Alzheimer's disease is the most common neurodegenerative disease and type of dementia, accounting for 60% to 80% of all dementia. Its core pathological changes are the abnormal accumulation of beta-pollin proteins in the brain to form age spots, excessive oxidation of tau proteins to form neurotransmitter freezes, leading to neurodegenerative death, brain contraction, and persistent cognitive decline. Alzheimer's disease begins to hide, progress slowly, and gradually develops from mild memory decline to comprehensive cognitive impairment, mental abnormalities and complete dependence on daily life, bringing heavy burdens on patients, families and society.
It is most common in older people over 65 years of age, and the incidence of Alzheimer's disease increases dramatically with age. The causes of Alzheimer's disease are complex and are the result of a combination of genetic, age and environmental factors. Age is the greatest risk factor; genetically, a few cases of early onset are associated with mutations in the APP, PSEN1, PSEN2 genes, late onset is associated with genes such as lipoprotein E (APOE) e4, family history increases the risk of disease; vascular risk factors (high blood pressure, diabetes, high blood fat, smoking, obesity) are thought to be associated with the disease; Low level of education, lack of brain activity, social isolation, traumatic brain injury history, and depression are also risk factors.
The clinical manifestations of Alzheimer's disease are progressive. Early manifestations are mainly recent memory loss (forgetting what just happened, repeatedly asking the same questions), decreased ability to learn new knowledge, which can be accompanied by mild mood swings, but everyday life is still self-sufficient, and this period is often mistaken for 'old confusion'. Medium-term memory disorders are exacerbated, long-term memory is impaired, there are disorders of orientation (discernment of time, place, person), language disorders (difficulty finding words, confusion in expression), decreased computational ability, a marked decrease in daily life ability (not cooking, not managing money, losing weight), and symptoms of psychological behavior (doubts, delusions, hallucinations, cravings, dizziness).
Late-term patients lose language and cognitive abilities, especially sleep deprivation, difficulty sleeping, difficulty swallowing, combined infections and dizziness. The diagnosis of Alzheimer's disease relies on detailed medical history (family provided) cognitive functional metrics (MMSE, MoCA), neuropsychiatric examination and imaging examination. Head MRI can be seen in hemorrhoids and epithelial cysts; positive electron emission breakdown scans (PET) can show β-pollin deposits, cerebrospinal fluid screening can help with early diagnosis and identification.
Diagnosis with vascular dementia, Lou Gehrig's disease, and other forms of dementia is needed, and treatable causes such as thyroid dysfunction, vitamin B12 deficiency, and depression are excluded. Currently, there is no cure for Alzheimer's disease, but early intervention can delay progress and improve quality of life. Medicinal treatments: choline enzyme inhibitors (Donaitze, Kabalaze, Galantamine) for mildly moderate patients to improve cognitive and behavioural symptoms; NMDA receptor antibodies (NMDA) for moderate-weight patients; single-clonal antibodies to beta-blocking proteins (Cannaitze antibodies, Donaitze antibodies) approved for early patients since 2023, which can clear the plaques of cerebrospinal powder, delay cognitive decline, and are important breakthroughs in treatment.
Non-drug interventions are equally important: cognitive training, regular exercise, music therapy, behavioral interventions, caregiver support, etc. While actively controlling cardiovascular risk factors, preventing falls and loss, ensuring nutrition and sleep. The prevention of Alzheimer's disease is focused on 'whole life cycle management'.
Caregivers need to master the scientific approach to care, to rationalise their own stress, and to use community and social resources to ensure that patients live a dignified and caring life.
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