Neurodegenerative diseases are diseases whose main feature is the progressive death of nerve cells. The best known include Alzheimer’s disease, Parkinson’s disease and amyotrophic lateral sclerosis (ALS). In addition, rarer diseases such as Creutzfeldt-Jakob disease and Huntington’s disease fall into this group.
What are neurodegenerative diseases?
Neurodegenerative diseases usually occur in old age – unlike in the physiological aging process, the breakdown of nerve cells progresses faster and to a greater extent. As a result, massive impairments of mental and physical abilities occur, which increase more and more. See percomputer for Carbuncle Explanation.
The pathological degradation processes of the nerve cells are usually limited to certain parts of the brain, but can also affect the entire central nervous system. Due to the increasing life expectancy, neurodegenerative diseases are becoming increasingly important. Despite intensive research, a cure is not yet possible.
Causes
The causes of the pathological degradation of the nerve cells have not yet been clearly clarified. Genetic factors also play a role, as do disturbances in protein metabolism, as a result of which protein deposits lead to the death of nerve cells in the brain. Unlike other cells in the human body, brain cells are usually very long-lived, but their ability to regenerate is limited.
It is therefore difficult for the organism to compensate for premature cell death. Infections and inflammatory processes, environmental toxins and traumatic brain damage are also discussed as triggers. Whether risk factors such as obesity, high blood pressure and diabetes mellitus also promote the development of a neurodegenerative disease has not yet been fully clarified.
Symptoms, Ailments & Signs
The symptoms of each disease depend on the type of nerve affected. In Parkinson’s disease, for example, the nerve cells that produce the hormone dopamine required for the coordination of movements die: This leads to the typical tremor, stiff gait and slowed movements.
In the case of the hereditary disease Huntington ‘s disease, involuntary movements of the head and extremities are initially noticeable, followed by speech and swallowing disorders. Alzheimer’s disease is characterized by an increasing forgetfulness that goes far beyond the normal level – temporal and spatial orientation is also becoming increasingly difficult.
In amyotrophic lateral sclerosis, which can also occur at a young age, only the nerve cells responsible for muscle movement (motor neurons) are affected, resulting in spastic paralysis and increasing muscle weakness. As with Parkinson’s disease, the intellectual abilities are usually not impaired in this disease, but depression, sleep disorders and anxiety often occur as a result of the physical symptoms.
Diagnosis & course of disease
The diagnosis is preceded by a detailed questioning and examination of the patient and his relatives: Conspicuous movement disorders or significant impairments of mental abilities already provide initial information about the clinical picture. If there is a suspicion of dementia, psychological test procedures provide further clues.
Computer tomography, nuclear spin tomography and magnetic resonance imaging are available as technical examination methods, which can be used to visualize pathological changes in the brain. In order to rule out other diseases, comprehensive blood tests are carried out – an examination of the cerebrospinal cord water (liquor) can confirm the suspicion of Alzheimer’s disease or Parkinson’s disease.
Genetic tests are used to detect hereditary diseases such as Huntington’s disease. Electrical muscle activity and nerve conduction velocity are measured to confirm amyotrophic lateral sclerosis (ALS) and spinal muscular atrophy. In some neurodegenerative diseases, such as Creutzfeldt-Jakob disease, changes in the brain waves are noticeable in the electroencephalogram (EEG).
The loss of mental and/or physical abilities progresses steadily over the years in all neurodegenerative diseases. In the advanced stage, independent living is usually no longer possible.
Complications
Neurodegenerative diseases are always progressive and often lead to serious complications in the late stages. Therefore, the most important task is to slow down the process of degeneration. Which complications can occur also depends on the respective disease. Alzheimer’s disease is characterized by the fact that cognitive abilities decrease more and more. Like many other neurodegenerative diseases, Alzheimer’s is not a fatal disease.
In the late stages of the disease, however, the affected patient must be constantly cared for by nursing staff, since the increasing inability to look after themselves can lead to death from starvation or thirst. It is also no longer guaranteed that you will be able to take essential medicines. In addition, neurodegenerative diseases such as Alzheimer’s or Parkinson’s can also lead to other complications in the later stages, such as life-threatening infections of the respiratory tract (pneumonia), swallowing disorders up to complete cessation of swallowing or life-threatening falls.
One of the most serious diseases of this type is Huntington’s disease. Huntington’s disease itself always leads to death, which usually occurs 15 years after diagnosis. During the course of this disease, energy consumption increases constantly and there are problems with eating. As with many neurodegenerative diseases, there is also an increased risk of suicide in Huntington’s disease. There is currently no causal therapy for any neurodegenerative disease. Only the symptoms can be alleviated.
When should you go to the doctor?
If people around you notice trembling hands or restless limbs in an affected person, the observation should be discussed openly and followed up. If the tremor persists or increases in intensity, a doctor should be consulted to clarify the symptoms and make a diagnosis. If there are changes in the usual movement sequences, slow movement or a stiff gait, the examination of the symptoms is indicated.
Disturbances in coordination, problems in carrying out usual sporting activities and an increased risk of accidents are signs of an irregularity that must be discussed with a doctor. Any unusual head movement is a cause for concern and a doctor should be consulted. A doctor is needed if memory problems occur, if there is forgetfulness or if the recall of learned skills is impaired. If the person concerned complains of difficulties with swallowing, loss of appetite or if there is a change in weight, a doctor should be consulted.
Changes in mood, depressive behavior, listlessness and withdrawal from social life should be discussed with a doctor. Sleep disorders, diffuse fears and a decrease in physical performance indicate a disease that requires action. Paralysis or general complaints of the muscular system should be examined.
Treatment & Therapy
Despite intensive research, neurodegenerative diseases cannot yet be cured. The aim of therapy is therefore to slow down the progression. The course of Parkinson’s disease can be positively influenced by drugs that compensate for the dopamine deficiency underlying the disease: In many cases, the symptoms remain stable for years, but unpleasant side effects are not uncommon.
Good results can also be achieved by inserting a brain pacemaker for deep brain stimulation – since the operation is not free of risks, it is only carried out after exhausting the medicinal possibilities. Targeted coordination and movement exercises counteract muscle weakness and muscle tension that occur in neurodegenerative diseases.
Voice and speech therapy may also be indicated. If, as in the case of Alzheimer’s disease, the focus is on the decline in mental abilities, psychotherapy and memory training are used in addition to drug treatment. A gastric tube ensures food intake in the advanced stage of amyotrophic lateral sclerosis (ALS), in which mechanical support of breathing activity may also be necessary.
In addition to conventional medical therapy, the use of alternative treatment methods – such as osteopathy or acupuncture – can also help to alleviate the symptoms in some cases.
Outlook & Forecast
Patients diagnosed with a neurodegenerative disease have an unfavorable prognosis. Although the intensity of the disease and the progress of the underlying disease must be assessed individually, the decay of the nerve cells is common to all.
The cognitive degradation processes can be slowed down if the diagnosis is made early and treatment is started in the early stages of the disorder. However, they are not completely prevented. At the same time, there is no way for the already damaged nerve cells to regenerate. The focus of the underlying disease is basically on improving the current quality of life and delaying further degradation processes.
The general life expectancy of those affected is reduced. If medical care is not sought, a faster deterioration in general health can be seen. It is often no longer possible to cope with everyday life without help. In addition to disturbances in mental capacities, there is also a loss of mobility as the disease progresses. States of confusion, disorientation and an increased risk of accidents are given.
The underlying diseases represent a strong emotional burden for the patient and their relatives. Therefore, when making a prognosis for the further development of the disease, the probability of developing a mental illness must be taken into account. These lead to a further deterioration in the overall situation, since they also take an unfavorable course on the development of physical abilities.
Prevention
The causes of neurodegenerative diseases have not yet been fully researched. At least some diseases in this group are based on genetic factors: Targeted prevention is therefore only possible to a limited extent. A healthy lifestyle with plenty of exercise, mental challenges, but also the necessary recovery phases seems to have a positive effect, at least on the occurrence of Alzheimer’s disease.
Certain environmental toxins (pesticides, heavy metals) are suspected of promoting Parkinson’s disease – contact with such products should therefore be avoided as far as possible. Early detection plays an important role: If treatment begins in the early stages of the disease, its progression can often be significantly delayed.
Aftercare
In principle, neurodegenerative diseases cannot be cured. In addition, they progress inexorably and deprive patients of their independence in the long term. Therefore, those affected are always dependent on permanent aftercare until the end of their lives.
The quality of aftercare also determines the patient’s quality of life. The type of follow-up care in turn depends on the disease in question and the phase of the disease. In mild cases, in addition to drug treatment, exercise and mental training help to compensate for certain deficits.
The more intensively the patient is cared for in this regard, the longer he can maintain his independent lifestyle. However, when dementia and disability are more advanced, those affected often need professional support in all situations and at any time of the day. In many cases, this help in the home environment can no longer be provided by the relatives alone.
Well-trained nursing staff who look after the patient day and night then provide a great deal of help in caring for your sick family member. In other cases, only accommodation in a care facility can guarantee those affected a decent life. Neurodegenerative diseases without dementia, such as ALS, also require permanent care due to the increasing restriction of mobility and organ functions.
You can do that yourself
When dealing with the patient in everyday life, correcting, reprimanding or pointing out deficits should be avoided. Instead, recognition and praise for what has been done lead to positive success in the relationship with the patient. With regard to his resources and skills, he is to be given smaller tasks or simple activities. It is not about a perfect execution of a task. Rather, the focus is on the aspect of being useful and still being able to achieve something.
Relatives must learn to enter the world of the sick person and to treat them with respect. Naomi Feil, founder of integrative validation as a form of communication with people with dementia, called it: “Walking in the shoes of the other.” She explained that the sick person must be picked up from where they are in terms of their psychological, emotional and mental state. Only on this level is communication with the patient possible with a lot of empathy and compassion.
Withdrawal due to illness should be avoided. Rather, the social environment must be informed and enlightened about the case of illness, the clinical picture and the associated changes in living together. Acceptance and recognition by the social environment are equally important for the patient and their relatives in everyday life.
