Dementia
About 5-8% of all people over the age of 65 have some
form of dementia, and this number doubles every five years above that
age.
Dementia is the loss of mental ability that is severe enough to
interfere with
people's every life and Alzheimer's disease is the most common type of
dementia
in aging people. American typical diet contains high amount of saturated
and trans fat, artificial ingredients with less fruits and vegetable
which can lead to dementia and other kind of diseases.
Treatments
Depending to the causes of disease, most medication are to control the symptoms
A. Alzheimer's disease and Diminished quality of acetylcholine
A.1. Treatments of mild and moderate Alzheimer's disease and Diminished quality of acetylcholine
1. Cholinesterase inhibitors
a. Cholinesterase inhibitors are the
primary treatment, including tacrine (Cognex), donepezil (Aricept),
rivastigmine (Exelon), and galantamine (Reminyl) for the cognitive
symptoms of Alzheimer disease
(AD). Dr. Trinh NH and the research team at the Massachusetts General
Hospital, showed that for neuropsychiatric outcomes, 10 trials included
the ADAS-noncog and 6
included the NPI. Compared with placebo, patients randomized to cholinesterase inhibitors
improved 1.72 points on the NPI (95% confidence interval [CI],
0.87-2.57 points), and 0.03 points on the ADAS-noncog (95% CI, 0.00-0.05
points). For functional outcomes, 14 trials used ADL and 13 trials used
IADL scales. Compared with placebo, patients randomized to cholinesterase inhibitors
improved 0.1 SDs on ADL scales (95% CI, 0.00-0.19 SDs), and 0.09 SDs on
IADL scales (95% CI, 0.01 to 0.17 SDs). There was no difference in
efficacy among various cholinesterase inhibitors(1). Some researchers suggested that Persistent drug treatment had a positive impact on AD progression
assessed by multiple cognitive, functional, and global outcome measures.
The magnitude of the treatment effect was clinically significant.
Positive treatment effects were even found in those with advanced disease(2). Some researchers suggested that if there is a decrease in the level of
acetylcholine, a chemical messenger that assists memory, thought and
judgment, then cholinesterase inhibitors may eventually lose their
effect. In the article, Cholinesterase Inhibitors, posted in the
Minister of health, the author(s) wrote that Cholinesterase inhibitors
were developed to improve the effectiveness of
acetylcholine either by increasing the levels in the brain or by
strengthening the way nerve cells respond to it. Increased
concentrations of acetylcholine in the brain lead to increase
communication between nerve cells and may temporarily improve or
stabilize the symptoms of Alzheimer's disease. These drugs appear to
work best in the early and moderate stages of Alzheimer's Disease(3).
b. Side effects are not limit to
b.1. Nausea
b.2. Diarrhea
b.3. Vomiting
b.4. Indigestion.
b.5. Abdominal pain
b.6. Loss of appetite
b.7. Fatigue
b.8. Weight loss
b.9. Etc.
A.2. Treatment of moderate and Severe Alzheimer's disease and Diminished quality of acetylcholine
a. Namenda® (memantine), an N-methyl D-aspartate (NMDA) antagonist are
the most common medication used to moderate and Severe Alzheimer's
disease.Scientists at the Brigham and Women's Hospital, Harvard Medical
School, indicated that The key to memantine's therapeutic action lies in
its uncompetitive
binding to the NMDAR through which low affinity and rapid off-rate
kinetics of memantine at the level of the NMDAR-channel preserves the
physiological function of the receptor, underpinning memantine's
tolerability and low adverse event profile. As the biochemical pathways
evoked by NMDAR antagonism also play a role in PD and since no other
drug is sufficiently effective to substitute for the first-line
treatment of L-dopa despite its side effects, memantine may be useful in
PD treatment with possibly fewer side effects(7). Others suggested that
Moderate to severe AD. Two out of three six month studies show a small
beneficial effect of memantine but not those in vascular dementia(8).
b. Side effects are not limit to
b.1. Confusion,
b.2. Dizziness
b.3. Drowsiness
b.4. Headache
b.5. Insomnia,
b.6. Agitation
b.7. Vomiting
b.8. Anxiety
b.9. Etc.
A.3. Other medication
3.1. Anticonvulsants
a. Anticonvulsants are a diverse group of pharmaceuticals used in the treatment of seizures, the clinical syndrome of Alzheimer's disease by suppressing
the rapid and excessive firing of neurons that start a seizure. Some
research suggested that Seizure pathophysiology may relate to increased
amyloid beta-peptide
production, structural alterations in neurones related to cytoskeletal
dysfunction, cerebrovascular changes, neurotransmitter dysfunction or
combinations thereof. Through modification of these pathophysiological
pathways, there may be possible roles for anti-epileptic drugs such as
sodium valproate and lacosamide in the treatment of Alzheimer's disease(4)
b. Side effects are not limit to
b.1. Dizziness
b.2. Drowsiness
b.3. Unsteadiness
b.4. Nausea
b.5. Vomiting
b.6. Skin rashes
b.7. Etc.
3.2. Sedatives
a. A sedative or tranquilizer is a drug that calms a patient, reducing
irritability and excitement by by modulating signals within the central
nervous system.The medication are highly addictive. Researchers at the
Weill Cornell Medical College showed that antidepressant
efficacy in BPSD other than depression (in particular, agitation,
aggression and, occasionally, psychotic symptoms) do not influence
prescription choices. Depressive symptoms may be taken more seriously in
the absence of a previous history of depression, leading to increased antidepressant prescription rates in individuals presenting with depression for the first time(5).
b. Side effects are not limit to
b.1. Stomach upset
b.2. Blurred vision
b.3. Headache
b.4. Impaired coordination
b.5. Depression
b.6. Memory loss
b.7. Drowsiness
b.8. Etc.
3.3. Antidepressants
a. Antidepressant is a type of
psychiatric medication used to treat depression, including mood
disorder, dysthymia and anxiety disorders.In the study to assess the prevalence of antidepressant use in AD and to identify the clinical factors associated with antidepressant prescription, Dr. Arbus C, and the team at the Purpan-Casselardit Hospital, suggested that Antidepressant
treatment was prescribed for 34.8% of patients. Clinically significant
depressive symptoms (NPI >or= 4) were observed in 20.5% of the total
population. Although depressed subjects were significantly more likely
to be treated with antidepressants than non-depressed subjects
(p<0.0001), only 60% of depressed subjects overall were prescribed an
antidepressant. In multivariate analysis, clinically significant depressive symptoms were associated with antidepressant prescription although this result was only observed in subjects without a previous history of depression(6).
b. Side effects are not limit to
b.1. Dry mouth,
b.2. Blurred vision
b.5. Drowsiness,
b.4. Dizziness
b.5. Tremors
b.6. Sexual problems
b.7. Etc.
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Sources
Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/12517232
(2) http://www.ncbi.nlm.nih.gov/pubmed/19845950
(3) http://www.health.gov.bc.ca/pharmacare/adti/clinician/cholinesterase.html
(4) http://www.ncbi.nlm.nih.gov/pubmed/19557550
(5) http://www.ncbi.nlm.nih.gov/pubmed/20980585
(6) http://www.ncbi.nlm.nih.gov/pubmed/19735591
(7) http://www.ncbi.nlm.nih.gov/pubmed/21875407
(8)
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003154.pub4/abstract;jsessionid=81B82BC5B10FAB9959A92CF39D439C21.d02t02
Health Researcher and Article Writer. Expert in Health Benefits of Foods, Herbs, and Phytochemicals. Master in Mathematics & Nutrition and BA in World Literature and Literary criticism. All articles written by Kyle J. Norton are for information & education only.
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