioral symptoms confirmed by history and examination, and in addition to qualifying for a dementia diagnosis, should have:
1. Stealth onset.
2. Report or observe a clear history of cognitive deterioration.
3. Medical history and examination confirm that early and significant cognitive impairment has one of the following: amnesia symptoms and non-amnesia symptoms.
4. Meet the exclusion criteria. A history of cognitive decline or the presence of a mutation in a pathogenic Alzheimer's disease gene (APP, PSEN1, or PSEN2) can increase the certainty of a clinical diagnosis of Alzheimer's disease.
In general, the clinical manifestations of Patients with Alzheimer's disease range from mild forgetfulness, gradual loss of language ability, to moodiness, paranoia, and eventually to the inability to take care of themselves. For the elderly and their families, if they notice any one or more warning symptoms of varying degrees or those around them, they should ask their families to accompany them to the geriatrics, neurology, psychiatry/psychology, memory clinic or mental health specialist hospital of the general hospital in a timely manner.
Knowledge point three
The course of Alzheimer's disease is progressive, and the help of family members and caregivers should be provided throughout the entire cycle of the disease, including helping patients to eat a balanced diet, take medication correctly, regularly review, rehabilitation training, etc., and pay attention to all details, and there are different care points at each stage.
Early care
1. Patients need to be reminded to take medication and make medication records.
2. Check if the patient is taking the right medication at the right time.
3. Rearrange the drug if necessary.
4. Make an appointment with the doctor for the patient.
5. Accompany the patient to the doctor and bring the patient's medication list.
6. If the doctor does not know the patient, a health record should be prepared and the patient's symptoms should be described in detail.
Medium-term care
At this stage, patients may be less cooperative with treatment, may refuse to take necessary medications or eat regularly, or refuse to do other activities to maintain health, in which case certain medications that reduce irritability, anger, and uncooperativeness should be taken as prescribed by their physician. As with all medications, caregivers should check regularly to ensure that the medications are valid and to observe side effects.
Late care
Late in the patient's course, the family had to speak in place of the patient, telling the medical staff about the care intentions that the patient had mentioned when he was still able to express his thoughts.
Author: Xu Jian, Guangdong Shenzhen Chronic Disease Prevention and Control Center, Zhang Yan, Yuan Xueli
Review: Expert of the National Health Science Popularization Expert Database
Zhang Jian, Director of the Department of Geriatrics and Clinical Nutrition, Institute of Nutrition and Food, Chinese Center for Disease Control and Prevention
Video source: Shenzhen Chronic Disease Prevention and Control Center, Guangdong Province
Video recommendation: National Office of Action for Healthy Lifestyle Action for All
Planner: Tan Jia Yu Yunxi
Editor: Yu Yunxi