1.D.N. developed Alzheimer’s disease at age 50. Early signs were vague and included occasional errors in judgment and increased criticism of others, noted only in retrospect. Several years later, following several episodes of extreme anger, a diagnosis of Alzheimer’s disease was made. At this time, it was suspected that his father had also had AD, but had died from an unrelated cause before a diagnosis could be made.
1. Why is a diagnosis difficult in the early stage of AD?
2. Could there be a familial factor?
3. Describe the pathologic changes that occur in the brain with AD. The neurologist prescribed galantamine (Reminyl), an anticholinesterase inhibitor and regular attendance at a group center offering appropriate activities.
4. How would this drug be useful in treating AD?
The degeneration progressed rapidly over the next 2 years. The maximum dose of galantamine is no longer effective. He is confused about any change and not capable of performing simple activities. Communication is impaired, including that with family members.
5. Describe what might be expected in the final stage of AD.