Medical Health Information

Memory disorders: definition
The memory is a common complaint falters in the second half of life. It is then necessary to distinguish natural hazards occasional memory and those who preach organic brain impairment. The public is alerted not to say alarmed by the Plan Alzheimer and media relay, disorder memory evokes this disease.

From the age of 60, a memory disorder may be the first sign of a degenerative disease of the brain (neuro-degenerative disease for doctors), the most common is Alzheimer's disease. After 65 years, the frequency becomes significant, affecting 30% of people age 85 and increases continuously with age.

Risks and consequences of memory disorders
They are associated with addiction disorders resulting more or less severe memory. Only early diagnosis provides medical care and social organization that provides a better quality of life for patients and those who help them, it delays the entry into institution patients. This is why the Health Authority in March 2008 recommended a diagnostic approach, that is to say, a medical consultation, people complaining of a recent change in their functions called "cognitive" or mental in everyday language: memory, judgment, reasoning and understanding. This may be the entourage that offers consultation after notice of such changes.

Memory disorders Tips

When should you consult?

1 - When we asked about his memory
Should never stay on a question unsatisfied. It is the source of anxiety which exacerbates the damaging disorders and their perception. The doctor gives an opinion on the pathological nature of the complaint. He decides or not to deepen the balance in a specialized center: Center Memory Memory Resources and Research.
2 - In memory disorders that are characterized fear Alzheimer's disease or a related disorder
Disorders of memory are usually the first symptoms of Alzheimer's disease. They occur gradually as forgetting recent events, a difficulty with retention of new information or recall them in the "bank personal memories." Omissions in the conduct of daily life become more frequent and important. They often warn the family before the patient himself. The memory of old facts is best preserved early in the disease.
3 - In memory problems associated with other cerebral signs

At these memory problems are other symptoms:

- A language disorder characterized by a patient's difficulty in finding the right word when trying to say something, and what doctors call aphasia;

- Difficulty to recognize objects or faces, and there is no disturbance of vision, and is called agnosia (objects or people are known but are not recognized);

- Difficulty in daily tasks (preparing meals, dressing, shopping) with blunders gestures, called apraxia;

- Difficulties to orient themselves in time and space, difficulty reasoning, behavior change (sudden attacks of anger, apathy ...) or mood, which can go up to depression.

How is the consultation of doctor?

The doctor conducts simple tests focusing on memory. Upon completion of the comprehensive examination, especially neurological, or he decides not need a specialist.

It was the end of 2010, 507 reception points distributed throughout the territory, including the overseas departments: these consultations can detect Alzheimer's disease and its related diseases or make a definitive diagnosis before a memory impairment in the elderly.

How to prepare a consultation on memory?
Preventing the doctor in advance of the reason for the consultation so that it provides the time needed for this particular consultation.

Noting on paper the detailed facts that warrant concern and consultation.
Also noting all issues of concern to patients and their families to get informed about the firm, regardless of the doctor's advice.

With what should we not be confused?
With memory impairment associated with normal aging: occasional and transient, closely linked to attention provided.

Depression, side effects of drugs, alcohol, a sleep debt, a cerebrovascular accident (CVA) and various diseases are other possible causes of transient memory disorder.

Auditory and visual problems may worsen memory problems making it difficult to communicate with others.

Are there possible prevention of memory disorders pre-Alzheimer?
Anything that keeps the brain during life is desirable for a better age. Sleep hygiene, food (varied without toxic), maintenance of brain activity (crossword puzzles, games, learning various general culture).

It also slows the decline in brain first with an active lifestyle (regular exercise daily has proven its protective effect against brain atrophy and hippocampal) and multiple stimuli, maintaining exchanges with the surrounding world and emotional.

Can keep a diary of his daily life to help locate themselves in time. This is the fastest which appear blackouts for the physician and the family.

You can also opt for compensatory strategies oversights, as always put important items such as keys to the same locations.

Mild cognitive impairment pre-Alzheimer Preparing consultation

When do you consult?
Must consult your doctor if in doubt, especially when you're worried. Anxiety disorders charge on the memory since much depends on the mood, especially as they age.

Fear of diagnosis does not prevent the disease. The entry in dementia is a challenge that takes time to be accepted and supported, it is better not to wait for a crisis to react calmly and wisely.

Memory consultations are open throughout, as well as research centers and memory resources (CMRR) that support all aspects of the disease throughout its evolution. You can go directly to them to go faster diagnosis, anxiety or when important decisions for the future are to be taken.

How to prepare for the consultation with the doctor?
Describe as precisely as possible the memory disorders, date and circumstances of onset, disease and current treatments. With the help of a relative or not to confirm his "impressions". If difficulty managing daily exist, we must speak frankly to the doctor.

What is the doctor?
He asks questions to establish or rule out the diagnosis of Alzheimer's disease. It examines, offers a biological assessment to assess the condition and find a lack of essential vitamins neurons (B9 and B12) and a thyroid disorder. It verifies the impact of current medications on memory and the brain. Especially it is short tests to explore memory.

If the diagnosis of incipient Alzheimer disease is likely, the doctor prescribed an MRI to assess the atrophy of seahorses (areas responsible for memory) and eliminate other causes for signs of dementia.

Increasingly, research on markers of Alzheimer's disease in cerebrospinal fluid by lumbar puncture, to strengthen the diagnostic probability. But this test is usually done by a neurologist in a Center of Memory Resources and Research (CMRR) where the doctor sends his patient.

Memory consultations also welcome patients with memory complaints, they are diagnostic structure lighter and more numerous.

Support 100% of patients diagnosed "early dementia" is the affection of long duration (ALD) No. 15 "Alzheimer and related diseases.

Evident before the onset of Alzheimer's dementia, occurs a slow deterioration of brain function, especially memory. Mild cognitive impairment (mild cognitive impairment in English) is the best known pre-dementia disorders. Its existence has been questioned especially by Professor Bruno Dubois, a specialist in Alzheimer's disease, while an article published in July 2007 (Lancet Neurology).

With the International Working Group for New Research Criteria for the Diagnosis of Alzheimer's Disease, the same author confirmed in November 2010 (The Lancet Neurology) The term mild cognitive impairment should disappear in favor of the diagnosis of "Alzheimer beginner or early stage, "according to new diagnostic criteria.

Risks and challenges pre-Alzheimer disorders
The diagnosis of Alzheimer's disease is made on average after 2.5 to 3 years of evolution and even later manifest in patients less than 65 years, according to the collective expertise of INSERM (2007). Hence the importance of early detection of Alzheimer's disease for early care and well organized. The first signs of cognitive decline appear very early in the disease (some 10 to 12 years before), because brain lesions do not affect the behavior of patients when the compensation phenomena are overwhelmed.

Alzheimer's disease currently affects 850,000 and a forecast of 1.2 million people in 2020 (IFRAD Foundation for Research on Alzheimer's Disease, 2011). Nearly half of patients are at a stage of severity moderately severe to severe, or more than 400,000 people (estimate based on group data and study EURODEM PAQUID

Foundation IFRAD, Professor Bruno Dubois).

It is estimated that nearly 20,000 the number of "young" patients with early-onset form, the greatest risk is being unfairly treated for a psychiatric illness then it is a neurological disease.

Causes of pre-Alzheimer disorders
In a world first article showing how early brain damage (Amieva et al. Annals of Neurology, November 2010), the team of Prof. Jean-François Dartigues certify that the cohort of 3 cities early signs of deterioration Intellectual appear 10 to 12 years before diagnosis of Alzheimer obvious.

For Professor Dartigues this insidious deterioration is the lack of compensation brain aging. A closer examination, normal aging and dementia Alzheimer carry the same mechanisms, but in the second case, they are more serious and unevenly distributed in the brain. As if the metabolic derailed, under the combined effect of a real aggravation and lack of usual correction.

Neurons in the medial temporal region of the brain called the hippocampus deteriorates first. The hippocampus is where registers lasting memory of the events of daily life personal: we speak of memory "episodic" literally translating English, but it is the memory of autobiographical events so personal , the correct term is "autobiographical memory."

Then, other neurons are affected by oil stain until the general collapse of the brain. It is due to this disorder early autobiographical memory that doctors and patients are alerted.

Two other neural systems of memory are allocated quickly semantic memory (general knowledge about the world and the ideas, famous people, for example) and working memory which brings together knowledge from many briefly to occasionally something complex: the short-term memory to a mental calculation example.

Signs and symptoms of memory problems pre-dementia
Long, up to 10 years before major signs, deteriorating brain appears only psycho-neurological tests. Nobody really notices unless arise in consultation Memory stock.

Then the circle can be noted blackouts particular, that the patient may have noticed but denied for fear of evoking the tragic event of dementia during the installation. Very recent events seem important and definitely forgotten by the patient: the birth or marriage of a small - a child, a close bereavement.

In fact, they are not forgotten, they were never saved. This never happens in memory loss by normal aging, in which case it is only the lability of attention (such as children) that makes lightly loaded small events of interest are not included.

Characteristically, in incipient Alzheimer's disease, the memory impairment is not reversible (never found the missing event) and it gets worse over time. It lies close memories to personal memories older.

Deterioration of semantic memory itself (which gives the meaning of things, concepts) that the patient can not answer a question "simple" like "what the sun and what is here? "This disorder semantics extends gradually stabilizing sometimes, but never regress. One day the patient does not know what is ... range when asked the question. This is especially noticeable in games like "Questions for a champion."

Definition
Alzheimer's disease was described for the first time there are more than 100 years. Alzheimer's disease is closely linked to aging and the lengthening of the average life, is characterized by progressive loss of memory and cognitive functions, and is accompanied by behavioral disorders.

Risks and origins of Alzheimer's disease

Nearly 350,000 people receive care for Alzheimer's and related diseases. This condition should continue to grow in the coming years due to the increase in life expectancy: Alzheimer's disease has been decided "national cause" in 2007. A government plan "Alzheimer's 2008-2012" is underway to strengthen research on the disease and improve the care of patients.

Causes and mechanisms of Alzheimer's disease

Alzheimer's disease has an unknown origin. The brain of patients with this disease senile plaques and degeneration. Related to aging, Alzheimer's disease may be earlier onset, with approximately 10,000 new patients each year under age 60.

Repeated trauma to the head (boxers ...), as well as certain diseases (hypertension, diabetes ...) could play a role in the onset of Alzheimer's disease.

Symptoms of Alzheimer's disease

The evolution differs from one patient to another, but it is marked by a worsening of the disorder over time.
Symptoms first discrete and touching only the immediate memory of recent events, the memory loss is more pronounced. Impaired judgment and reasoning deteriorate. Language disorders appear a second time, with difficulty making elaborate gestures and simple gestures. With disorientation (time and space), the non-recognition of loved ones, home maintenance becomes difficult, especially as mood and behavior make relations difficult for the environment.

All these symptoms usually has an impact with eating disorders that cause weight loss may be important. Ultimately, the dependence is total until the death of the patient.

With what must it be confused with Alzheimer's disease?

Only an examination of the brain at autopsy can make the definitive diagnosis of Alzheimer's disease. Therefore, all the medical approach is to eliminate the symptoms of other diseases relatives, some are curable (depression, stroke, drug effects ...).

Is there a prevention possible?

The only possible prevention is to limit the evolution. Psychological support and psychocomportemental integral part of treatment, with memory exercises and socialization to renew the patient's home with the family.

Physiotherapy can mobilize the sickest patients. The house can quickly become a danger, should prevent accidents: label doors, drawers and furniture to easily identify and locate their content to accompany the patient to move about (or bracelet with name and address) to ensure that immediate environment presents little danger.

Small "tricks" to facilitate communication, such as sick leave at pictures of his house, his street and his family with the names listed on the back.

When to consult?

An early treatment can improve the lives of patients and their families. Consultations memory are implemented in hospitals (360 consultations currently in place). They allow screening for disease, for example to memory problems and reassure patients and their families in case of benign disorders.

What is the doctor?

The diagnosis of Alzheimer's disease may take time, because no test can say with certainty. Examinations performed (CT, MRI, blood ...) are useful to rule out other causes.

Once the diagnosis is confirmed, the management is multidisciplinary (physician, neurologist, social worker ...) with one objective: to maintain the patient at home as long as possible in good conditions. Many aids are available and facilitate this maintenance, while relieving families who bear the burden.

Alzheimer's disease is part of the list of long-term illnesses (ALD), including the cost of care and treatment is covered at 100% of the price of the Social Security Insurance.

Drugs available today do not cure Alzheimer's disease but hinder its development. They help fight against agitation, depression, hallucinations ...

How to prepare my next visit?

Note on a notebook to carry always with you, appointments or tasks to accomplish each day: it helps the everyday and can also identify reportable events to the doctor. Attending physician becomes a partner to coordinate decision supported.