WHAT ARE the ten good reasons to choose a facility that treats those affected by Alzheimer’s? The dilemma of how to recognize a valid specialized center, be it public or private, arises when one’s family member shows evident cerebral failures. The most frequent one, which sounds like a sentence when the diagnosis of Alzheimer’s may have already come some time before, are behavioral disorders: if your family member has little awareness of the environment and does not recognize who cares for him, it is better to hospitalize him. . “The ideal is that the patient, once the diagnosis is made, remains at home as long as possible – he explains Stefano Cappa, professor of Neurology at the Iuss of Pavia and head of the Mondino dementia research center – but when these disorders occur it is necessary to contact a structure “.
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When Alzheimer’s is diagnosed
Alzheimer’s disease is the most common form of dementia. It comes especially in old age: it is a neurodegenerative syndrome, which involves a gradual and irreversible loss of cognitive functions. The most characteristic symptoms they are memory deficit, language problems, personality changes, lack of initiative, confusion, disorientation and loss of reasoning and judgment skills. Experts believe that genetic and environmental factors, plus a certain style and, sometimes, familiarity with the disease contribute to causing Alzheimer’s disease. The evidence is clear on the pathophysiology of this form of dementia: the patient’s brain undergoes a process of atrophy and at an extra and intracellular level it accumulates protein aggregates, which seem to affect the survival and function of neurons.
The diagnosis is complex; In fact, numerous investigations are needed, including: physical examination, anamnesis, neurological examination, cognitive and neuropsychological tests, laboratory tests of various kinds and imaging diagnostics (brain CT scan and magnetic resonance imaging of the brain). Currently, Alzheimer’s disease is not curable. However, patients can count on various symptomatic treatments, which are able to alleviate the symptoms and slow down the inexorable cognitive deterioration typical of the disease.
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What options to choose for the sick person
“A real public health problem”, is how Cappa defines it. He underlines: “The increase in the duration of life has as a side effect an increase in diseases related to aging. In our clinic specializing in cognitive disorders we visit over a thousand patients a year, who are followed up over time. The current effort is to diagnose Alzheimer’s patients in the initial phase of the disease, because in this way we can influence aging. There are no definitive therapies, but for each patient a lot can be done through the intake of drugs that control the symptoms and also by affecting lifestyle. For example, in the initial phase you can participate in drug trials “.
What the patient needs to stop dementia
“Focus on improving your lifestyle, on a targeted diet, considering the protective effect that the Mediterranean type has; low in fat and rich in fruit and vegetables. And then physical exercise, even modest but regular. Not to mention the need to keep the brain busy with activities such as reading, playing and therefore social interaction “. According to the Mondino professor, the priorities for Alzheimer’s patients are these. In addition to the “need to avoid isolation and loneliness, along with all vascular risk factors, such as smoking, and to monitor blood pressure and blood sugar, things that the general practitioner can do well”.
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Where do we put the grandfather?
Based on these assumptions, and bearing in mind that Alzheimer’s mainly affects people over the age of 65, it is necessary to understand what to do, and how to do it best. So: on the basis of what assumptions do we choose the structure that may be most suitable for the grandfather with Alzheimer’s? “It depends on what stage the disease is in – clarifies Cappa -. If possible we keep it at home. We are talking about a pathology that can last up to 10-15 years. These patients, if treated at best, die not from Alzheimer’s. but for associated pathologies, such as infections or caused by immobility. So the ideal solution would be for the patient, once the diagnosis is made, to remain in his home as long as possible, especially if there are no behavioral disturbances. context must be followed: an assistant is needed or a day center can also be good “. What if it gets worse? “It can happen even after years – continues Cappa – it may be that over time he accuses symptoms such as sleep disturbances, poor awareness of the environment that surrounds him and maybe he doesn’t even recognize family members. Then hospitalization is the best choice”.
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Which structures to choose: the ten rules
But what characteristics must a health facility have in order for it to be considered suitable to best accommodate an Alzheimer’s patient? According to the Mondino expert, these are:
1 – a good quality environment, which can be a factor in slowing the disease. Structure that has knowledge of the pathology and knows how to manage it;
2 – medical expertise, with health personnel trained for the treatment of Alzheimer’s patients;
3 – a context that allows the patient to move, while being followed, for example in a garden or park;
4 – particular attention must be paid to food-related aspects. Alzheimer’s patients should preferably be directed towards a Mediterranean diet: low in fat and rich in vegetables;
5 – it is essential to ensure the patient the opportunity to exercise, so better if the chosen facility has a gym available;
6 – on the same level, in terms of importance, there is the game. The elderly with Alzheimer’s can stimulate their cognitive activity through play, for example playing cards. The presence of a day center can do the job;
7 – stimulating rehabilitation activities also involve music and dance. Some centers have successfully introduced them;
8 – the confrontation with the social is fundamental to keep the brain activity of the patients active. Then the contact with volunteers, who attend Alzheimer’s centers bringing moments of animation;
9 – pharmacological therapy, even experimental, is a fundamental point in choosing the right structure for the patient;
10 – attention to how to design the environment. When an Alzheimer’s patient moves, he needs non-tortuous paths and clear signals. Whoever designs or renovates a building suitable for hosting these patients must create linear and defined paths, if possible with the help of colors.
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Alzheimer’s patients in Italy and around the world
In Italy, according to the estimate of the Dementia Observatory of the Higher Institute of Health, about one million over 65 suffer from dementia (and about 40 thousand between the ages of 50-64), of which 600 thousand with Alzheimer’s (20-30 percent between 50-64 years). In 2020, the World Health Organization (WHO) reported that around 50 million people were suffering from dementia worldwide. Taking into account that Alzheimer’s disease accounts for 60-70% of all forms of dementia, this disease had between 30 and 35 million patients in the same year. As a result of the lengthening of the average life span of the human being, experts believe that the number of people with Alzheimer’s and, more generally, those with dementia is destined to increase progressively.
This prediction is also confirmed in past data: in 2010, there were 36 million people with dementia in the world, therefore 14 million fewer than in 2020. Also according to what reported by the WHO, every year, in the world, there would be 6 to 7 million new cases of Alzheimer’s (10 million new cases of dementia in total).
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