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Galantamine is a medication used to treat memory loss and dementia in patients with Alzheimer's Disease. Galantamine has several possible side effects that may occur. Some of these side effects are dizzyness, nausea, vomiting, and fainting. There are also possible drug interactions to be aware of if taking this medication.

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Acetylcholinesterase inhibitors, of course! These include ambinonium (Mytelase), physostigmine, neostigmine (Prostigmin, Vagostigmin), galantamine (Razadyne, Reminyl, Nivalin), pyridostigmine, Tacrin (Cognex), donepezil (Aricept), edrophonium (Tensilon, Enlon, Reversol) and rivastigmine (Exelon), and others.

3 answers


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Medical uses for the daffodil plant:

  1. In the daffodil tissue, there is a chemical called galantamine. This has been used to combat Alzheimer's disease.
  2. In Japan, a paste is made from daffodil to assist in wound healing.
  3. For centuries the daffodil has been used to induce vomiting.

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Dementia can be treated with medications such as tacrine and galantamine. These drugs can help to stabilize thinking and memory. Other treatments used are activities that stimulate the mind such as flash cards or computerized educational games. There are methods such as yoga and meditation which some people find helpful as well.

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Obsessive-Compulsive Disorder. Reminyl (galantamine hydrobromide) is now called Razadyne and is used for the treatment of mild to moderate dementia associated with Alzheimer's Disease. For more info: http://www.rxlist.com/cgi/generic/razadyne_ids.htm PS: i like pie

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There is currently no cure for Alzheimer's Disease. However, there are drug and drug-free treatments that can help with the symptoms. The medications that are currently used are from a class of medicines called cholinesterase. Three inhibitors are currently FDA approved; donepezil, Rivastigmine, and galantamine. These medicines work by preventing the breakdown of a chemical messenger called acetylcholine. There are also some treatments that focus on the behavioral and psychiatric symptoms related to the disease.

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All Narcissus (daffodils included) contain an alkaloid poison called lycorine. If ingested it will cause vomiting in humansas well as high blood pressure, headaches, blurred vision, irregular heartbeat and possibly death. Accidental ingestion is due to someone mistaking a daffodil bulb for an onion or shallot.

Another human response is the "daffodil itch" which as a common inflammation of the skin, especially in florist. This is caused by calcium oxalate in the sap, and will produce dryness, fissures, scalines and redening of the hands.

The ASPCA puts out a document which list the different animals and what is toxic to those particular animals. Daffodils are poisonous for all common household pets and livestock.

However, the good news is that there is a chemical called galantamine that daffodils produce. This has been used to combat Alzheimer's disease.
All Narcissus (daffodils included) contain an alkaloid poison called lycorine. If ingested it will cause vomiting in humansas well as high blood pressure, headaches, blurred vision, irregular heartbeat and possibly death. Accidental ingestion is due to someone mistaking a daffodil bulb for an onion or shallot.

Another human response is the "daffodil itch" which as a common inflammation of the skin, especially in florist. This is caused by calcium oxalate in the sap, and will produce dryness, fissures, scalines and redening of the hands.

The ASPCA puts out a document which list the different animals and what is toxic to those particular animals. Daffodils are poisonous for all common household pets and livestock.

However, the good news is that there is a chemical called galantamine that daffodils produce. This has been used to combat Alzheimer's disease.
All Narcissus (daffodils included) contain an alkaloid poison called lycorine. If ingested it will cause vomiting in humansas well as high blood pressure, headaches, blurred vision, irregular heartbeat and possibly death. Accidental ingestion is due to someone mistaking a daffodil bulb for an onion or shallot.

Another human response is the "daffodil itch" which as a common inflammation of the skin, especially in florist. This is caused by calcium oxalate in the sap, and will produce dryness, fissures, scalines and redening of the hands.

The ASPCA puts out a document which list the different animals and what is toxic to those particular animals. Daffodils are poisonous for all common household pets and livestock.

However, the good news is that there is a chemical called galantamine that daffodils produce. This has been used to combat Alzheimer's disease.
All Narcissus (daffodils included) contain an alkaloid poison called lycorine. If ingested it will cause vomiting in humansas well as high blood pressure, headaches, blurred vision, irregular heartbeat and possibly death. Accidental ingestion is due to someone mistaking a daffodil bulb for an onion or shallot.

Another human response is the "daffodil itch" which as a common inflammation of the skin, especially in florist. This is caused by calcium oxalate in the sap, and will produce dryness, fissures, scalines and redening of the hands.

The ASPCA puts out a document which list the different animals and what is toxic to those particular animals. Daffodils are poisonous for all common household pets and livestock.

However, the good news is that there is a chemical called galantamine that daffodils produce. This has been used to combat Alzheimer's disease.

8 answers


All Narcissus (daffodils included) contain an alkaloid poison called lycorine. If ingested it will cause vomiting in humansas well as high blood pressure, headaches, blurred vision, irregular heartbeat and possibly death. Accidental ingestion is due to someone mistaking a daffodil bulb for an onion or shallot.

Another human response is the "daffodil itch" which as a common inflammation of the skin, especially in florist. This is caused by calcium oxalate in the sap, and will produce dryness, fissures, scalines and redening of the hands.

The ASPCA puts out a document which list the different animals and what is toxic to those particular animals. Daffodils are poisonous for all common household pets and livestock.

However, the good news is that there is a chemical called galantamine that daffodils produce. This has been used to combat Alzheimer's disease.

1 answer


All Narcissus (daffodils included) contain an alkaloid poison called lycorine. If ingested it will cause vomiting in humansas well as high blood pressure, headaches, blurred vision, irregular heartbeat and possibly death. Accidental ingestion is due to someone mistaking a daffodil bulb for an onion or shallot.

Another human response is the "daffodil itch" which as a common inflammation of the skin, especially in florist. This is caused by calcium oxalate in the sap, and will produce dryness, fissures, scalines and redening of the hands.

The ASPCA puts out a document which list the different animals and what is toxic to those particular animals. Daffodils are poisonous for all common household pets and livestock.

However, the good news is that there is a chemical called galantamine that daffodils produce. This has been used to combat Alzheimer's disease.

1 answer


All Narcissus (daffodils included) contain an alkaloid poison called lycorine. If ingested it will cause vomiting in humansas well as high blood pressure, headaches, blurred vision, irregular heartbeat and possibly death. Accidental ingestion is due to someone mistaking a daffodil bulb for an onion or shallot.

Another human response is the "daffodil itch" which as a common inflammation of the skin, especially in florist. This is caused by calcium oxalate in the sap, and will produce dryness, fissures, scalines and redening of the hands.

The ASPCA puts out a document which list the different animals and what is toxic to those particular animals. Daffodils are poisonous for all common household pets and livestock.

However, the good news is that there is a chemical called galantamine that daffodils produce. This has been used to combat Alzheimer's disease.

1 answer


Examples of alkaloids are: the local anesthetic and stimulant cocaine; the psychedelic psilocin; the stimulants caffeine and nicotine; the analgesic morphine; the antibacterial berberine; the anticancer compound vincristine; the antihypertension agent reserpine; the cholinomimetic galantamine; the anticholinergic agent atropine; the vasodilator vincamine; the antiarrhythmia compound quinidine; the antiasthma therapeutic ephedrine; and the antimalarial drug quinine. No matter the type or use, alkaloids invoke a bitter taste.

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As of 2003, the FDA had approved four prescription medications for treatment of Alzheimer's. Tacrine, donepezil, riviastigmine, and galantamine are cholinesterase inhibitors that enhance memory.

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Alzheimer's disease is unfortunately a disease that cannot be cured. Most doctors will try a variety of things to slow the progression, and precautions must be taken at home to ensure the affected person does not get hurt. With the support of family and the proper precautions, a patient with Alzheimer's can live with the disease in relative safety and comfort.

7 answers


All Narcissus (daffodils included) contain an alkaloid poison called lycorine. If ingested it will cause vomiting in humansas well as high blood pressure, headaches, blurred vision, irregular heartbeat and possibly death. Accidental ingestion is due to someone mistaking a daffodil bulb for an onion or shallot.

Another human response is the "daffodil itch" which as a common inflammation of the skin, especially in florist. This is caused by calcium oxalate in the sap, and will produce dryness, fissures, scalines and redening of the hands.

The ASPCA puts out a document which list the different animals and what is toxic to those particular animals. Daffodils are poisonous for all common household pets and livestock.

However, the good news is that there is a chemical called galantamine that daffodils produce. This has been used to combat Alzheimer's disease.

5 answers


Animals learn very quickly not to bother the daffodils. Not only to they taste horrible, but they are poisonous - every inch of them.

All Narcissus (daffodils included) contain an alkaloid poison called lycorine. If ingested it will cause vomiting in humans as well as high blood pressure, headaches, blurred vision, irregular heartbeat and possibly death. Accidental ingestion is due to someone mistaking a daffodil bulb for an onion or shallot.

Another human response is the "daffodil itch" which as a common inflammation of the skin, especially in florist. This is caused by calcium oxalate in the sap, and will produce dryness, fissures, scalines and redening of the hands.

The ASPCA puts out a document which list the different animals and what is toxic to those particular animals. Daffodils are poisonous for all common household pets and livestock.

However, the good news is that there is a chemical called galantamine that daffodils produce. This has been used to combat Alzheimer's disease.

2 answers


they grow two times as much if you cut them under water and over night.
There are about 3,000 known varieties of cultivated tulips. The majority of tulips are grown and exported from Holland. A tulip plant typically has two to six leaves, and some species have up to twelve leaves.

4 answers


Many herbal medicines contain plants, such as echinacea for immune support, peppermint for digestion, and valerian for relaxation. Herbal remedies have been used for centuries in traditional medicine practices around the world. It's important to note that the effectiveness and safety of herbal medicines can vary, so it's best to seek guidance from a healthcare provider before use.

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Call the Poison Control Center (1-800-222-1222) if you or another human has ingested daffodil tissue. If a child chews on a bulb briefly, they will advise that in about 30 minutes the child will start to vomit. When the vomiting subsides, that will be the end of the problem. Someone from the center will contact you to make sure there is no further problem. If a soup has been made with daffodil bulbs, mistaken for onions, the center will advise you to head for the nearest emergency room, and they will monitor your care at the hospital.

All Narcissus (daffodils included) contain an alkaloid poison called lycorine. If ingested it will cause vomiting in humansas well as high blood pressure, headaches, blurred vision, irregular heartbeat and possibly death. Accidental ingestion is due to someone mistaking a daffodil bulb for an onion or shallot.

Another human response is the "daffodil itch" which as a common inflammation of the skin, especially in florist. This is caused by calcium oxalate in the sap, and will produce dryness, fissures, scalines and redening of the hands.

The ASPCA puts out a document which list the different animals and what is toxic to those particular animals. Daffodils are poisonous for all common household pets and livestock.

However, the good news is that there is a chemical called galantamine that daffodils produce. This has been used to combat Alzheimer's disease.

1 answer


Definition

Dementia is a loss of brain function that occurs with certain diseases. It affects memory, thinking, language, judgment, and behavior.

See also: Alzheimer's disease

Alternative Names

Chronic brain syndrome; Lewy body dementia; DLB; Vascular dementia; Mild cognitive impairment; MCI

Causes, incidence, and risk factors

Most types of dementia are nonreversible (degenerative). Nonreversible means the changes in the brain that are causing the dementia cannot be stopped or turned back. Alzheimer's disease is the most common type of dementia.

Lewy body disease is a leading cause of dementia in elderly adults. People with this condition have abnormal protein structures in certain areas of the brain.

Dementia also can be due to many small strokes. This is called vascular dementia.

The following medical conditions also can lead to dementia:

Some causes of dementia may be stopped or reversed if they are found soon enough, including:

Dementia usually occurs in older age. It is rare in people under age 60. The risk for dementia increases as a person gets older.

Symptoms

Dementia symptoms include difficulty with many areas of mental function, including:

  • Language
  • Memory
  • Perception
  • Emotional behavior or personality
  • Cognitive skills (such as calculation, abstract thinking, or judgment)

Dementia usually first appears as forgetfulness.

Mild cognitive impairment is the stage between normal forgetfulness due to aging and the development of dementia. People with MCI have mild problems with thinking and memory that do not interfere with everyday activities. They are often aware of the forgetfulness. Not everyone with MCI develops dementia.

Symptoms of MCI include:

  • Forgetting recent events or conversations
  • Difficulty performing more than one task at a time
  • Difficulty solving problems
  • Taking longer to perform more difficult mental activities

The early symptoms of dementia can include:

  • Language problems, such as trouble finding the name of familiar objects
  • Misplacing items
  • Getting lost on familiar routes
  • Personality changes and loss of social skills
  • Losing interest in things you previously enjoyed, flat mood
  • Difficulty performing tasks that take some thought, but that used to come easily, such as balancing a checkbook, playing games (such as bridge), and learning new information or routines

As the dementia becomes worse, symptoms are more obvious and interfere with the ability to take care of yourself. The symptoms may include:

  • Forgetting details about current events
  • Forgetting events in your own life history, losing awareness of who you are
  • Change in sleep patterns, often waking up at night
  • More difficulty reading or writing
  • Poor judgment and loss of ability to recognize danger
  • Using the wrong word, not pronouncing words correctly, speaking in confusing sentences
  • Withdrawing from social contact
  • Having hallucinations, arguments, striking out, and violent behavior
  • Having delusions, depression, agitation
  • Difficulty doing basic tasks, such as preparing meals, choosing proper clothing, or driving

People with severe dementia can no longer:

  • Understand language
  • Recognize family members
  • Perform basic activities of daily living, such as eating, dressing, and bathing

Other symptoms that may occur with dementia:

Signs and tests

Dementia can often be diagnosed with a history and physical exam by a skilled doctor or nurse. A health care provider will take a history, do a physical exam (including a neurological exam), and perform some tests of mental function called a mental status examination.

The health care provider may order tests to help determine whether other problems could be causing dementia or making it worse. These conditions include:

The following tests and procedures may be done:

Treatment

For information on how to take care of a loved one with dementia, see: Dementia - home care

The goal of treatment is to control the symptoms of dementia. Treatment depends on the condition causing the dementia. Some people may need to stay in the hospital for a short time.

Stopping or changing medications that make confusion worse may improve brain function.

There is growing evidence that some kinds of mental exercises can help dementia.

Treating conditions that can lead to confusion often greatly improve mental functioning. Such conditions include:

  • Anemia
  • Decreased oxygen (hypoxia)
  • Depression
  • Heart failure
  • Infections
  • Nutritional disorders
  • Thyroid disorders

Medications may be needed to control behavior problems caused by a loss of judgement, increased impulsivity, and confusion. Possible medications include:

  • Antipsychotics (haloperidol, risperdal, olanzapine)
  • Mood stabilizers (fluoxetine, imipramine, citalopram)
  • Serotonin-affecting drugs (trazodone, buspirone)
  • Stimulants (methylphenidate)

Certain drugs may be used to slow the rate at which symptoms worsen. The benefit from these drugs is often small, and patients and their families may not always notice much of a change.

  • Donepezil (Aricept), rivastigmine (Exelon), galantamine (Razadyne, formerly called Reminyl)
  • Memantine (Namenda)

A person's eyes and ears should be checked regularly. Hearing aids, glasses, or cataract surgery may be needed.

Psychotherapy or group therapy usually does not help because it may cause more confusion.

Expectations (prognosis)

People with mild cognitive impairment do not always develop dementia. However, when dementia does occur, it usually gets worse and often decreases quality of life and lifespan.

Complications

Complications depend on the cause of the dementia, but may include the following:

  • Abuse by an overstressed caregiver
  • Increased infections anywhere in the body
  • Loss of ability to function or care for self
  • Loss of ability to interact
  • Reduced lifespan
  • Side effects of medications used to treat the disorder
Calling your health care provider

Call your health care provider if:

  • Dementia develops or a sudden change in mental statusoccurs
  • The condition of a person with dementia gets worse
  • You are unable to care for a person with dementia at home
Prevention

Most causes of dementia are not preventable.

You can reduce the risk of vascular dementia, which is caused by a series of small strokes, by quitting smoking and controlling high blood pressure and diabetes. Eating a low-fat diet and exercising regularly may also reduce the risk of vascular dementia.

References

Brewer JB, Gabrieli JDE, Preston AR, Vaidya CJ, Rosen AC. Memory. In: Goetz CG, ed. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 5.

Farlow MR, Cummings JL. Effective pharmacologic management of Alzheimer's disease. Am J Med, 2007;120:388-397.

Burns A, Iliffe S. Alzheimer's disease. BMJ. 2009;338:b158.doi:10.1136/bmj.b158.

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== == == == Please see link at bottom. Note: Because someone forgets certain things as they age this does notmean they have on-set dementia connected to Alzheimer's Disease and is called 'the aging process' and is quite normal. Only 2% of the ages of 30's, 40's and 50's may be prone to the on-set of Alzheimer's Disease. Scientists have found that people that are constantly learning and using their brain on a daily basis seem less likely to be prone to memory loss. If one should be concerned about their memory loss as they age or of anyone in their family it's important that they see their physician for early detection. Physical Symptoms with a person with Alzheimer's Disease: * Slowly their memory will worsen and they will forget such things as a pot of water boiling on the stove and as the disease progresses may not even recognize their mate or own home. Eventually they will find they can't find the right words or forget how to read and write. Comprehension of what they read will reduce to almost zero percent. * Shuffling of the feet. * Stooped posture. * Wandering. The person will often forget where they are and leave the house only to get lost. If they are with a caregiver and are separated from them they can wander off quite quickly and some people with this disease will just keep walking or taking one bus after the other, while some will go into sheer panic mode. * Alzheimer's patients at the beginning of their disease can remember old memories very clearly, but find it difficult to comprehend conversations or new memories. Example: They may forget that they were at a grandchild's birthday party days ago or even just a few weeks previous. * Choking. The person with Alzheimer's can choke very easily on food because the brain is not sending the correct electrical impulses for the swallowing process and the esophagus does not work correctly (sort of like slinky toy) which pushes the food down into the stomach. * Anger Outburst. The person with Alzheimer's will eventually become angry (appear just old and cranky to members of the family) and prefer to be by themselves. Eventually, outburst of rage will appear and they can and will physically strike out at their caregiver. * Paranoia. The person with Alzheimer's will think perhaps that one of their family members is stealing something in their home or they may have given something to someone and call them a thief. They are paranoid of strangers and family alike which can cause the caregiver in the family and other family members great pain. * Insomnia * Swearing. Because Alzheimer's is a disease of the brain people with the disease can swear a blue streak even if they have never been much at swearing through their past lives. * Loss of language skills. The person with Alzheimer's may know what they want to say, but their brain refuses to compute and the person will become extremely agitated and as the Alzheimer's Disease progresses they are unaware of what they are saying or not saying. * High blood pressure. * Cholesterol problems. * Depression. * Adverse drug reactions * Nutritional difficulties (to the point of Anorexia) * Hypothyroidism As many as 4 million to 6 million people in the United States have the disorder. Given our aging population, it has been estimated that 14 million Americans will have Alzheimer's disease by the middle of this century unless we find a cure or preventive measures. The average length of time between the appearance of the first symptoms of Alzheimer's and death seems to range from 4 to 16 years. Women with the disease generally survive longer than men. Most Alzheimer's patients die of complications such as pneumonia. Diagnosing Alzheimer's Disease It is essential to note that memory loss does not necessarily presage Alzheimer's disease. All of us forget things once in a while. Furthermore, some slowing of memory is a normal consequence of aging. If you experience memory loss, but not at a level that interferes with the activities of daily life, you probably do not have the disease. The vast majority of people past the age of 65 do not have Alzheimer's disease. Only after doctors rule out other neurological or medical problems do they focus on the diagnosis of Alzheimer's disease. Then they use neuropsychological testing, brain imaging, and other techniques, such as blood tests and neurological and physical examination and history, to place people on two levels of diagnostic certainty: * Probable Alzheimer's disease-the person has no other illnesses that may contribute to the symptoms * Possible Alzheimer's disease the person meets the criteria for other illnesses that may contribute to his or her mental problems, such as hypothyroidism or cerebrovascular disease. What Affects the Risk for Alzheimer's Disease? While popular reports periodically circulate about dietary (for example, zinc) and other environmental factors (such as aluminum), none of these suspects have yielded anything definitive under investigation. People who develop Alzheimer's disease tend to use anti-inflammatory agents like aspirin and acetaminophen less often than their peers. Because chronic inflammation has been associated with amyloid deposition, anti-inflammatory agents could play an important role in slowing or inhibiting the disease. Several large studies are now in progress to test whether or not these drugs can prevent Alzheimer's disease. Drug Treatments for Alzheimer's Disease Since there is no cure for Alzheimer's, current treatment focuses on lessening its symptoms. Some researchers consider the loss of acetylcholine to be the reason for declining memory, so scientists have adopted the strategy of enhancing the brain's acetylcholine production. A class of drugs called cholinesterase inhibitors has a modest but positive effect on the memory-loss symptoms of the disease. * Tacrine (tetrahydroaminoacridine), sold as Cognex * Donepezil (Aricept) was approved for Alzheimer's disease in 1996. * Rivastigmine (Exelon) * Galantamine (Reminyl)Although there has been some indication that antioxidants can protect against memory loss, none has been shown to prevent Alzheimer's disease. People with Alzheimer's disease given vitamin E (2000 IU per day) lived longer than those taking a placebo, but showed no improvement in their mental function. Ginkgo biloba was found to provide a small benefit on cognitive testing in people with Alzheimer's disease, but the large number of dropouts in that trial has raised concerns about the validity of the results. Antidepressants, beta-adrenergic antagonists, lithium, benzodiazepines, and anticonvulsant drugs all show inconsistent results but are worth trying because they can help some individuals. In addition to sedating the person, many of these drugs worsen cognitive function; they have also been associated with falls and fractures. Antidepressants or sedatives will help an Alzheimer's patient with their insomnia. The Late Stages of Alzheimer's Disease In the last stages of illness, people with Alzheimer's disease are often unable to care for their most basic needs. Many individuals need round-the-clock care and are placed in nursing homes. People at this stage of illness may require tube feedings to maintain nutrition and decrease the risk of aspiration or choking. Skin care to prevent bedsores is important, as is bowel care. Maintaining the dignity of the individual is still important: dressing, bathing, feeding, and grooming a person with Alzheimer's each day is essential even though that person may appear unaware of his or her surroundings. When making end-of-life decisions the family should follow an individuals wishes, but that may not be possible if the person has not made appropriate legal decisions. Some people make out documents authorizing certain life-support measures and not others, called Advance Directives, before they succumb to dementia. For people who have not put these choices in writing, the decision is usually up to the next of kin or legal guardian. Disagreements within the family can cause a great deal of difficulty, particularly when a rapid medical decision is required. Counseling can be of help.

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Definition

Dementia is a loss of brain function that occurs with certain diseases. Alzheimer's disease (AD), is one form of dementia that gradually gets worse over time. It affects memory, thinking, and behavior.

Memory impairment, as well as problems with language, decision-making ability, judgment, and personality, are necessary features for the diagnosis.

Alternative Names

Senile dementia - Alzheimer's type (SDAT); SDAT

Causes, incidence, and risk factors

Age and family history are risk factors for AD.

  • As you get older, your risk of developing AD goes up. However, developing Alzheimer's disease is not a part of normal aging.
  • Having a close blood relative, such as a brother, sister, or parent who developed AD increases your risk.
  • Having certain combination of genes for proteins that appear to be abnormal in Alzheimer's disease also increases your risk.

Other risk factors that are not as well proven include:

  • Longstanding high blood pressure
  • History of head trauma
  • Female gender

There are two types of AD -- early onset and late onset.

  • In early onset AD, symptoms first appear before age 60. Early onset AD is much less common than late onset. However, it tends to progress rapidly. Early onset disease can run in families. Several genes have been identified.
  • Late onset AD, the most common form of the disease, develops in people age 60 and older. Late onset AD may run in some families, but the role of genes is less clear.

The cause of AD is not entirely known, but is thought to include both genetic and environmental factors. A diagnosis of AD is made when certain symptoms are present, and by making sure other causes of dementia are not present.

The only way to know for certain that someone has AD is to examine a sample of their brain tissue after death. The following changes are more common in the brain tissue of people with AD:

  • "Neurofibrillary tangles" (twisted fragments of protein within nerve cells that clog up the cell)
  • "Neuritic plaques" (abnormal clusters of dead and dying nerve cells, other brain cells, and protein)
  • "Senile plaques" (areas where products of dying nerve cells have accumulated around protein).

When nerve cells (neurons) are destroyed, there is a decrease in the chemicals that help nerve cells send messages to one another (called neurotransmitters). As a result, areas of the brain that normally work together become disconnected.

The buildup of aluminum, lead, mercury, and other substances in the brain is no longer believed to be a cause of AD.

Symptoms

Dementia symptoms include difficulty with many areas of mental function, including:

  • Language
  • Memory
  • Perception
  • Emotional behavior or personality
  • Cognitive skills (such as calculation, abstract thinking, or judgment)

Dementia usually first appears as forgetfulness.

Mild cognitive impairment is the stage between normal forgetfulness due to aging, and the development of AD. People with MCI have mild problems with thinking and memory that do not interfere with everyday activities. They are often aware of the forgetfulness. Not everyone with MCI develops AD.

Symptoms of MCI include:

  • Forgetting recent events or conversations
  • Difficulty performing more than one task at a time
  • Difficulty solving problems
  • Taking longer to perform more difficult activities

The early symptoms of AD can include:

  • Language problems, such as trouble finding the name of familiar objects
  • Misplacing items
  • Getting lost on familiar routes
  • Personality changes and loss of social skills
  • Losing interest in things previously enjoyed, flat mood
  • Difficulty performing tasks that take some thought, but used to come easily, such as balancing a checkbook, playing complex games (such as bridge), and learning new information or routines

As the AD becomes worse, symptoms are more obvious and interfere with your ability to take care of yourself. Symptoms can include:

  • Forgetting details about current events
  • Forgetting events in your own life history, losing awareness of who you are
  • Change in sleep patterns, often waking up at night
  • Difficulty reading or writing
  • Poor judgment and loss of ability to recognize danger
  • Using the wrong word, mispronouncing words, speaking in confusing sentences
  • Withdrawing from social contact
  • Having hallucinations, arguments, striking out, and violent behavior
  • Having delusions, depression, agitation
  • Difficulty doing basic tasks, such as preparing meals, choosing proper clothing, and driving

People with severe AD can no longer:

  • Understand language
  • Recognize family members
  • Perform basic activities of daily living, such as eating, dressing, and bathing

Other symptoms that may occur with AD:

Signs and tests

AD can often be diagnosed through a history and physical exam by a skilled doctor or nurse. A health care provider will take a history, do a physical exam (including a neurological exam), and perform a mental status examination.

Tests may be ordered to help determine whether other medical problems could be causing dementia or making it worse. These conditions include:

Computed tomography (CT) or magnetic resonance imaging(MRI) of the brain may be done to look for other causes of dementia, such as a brain tumor or stroke.

  • In the early stages of dementia, brain image scans may be normal. In later stages, an MRI may show a decrease in the size of different areas of the brain.
  • While the scans do not confirm the diagnosis of AD, they do exclude other causes of dementia (such as stroke and tumor).
Treatment

Unfortunately, there is no cure for AD. The goals in treating AD are to:

  • Slow the progression of the disease (although this is difficult to do)
  • Manage behavior problems, confusion, sleep problems, and agitation
  • Modify the home environment
  • Support family members and other caregivers

DRUG TREATMENT

Most drugs used to treat Alzheimer's are aimed at slowing the rate at which symptoms become worse. The benefit from these drugs is often small, and patients and their families may not always notice much of a change.

Patients and caregivers should ask their doctors the following questions about whether and when to use these drugs:

  • What are the potential side effects of the medicine and are they worth the risk, given that there will likely be only a small change in behavior or function?
  • When is the best time, if any, to use these drugs in the course of Alzheimer's disease?

Two types of medicine are available:

  • Donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne, formerly called Reminyl) affect the level of a chemical in the brain called acetylcholine. Side effects include indigestion, diarrhea, loss of appetite, nausea, vomiting, muscle cramps, and fatigue.
  • Memantine (Namenda) is another type of drug approved for treating AD. Possible side effects include agitation or anxiety.

Other medicines may be needed to control aggressive, agitated, or dangerous behaviors. These are usually given in very low doses.

It may be necessary to stop any medications that make confusion worse. Such medicines may include painkillers, cimetidine, central nervous system depressants, antihistamines, sleeping pills, and others. Never change or stop taking any medicines without first talking to your doctor.

SUPPLEMENTS

Many people take folate (vitamin B9), vitamin B12, and vitamin E. However, there is no strong evidence that taking these vitamins prevents AD or slows the disease once it occurs.

Some people believe that the herb ginkgo biloba prevents or slows the development of dementia. However, high-quality studies have failed to show that this herb lowers the chance of developing dementia. DO NOT use ginkgo if you take blood-thinning medications like warfarin (Coumadin) or a class of antidepressants called monoamine oxidase inhibitors (MAOIs).

If you are considering any drugs or supplements, you should talk to your doctor first. Remember that herbs and supplements available over the counter are NOT regulated by the FDA.

Support Groups

For additional information and resources for people with Alzheimer's disease and their caregivers, see Alzheimer's disease support groups.

Expectations (prognosis)

How quickly AD gets worse is different for each person. If AD develops quickly, it is more likely to worsen quickly.

Patients with AD often die earlier than normal, although a patient may live anywhere from 3 - 20 years after diagnosis.

The final phase of the disease may last from a few months to several years. During that time, the patient becomes immobile and totally disabled.

Death usually occurs from an infection or a failure of other body systems.

Complications
  • Loss of ability to function or care for self
  • Bedsores, muscle contractures (loss of ability to move joints because of loss of muscle function), infection (particularly urinary tract infections and pneumonia), and other complications related to immobility during end stages of AD
  • Falls and broken bones
  • Loss of ability to interact
  • Malnutrition and dehydration
  • Failure of body systems
  • Harmful or violent behavior toward self or others
  • Abuse by an over-stressed caregiver
Calling your health care provider

Call your health care provider if someone close to you experiences symptoms of senile dementia/Alzheimer's type.

Call your health care provider if a person with this disorder experiences a sudden change in mental status. (A rapid change may indicate other illness.)

Discuss the situation with your health care provider if you are caring for a person with this disorder and the condition deteriorates to the point where you can no longer care for the person in your home.

Prevention

Although there is no proven way to prevent AD, there are some practices that may be worth incorporating into your daily routine, particularly if you have a family history of dementia. Talk to your doctor about any of these approaches, especially those that involve taking a medication or supplement.

  • Consume a low-fat diet.
  • Eat cold-water fish (like tuna, salmon, and mackerel) rich in omega-3 fatty acids, at least 2 to 3 times per week.
  • Reduce your intake of linoleic acid found in margarine, butter, and dairy products.
  • Increase antioxidants like carotenoids, vitamin E, and vitamin C by eating plenty of darkly colored fruits and vegetables.
  • Maintain a normal blood pressure.
  • Stay mentally and socially active throughout your life.
  • Consider taking nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin), sulindac (Clinoril), or indomethacin (Indocin). Statin drugs, a class of medications normally used for high cholesterol, may help lower your risk of AD. Talk to your doctor about the pros and cons of using these medications for prevention.

In addition, early testing of a vaccine against AD is underway.

References

Aisen PS, Schneider LS, Sano M, Diaz-Arrastia R, van Dyck CH, et al. High-dose B vitamin supplementation and cognitive decline in Alzheimer's disease: a randomized controlled trial. JAMA. 2008;300:1774-1783.

DeKosky ST, Williamson JD, Fitzpatrick AL, Kronmal RA, Ives DG, Saxton JA, et al. Ginkgo biloba for prevention of dementia: a randomized controlled trial. JAMA. 2008;300:2253-2262.

Burns A, Iliffe S. Alzheimer's disease. BMJ. 2009;338:b158.doi:10.1136.bmj.b158.

Farlow MR, Cummings JL. Effective pharmacologic management of Alzheimer's disease. Am J Med. 2007;120:388-397.

3 answers


Definition

Parkinson's disease is a disorder of the brain that leads to shaking (tremors) and difficulty with walking, movement, and coordination.

Alternative Names

Paralysis agitans; Shaking palsy

Causes, incidence, and risk factors

Parkinson's disease was first described in England in 1817 by Dr. James Parkinson. The disease most often develops after age 50. It is one of the most common nervous system disorders of the elderly. Sometimes Parkinson's disease occurs in younger adults, but is rarely seen in children. It affects both men and women.

In some cases, Parkinson's disease occurs in families. When a young person is affected, it is usually because of a form of the disease that runs in families.

Nerve cells use a brain chemical called dopamine to help control muscle movement. Parkinson's disease occurs when the nerve cells in the brain that make dopamine are slowly destroyed. Without dopamine, the nerve cells in that part of the brain cannot properly send messages. This leads to the loss of muscle function. The damage gets worse with time. Exactly why the brain cells waste away is unknown.

Parkinson's in children may occur because the nerves are not as sensitive to dopamine. Parkinson's is rare in children.

The term "parkinsonism" refers to any condition that involves the types of movement changes seen in Parkinson's disease. Parkinsonism may be caused by other disorders (such as secondary parkinsonism) or certain medications.

Symptoms

The disorder may affect one or both sides of the body. How much function is lost can vary.

Symptoms may be mild at first. For instance, the patient may have a mild tremor or a slight feeling that one leg or foot is stiff and dragging.

Symptoms include:

  • Automatic movements (such as blinking) slow or stop
  • Constipation
  • Difficulty swallowing
  • Drooling
  • Impaired balance and walking
  • Lack of expression in the face (mask-like appearance)
  • Muscle achesand pains (myalgia)
  • Problems with movement
    • Difficulty starting or continuing movement, such as starting to walk or getting out of a chair
    • Loss of small or fine hand movements (writing may become small and difficult to read, and eating becomes harder)
    • Shuffling gait
    • Slowed movements
  • Rigid or stiff muscles (often beginning in the legs)
  • Shaking, tremors
    • Tremors usually occur in the limbs at rest, or when the arm or leg is held out
    • Tremors go away during movement
    • Over time, tremor can be seen in the head, lips, tongue, and feet
    • May be worse when tired, excited, or stressed
    • Finger-thumb rubbing (pill-rolling tremor) may be present
  • Slowed, quieter speech and monotone voice
  • Stooped position

Other symptoms:

Signs and tests

The health care provider may be able to diagnose Parkinson's disease based on your symptoms and a physical examination. However, the symptoms can be difficult to assess, particularly in the elderly. The signs (tremor, change in muscle tone, problems walking, unsteady posture) become more clear as the illness progresses.

An examination may show:

  • Difficulty starting or finishing voluntary movements
  • Jerky, stiff movements
  • Muscle atrophy
  • Parkinson's tremors
  • Variation in heart rate

Reflexes should be normal.

Tests may be needed to rule out other disorders that cause similar symptoms.

Treatment

There is no known cure for Parkinson's disease. The goal of treatment is to control symptoms.

Medications control symptoms, mostly by increasing the levels of dopamine in the brain. At certain points during the day, the helpful effects of the medication often wears off, and symptoms can return. Your doctor need to be change the:

  • Type of medication
  • Dose
  • Amount of time between doses
  • How the medications are taken

Work closely with your doctors and therapists to adjust the treatment program. Never change or stop taking any medications without talking with your doctor.

Many medications can cause severe side effects, including hallucinations, nausea, vomiting, diarrhea, and delirium. Monitoring and follow-up by the health care provider is important.

Eventually, symptoms such as stooped posture, frozen movements, and speech difficulties may not respond very well to drug treatment.

Medications used to treat symptoms of Parkinson's disease are:

  • Levodopa (L-dopa), Sinemet, levodopa and carbidopa (Atamet)
  • Pramipexole (Mirapex), ropinirole (Requip), bromocriptine (Parlodel)
  • Selegiline (Eldepryl, Deprenyl), rasagiline (Azilect)
  • Amantadine or anticholinergic medications -- to reduce early or mild tremors
  • Entacapone -- to prevent the breakdown of levodopa

Lifestyle changes that may be helpful for Parkinson's disease:

  • Good general nutrition and health
  • Exercising, but adjusting the activity level to meet changing energy levels
  • Regular rest periods and avoiding stress
  • Physical therapy, speech therapy, and occupational therapy
  • Railings or banisters placed in commonly used areas of the house
  • Special eating utensils
  • Social workers or other counseling services to help you cope with the disorder and get assistance (such as Meals-on-Wheels)

Less commonly, surgery may be an option for patients with very severe Parkinson's disease who no longer respond to many medications. These surgeries do not cure Parkinson's, but may help some patients:

  • In deep brain stimulation (DBS), the surgeon implants electrical stimulators in specific areas of the brain to help with movement.
  • Another type of surgery destroys brain tissues that cause Parkinson's symptoms.
Support Groups

Support groups may help you cope with the changes caused by the disease.

See: Parkinson's disease - support group

Expectations (prognosis)

Untreated, the disorder will get worse until a person is totally disabled. Parkinson's may lead to a deterioration of all brain functions, and an early death.

Most people respond to medications. How much the medications relieve symptoms, and for how long can be very different in each person. The side effects of medications may be severe.

Complications
  • Difficulty performing daily activities
  • Difficulty swallowing or eating
  • Disability (differs from person to person)
  • Injuries from falls
  • Pneumonia from breathing in (aspirating) saliva
  • Side effects of medications
Calling your health care provider

Call your health care provider if:

  • You have symptoms of Parkinson's disease
  • Symptoms get worse
  • New symptoms occur

Also tell the health care provider about medication side effects, which may include:

  • Changes in alertness, behavior or mood
  • Delusional behavior
  • Dizziness
  • Hallucinations
  • Involuntary movements
  • Loss of mental functions
  • Nausea and vomiting
  • Severe confusion or disorientation

Also call your health care provider if the condition gets worse and home care is no longer possible.

References

Lang AE. When and how should treatment be started in Parkinson disease? Neurology. 2009;72(7 Suppl):S39-43.

Miyasaki JM, Shannon K, Voon V, Ravina B, Kleiner-Fisman G, Anderson K, et al. Practice Parameter: evaluation and treatment of depression, psychosis, and dementia in Parkinson's disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2006;66:996-1002.

Pahwa R, Factor SA, Lyons KE, Ondo WG, Gronseth G, Bronte-Stewart H, et al. Practice Parameter: treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2006;66:983-995.

Suchowersky O, Reich S, Perlmutter J, Zesiewicz T, Gronseth G, Weiner WJ. Quality Standards Subcommittee of the American Academy of Neurology. Practice Parameter: diagnosis and prognosis of new onset Parkinson disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2006.66:968-975.

Weaver FM, Follett K, Stern M, et al. Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial. JAMA. 2009;301(1):63-73.

3 answers


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D
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E
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etoposide capsule++ Toposar®++, Vepesid®++
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F
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G
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H
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Q
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R
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S
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spironolactone tablet Aldactone®
spironolactone/HCTZ tablet Aldactazide®
stavudine capsule Zerit® capsule
sucralfate tablet Carafate®
sulfacetamide ophthalmic solution Bleph®-10
sulfacetamide sodium topical suspension Klaron®
sulfadiazine tablet Microsulfon®
sulfamethoxazole/trimethoprim tablet, suspension Bactrim®, Septra®
sulfasalazine tablet Azulfidine® EN-tabs®
sulfisoxazole tablet, suspension Gantrisin®
sulindac tablet Clinoril®
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T
tamoxifen tablet++ Nolvadex®++
temazepam capsule Restoril®
terbinafine HCL tablet Lamisil®
terazosin capsule Hytrin®
tetracycline capsule Achromycin®
theophylline tablet, capsule, elixir
thioridazine tablet, solution Mellaril®
thiothixene capsule Navane®
thyroid dessicated tablet
ticlopidine tablet Ticlid®
tilia FE tablet Estrostep® FE
timolol maleate ophthalmic solution Betimol®**
timolol maleate tablet Blocadren®
tizanidine tablet Zanaflex®
tobramycin ophthalmic solution Tobrex®
tolazamide tablet Tolinase®
tolbutamide tablet Orinase®
tolmetin tablet Tolectin®
tramadol tablet Ultram®
tramadol/APAP tablet Ultracet®
trandolapril tablet Mavik®
tranylcypromine sulfate tablet Parnate®
trazadone tablet Desyrel®
tretinoin capsule®++ Vesanoid®++
tretinoin cream, gel, lotion* Retin A®*
triamcinolone acetonide cream, ointment Aristocort®
triamcinolone tablet Aristocort®
triamterene/HCTZ tablet Maxzide®
triazolam tablet Halcion®
trifluoperazine tablet Stelazine®
trifluridine ophthalmic solution Viroptic®
trihexyphenidyl tablet Artane®
tri-legest FE tablet Estrostep® FE
trimethobenzamide capsule, suppository Tigan®
trimethoprim tablet Proloprim®
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U
unithroid tablet
urea cream, gel, lotion Keralac®
ursodiol capsule Actigall®
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V
valproic acid capsule, syrup Depakene®
valproate sodium syrup Depakene®
venlafaxine HCL tablet Effexor®
venlafaxine XR tablet Effexor XR® capsule
verapamil tablet Calan®
verapamil SR tablet Calan SR®
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W
warfarin tablet Coumadin®**
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Z
zaleplon capsule Sonata®
zidovudine capsule, tablet, syrup Retrovir®
zolpidem tartrate tablet Ambien®
zonisamide capsule zonegram

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