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What should I do if some of my relatives is in suspicion of…

What should I do if...
What should I do if some of my relatives is in suspicion of Alzheimer's disease, maybe into some phases already. What are the modern medical developments about this disease?Please don't cite some database or literature. I'd be appreciated if it's personal knowledge and confident data. What would the patients generally preferable to go? And finally, if there are a list of valuable medical textbooks will be very welcomed.
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Answered in 11 hours by:
2/18/2018
Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 6,255
Experience: American Board Certified Neurologist, Internal Medicine
Verified

Hi, I am an American Board Certified Neurologist with vast experience in diagnosing & treating all neurological as well as all other health/medical conditions, and I am very glad to help you with your health concerns related to your relative.

I see you are suspecting the possibility of AD (Alzheimer’s dementia) in some of your relatives, as a Neurologist I frequently diagnose & treat this type of health situation and I can certainly help you in this regard.

The following are the various diagnostic and therapeutic approaches related to AD (and these are all the most modern & latest developments);

With regard to the diagnosis of AD (Alzheimer’s dementia) the following are the various clinical and laboratory approaches towards ruling in or ruling out the possibility of AD;

1) Clinical evaluation and examination including a detailed mental status examination, especially by a neurologist, and sometimes additional cognitive functions related clinical testing such as a Neuropsychology testing too may be necessary

2) Blood tests to rule out other causes for memory loss (AD mimickers) – such as thyroid, disease, vitamin deficiencies, infections, inflammatory conditions, metabolic/electrolyte disturbances etc

3) An imaging study of the brain – such as a CAT scan or MRI scan of the brain. An MRI scan is superior to CAT scan of the brain.

4) There are certain advanced MRI protocols such as NeuroQuant – which measures the volume of the brain such as the areas of the brain that are commonly affected by AD such as atrophy or thinning of the Hippocampus and other regions of temporal and parietal regions of the brain

5) One of the special brain scans such as the following;

a) FDG PET (Fluro Deoxy Glucose PET scan)

b) Amyloid PET scan (Amyvid PET scan or Florbetapir F-18 PET scan)

c) 99mTc-HMPAO SPECT scan etc

6) A spinal tap (also called as Lumbar puncture or LP) to collect a sample of CSF (Cerebro spinal fluid) which is sent to the lab for identifying and quantifying CSF biomarkers such as p-tau, t-tau & Abeta-42 peptide csf levels etc

7) If none of the above investigations help then rarely a brain biopsy is considered too, although in real clinical practice a brain biopsy is almost never done to rule in or rule out AD since the above mentioned investigations are sufficient for this purpose and there is no need for invasive investigations such as brain biopsy etc

If a brain biopsy is indeed done then it will show under the microscope certain changes in the brain that are typical for AD, and if such changes are seen then it is diagnostic of AD. The definite diagnosis of Alzheimer's disease (AD) is based on the detection of deposits or presence of the following changes in the brain;

Diffuse Amyloid Beta (Aβ) Plaques

NFTs (Neurofibrillary Tangles)

Neuritic Plaques etc

The above findings are the pathological hallmarks of AD.

Other important finding that is also seen under microscope includes findings such as loss of brain cells (called as Neurons) too.

The above are the various diagnostic approaches towards ruling in or ruling out AD.

Now coming to the treatment of AD;

Please see there are no curative treatments that are yet available for AD. The treatments that are available currently are symptomatic, in the sense these treatments can help in improving the memory and also to some extent slow down the memory decline too, but curative treatments are still not available for AD.

This below is a list of various therapeutic interventions or treatment options to help with improving & slowing down the memory loss, and this list includes certain general measures, dietary modifications, physical exercises, mental exercises, sleep, OTC nutritional supplements, Prescription treatments, and certain additional and experimental treatments etc to help with AD.

This is the list for various therapeutic approaches that are available for AD;

A) Trying certain dietary modifications can help in improving the memory and also slowing down the memory loss. Scientific studies have shown - for example trying a healthy & balanced diet called as “Mediterranean diet” can help with memory function.

Mediterranean Diet is a diet rich with nuts, legumes (beans, pulses/lentils), whole grains (instead of refined grains), fruits, vegetables, fish, lean meat etc. This type of diet consists of very low amounts of red meat, processed meat & animal fat etc (animal fat consists of lot of cholesterol & saturated fat/trans fat – which are considered bad forms of fat). Fish fat is considered as good fat since it contains lots of omega 3 fatty acids such as EPA & DHA which are a type of polyunsaturated fatty acids (PUFAs) - and these types of fats are considered good for the health of the brain. Vegetable oils such as Canola oil or Olive oils are also promoted with this type of diet since these vegetable oils contain healthy monounsaturated & polyunsaturated fats and also omega 3 fatty acids, especially the canola oil.

B) Trying Physical exercises – Physical Exercises, especially the Aerobic exercises on regular basis help in improving memory, as well as slowing down memory loss. Examples of aerobic exercises include walking, running, jogging, stair climbing, swimming, hiking, aerobics classes, dancing, bicycling, cardio machines etc.

C) Trying Mental exercises such as solving tough crossword puzzles, brain teasers, communication, socialization, computer based mental exercises etc also can considerably help in improving memory as well as slowing down memory loss. Anything that challenges the brain such as memory games, puzzles, problem-solving, time tests, learning a new skill etc all can help. Brain HQ is an online brain training exercise system, and it can reduce the risk of dementia by 29%. And it is scientifically proven to help. This is the link for this brain training exercise system - https://www.brainhq.com

D) Adequate daily sleep. Sleep is important to memory formation. Memory formation, consolidation and storage occur when we sleep. The recommended amount of sleep to get is about 7– 9 hours every day.

E) Trying one or more of the nutritional supplements or OTC (Over the counter) preparations such as the ones mentioned below (these are also called as Cognitive supplements);

Methyl Guard Plus (This combination special multivitamin pill contains Active forms of Vitamin B12, Vitamin B9/Folic acid, Vitamin B6, & Vitamin B2)

Sulbutiamine (a special form of vitamin B1 that reaches the brain better than the regular form of vitamin B1)

Vitamin Niacin (vitamin B3), Vitamins A, D, E & C

Minerals such as Selenium, Calcium, Magnesium, Zinc

Fish oils or Omega 3 Fatty acids (DHA & EPA)

Curcumin/Turmeric extract

Ginkgo Biloba

Ginseng

Brain neurochemical “Acetyl choline” enhancers such as - Citicoline (CDP Choline), Alpha GPC (Alpha Glycero phosphor choline) etc

One of the Racetams such as Piracetam, or Aniracetam, or Omberacetam etc

Acetyl L Carnitine

ALA (Alpha Lipoic acid)

Coenzyme Q10 (CoQ10)

Bacopa Monnieri (Brahmi)

Anti-Oxidant preparations such as “Advanced Antioxidant Formula” or “Super Oxidants”

Ashwagandha

Gotu Kola

Rhodiola etc

All the above nutritional supplements or herbal or natural preparations are available as OTC (Over the counter) without the need for any prescriptions. Not all of the above nutritional supplements are required; I am providing a list like this so that you guys are familiar with the various nutritional supplements that are available to help with conditions such as AD.

F) Trying Aromatherapy

G) Trying one or more of the prescription medications or prescription medical foods such as the following can help too;

Medical Food such as Axona (Caprylic triglyceride)

Memantine

Rivastigmine

Donepezil

Razadyne etc

H) Trying NeuroAD-Therapy System – this is a medical device treatment - this medical device treatment has been found useful for AD

I) Individuals with resistant cognitive impairments and if no treatments mentioned above helps then trying one of the following treatments may need to be considered too;

Stem-cell treatment (this is still in experimental stage but has been found to be useful for individuals with cognitive impairments including memory loss etc)

Immunoglobulin Infusion etc

And regarding the valuable medical text books related to AD please try to use the below web links and these links will provide you with a list of varieties of commonly used and very good text books related to AD;

https://www.amazon.com/s/ref=nb_sb_noss?url=search-alias%3Daps&field-keywords=alzheimer+books

https://www.amazon.com/s/ref=nb_sb_ss_i_4_10?url=search-alias%3Daps&field-keywords=neurology+books&sprefix=neurology+%2Caps%2C519&crid=296JVXF21ZLLR&rh=i%3Aaps%2Ck%3Aneurology+books

I earnestly hope you will find the above information including the list of diagnostic approaches, and the list of treatments & the list of books related to AD helpful to you towards assisting your relative who is suspected to have AD (Alzheimer’s dementia).

Wishing you all - the best health!

All the very best!

Please let me know if you have any additional questions or if you want to discuss this further. Please do not forget to take a moment and kindly click a positive rating (preferably 5 Star/Excellent) to credit for the time & effort put by me in answering your health question, and this is the only way I will be credited for my service to you. Rating me now does not close your question and if you have follow-up or additional questions you can ask them after the rating too!

Assuring you the best services!

Best Regards!

Dr Subbanna MD

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Hi, I see you have not yet rated my answer, is it because you are not satisfied with the above answer, or is it due to some technical glitches? If you are not satisfied and if you are still looking for more information please let me know and I will be very glad to continue assisting you as long as you need my services. On the otherhand if rating was not done due to any technical glitches preventing you from rating please let me know and I can bring this to the notice of the company and they can help in fixing this glitch.

Please let me know.

Assuring you the best services!

Best Regards!

Dr Subbanna MD

Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 6,255
Experience: American Board Certified Neurologist, Internal Medicine
Verified
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Customer reply replied 4 months ago
Sorry I have not the habit of checking my e-mails. Thank you for your advices and they are extremely valuable. It will take me 1 or 2 days to read them word by word.

You are very welcome! My pleasure!

Once again I earnestly hope you will find the above information including the list of diagnostic approaches, and the list of treatments & the list of books related to AD helpful to you towards assisting your relative who is suspected to have AD (Alzheimer’s dementia).

Wishing you guys all the very best!

Thanks & Best Regards!

Dr Subbanna MD

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Customer reply replied 4 months ago
I have especially noticed racetams, and brahmi, and I'll ask my cousin if he had tried these kind of supplements, because I have no impression of ever read these approaches. I know magnetic resonance can detect both qualitative and quantitatively in molecular level of precision. I think what you depict is the full scope of modern screening techniques, and I thank for your patience and details of revelation. We'll find clues for which approach gonna be improving, where your advices are almost biblical.Can you tell me how to list you as my favorite physicians? When I have this kind of questions, I am sure you are the best one which can do help for us.
Customer reply replied 4 months ago
I have especially noticed racetams, and brahmi, and I'll ask my cousin if he had tried these kind of supplements, because I have no impression of ever read these approaches. I know magnetic resonance can detect both qualitative and quantitatively in molecular level of precision. I think what you depict is the full scope of modern screening techniques, and I thank for your patience and details of revelation. We'll find clues for which approach gonna be improving, where your advices are almost biblical.Can you tell me how to list you as my favorite physicians? When I have this kind of questions, I am sure you are the best one which can do help for us.Since this is a no therapy disease, we have to investigate it one by one. I just pray it will be recovering and just a false alarm.

You are very welcome! My pleasure!

I appreciate the compliments too!

I once again earnestly hope the above mentioned information including investigations & treatment approaches etc will help your cousin immensely!

I thought there is a link to save the expert as a favorite for future questions, if it is not seen at your side then it appears there is some technical glitch and you may please contact the company directly and they can help in fixing this technical glitch.

This is my direct link at Just Answer, if there are any future questions;

http://www.justanswer.com/medical/expert-drsubbannamd

Wishing you guys all the very best!

Best Regards!

Dr Subbanna MD

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Customer reply replied 4 months ago
I just temporarily bookmark your direct link.I'll immensely discuss with my relatives very soon. May you good health and a brilliant career. Thank you.

You are very welcome!

Thanks & Best Regards!

Dr Subbanna MD

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