Factors that Aggravate
Ronald C Hamdy
Larry B Hudgins
To study the phenomena of disease without
books is to sail an uncharted sea, while
to study books without patients, is not to
go to sea at all.
A generalized deterioration in functional activities of daily living is expected in patients with Alzheimer's disease. Progressive decline and gradual loss of higher cortical cognitive functions commonly spearchead the deterioration. However, in some patients the rate of declming function and disability may accelerate. When this occurs, reversible causes should be sought and actively treated because often the underlying Alzheimer's disease process is not the cause of this sudden physical and/or mental deterioration. In many instances some other specific disease is responsible. The presence of any factor that worsens the patient's mental and/or physical state should be detected since many such factors are reversible if treated early. If not detected in time, they may lead to further irreversible deterioration.
Alzheimer's disease is associated with a gradual deterioration. A rapid deterioration is usually due to other causes.
A person's mental functions are controlled by the brain, which is made up of many nerve cells, or neurons. These are described in Chapters 2 and 3. Brain functioning depends on the number of brain cells, their integrity, and the efficiency of the blood circulation. Since neurons have no nutrition stores, they depend entirely on the circulation to provide them with adequate quantities of glucose, oxygen, and various other nutrients. Similarly, an efficent circulation removes from the brain any waste or toxic substances that have been formed by the brain cells through their metabolic activity.
The blood flow through the brain provides it with substances essential for its functioning and removes waste products. If the blood circulation is ineffective,