Questioning Alzheimer’s

BBC Radio 4’s medical programme Check Up just broadcast a phone in on Alzheimer’s disease with neuroscientist Prof Clive Ballard.

The programme tackles issues of diagnosis, treatment and what actually happens in the brain.

I’m often surprised about how little people know about this relatively common neurological disorder.

One of the most common questions I have been asked is ‘what is the difference between dementia and Alzheimer’s disease?’

Dementia just describes any condition where the brain declines more quickly than would be expected due to normal ageing.

The MRI scan on the right shows the brain of a person affected by Alzheimer’s. Notice the ‘shrinkage’. Click for a comparison.

There are various different types of dementia and Alzheimer’s disease is one specific type where the brain is affected by amyloid plaques (abnormal clumps of protein) and neurofibrillary tangles (tangled bundles of protein fibres).

It’s possible to have these without suffering dementia, but it seems when the impairment reaches above a certain threshold, the brain quickly declines.

Although there are clear physical changes in the brain which indicate the disease, it’s actually impossible to diagnosis Alzheimer’s for sure until after the person has died and a brain autopsy can be completed.

So, to diagnose someone, a clinician might use a number of methods. In order of reliability they include history of memory and behavioural change, simple mental tests (commonly the MMSE), or a more comprehensive neuropsychological assessment that may be repeated over time to look for the exact pattern of change.

A truly comprehensive assessment will include all of the above, although it’s actually quite rare that this happens.

A full neuropsychological assessment for diagnosis has been an innovation of specialised ‘memory clinics‘ that might also provide a treatment service and family support.

Alzheimer’s seems to particularly affect key memory structures, and problems with memory are one of the most distinctive signs of the disorder.

However, less known are behavioural difficulties, personality change and psychotic symptoms (delusions and hallucinations) which occur in a significant proportion of suffers and are often more distressing for friends and family than the forgetfulness.

The programme tackles a wide range of issue including the role of medication, healthy living, the possible effectiveness of ‘brain training’ and how to deal with some of the challenges in living with someone with the condition.

The Alzheimer’s Association have created a fantastic tour that’s definitely worth a vist if you want a wonderful visual guide to the brain and how it breaks down during the progression of Alzheimer’s disease.

Link to Check Up on Alzheimer’s disease.
Link to Alzheimer’s information.
Link to fantastic tour of brain changes in Alzheimer’s.

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