PATIENT ENQUIRY

What Is?


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What Is?
What is What Is?
Alzheimer's
How to Treat Alzheimer's

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What is Alzheimer’s disease?

The most common types of dementia are Alzheimer’s disease, vascular dementia, Parkinson’s disease, dementia with Lewy bodies, fronto-temporal dementia, Huntington’s disease, alcohol-related dementia, and Creutzfeldt-Jacob disease.

Alzheimer’s disease is a neurodegenerative form of dementia that causes diffuse neuronal death throughout the brain, culminating in severe brain dysfunction and death. Alzheimer’s disease accounts for 60–80% of all cases of dementia, and includes all cases of dementia with cortical atrophy, neurofibrillary tangles, and senile plaques, irrespective of age of onset. The plaques consist of a protein called amyloid-beta and occur between dying brain cells. The tangles are due to disintegration of the protein tau and occur within the brain neurons.

All types of dementia are caused by brain cell death. Alzheimer’s is a neurodegenerative disease, which means there is progressive brain cell death over time, which leads to brain shrinkage with fewer nerve cells and neural connections.

Twenty-one genes have been found to be associated with Alzheimer’s, enabling doctors to test whether a person has any of the genes that pinpoint higher risk.

Genetics are behind early-onset familial Alzheimer’s disease, which presents typically during the period 30–60 years of age and affects people who have a family history. Only 5% of all Alzheimer’s cases are early-onset, but this type can be the most frustrating because physicians tend not to suspect Alzheimer’s when a person is less than 60 years of age.

What are the symptoms of Alzheimer’s disease?

What are the symptoms of Alzheimer’s disease?

Alzheimer’s disease is a neurological disorder in which the death of brain cells causes memory loss and cognitive decline. In the early stages a person exhibits only mild symptoms, but symptoms always worsen. Disturbance of higher cortical function occurs first, followed several years later by features of subcortical dysfunction, as the disease progresses.

The most common symptom characteristic of Alzheimer’s dementia is prominent memory loss, especially learning and recalling new information. But the first presenting symptom can also be struggling to find the right words when speaking. Dementia affects cognitive function or thinking, the way a person behaves, and a person’s ability to complete everyday tasks. With dementia brain function is affected enough to interfere with completing daily personal care, and social or work activities.

A person with prominent visuospatial deficits has difficulty recognizing objects and faces, comprehending separate parts of a scene at once (simultanagnosia), and difficulty with reading text (alexia). The deficits that charactise ‘executive dysfunction’ include problems with reasoning, judgment, and problem solving.

Signs and symptoms for Alzheimer’s:

  • Memory and language impairment
  • Fall in vocal output, which increases in severity as the disease progresses
  • Visuospatial difficulties
  • General cognitive impairment
  • Psychiatric problems are common – depression and anxiety
  • Delusions (15% cases) and hallucinations
  • Seizures – late in the disease
  • Myoclonus (brief involuntary twitching)

The progression of Alzheimer’s can be broken down into three stages:

  • Preclinical (no signs or symptoms yet)
  • Mild cognitive impairment
  • Dementia.
The clinical definition of Alzheimer’s disease

The clinical definition of Alzheimer’s disease

In order to diagnose Alzheimer’s a doctor must first establish a person has dementia. A patient will demonstrate a decline in cognitive or behavioural function that prevents them from functioning properly at work or at usual activities.

A decline in at least two of these five symptoms must be evident.

Worsened ability to take in and remember new information:

  • Repetitive questions or conversations
  • Misplacing personal belongings
  • Forgetting events or appointments
  • Getting lost on a familiar route.

Impairments to reasoning, complex tasking, exercising judgment:

  • Poor understanding of safety risks
  • Inability to manage finances
  • Poor decision-making ability
  • Inability to plan complex or sequential activities.

Impaired visuospatial abilities:

  • Inability to recognize faces or common objects or to find objects in direct view
  • Inability to operate simple implements, or orient clothing to the body.

Impaired speaking, reading and writing:

  • Difficulty thinking of common words while speaking, hesitations
  • Errors in speech, spelling, and writing.
  • Changes in personality and behaviour, including
  • Out-of-character mood changes, including agitation, apathy, social withdrawal, less interest, motivation or initiative
  • Loss of empathy
  • Compulsive, obsessive, or socially unacceptable behaviour.

A diagnosis of Alzheimer’s is based on atypical or insidious onset, which means symptoms develop gradually over months to years rather than hours to days, and a marked worsening of the individual person’s normal level of cognition in particular areas, through observation or personal report.

For a person who meets the core clinical criteria for probable Alzheimer’s, evidence of a causative genetic mutation (in APP, PSEN1, or PSEN2), increases the certainty that the condition is caused by Alzheimer’s pathology. Less than 5% of cases are true ‘familial Alzheimer’s’ when the disease runs in families. Having a parent or sibling with Alzheimer’s means a person has a higher chance of getting Alzheimer’s. While genetic risk cannot be changed, some risk factors can be modified to compensate.

The biomarkers for brain amyloid-beta protein deposition are low cerebro-spinal fluid Aβ42 and positive PET amyloid imaging.

The diagnosis of probable Alzheimer’s dementia should not be applied when there is evidence of:

  • Substantial concomitant cerebrovascular disease, defined by a history of a stroke temporally related to the onset or worsening of cognitive impairment, or the presence of multiple or extensive infarcts, or severe white matter hyperintensity burden
  • Core features of dementia with Lewy bodies other than dementia itself
  • Prominent features of behavioural variant frontotemporal dementia
  • Prominent features of primary progressive aphasia (difficulty talking)
  • Evidence of another concurrent, active neurological disease, or a non-neurological medical comorbidity, or use of medication that could have a substantial effect on cognition.

Jointly developed by the National Institute on Aging and the Alzheimer’s Association.

Alzheimer’s Disease is not a normal part of aging. Although most people with Alzheimer’s Disease are over 65 years of age, and the risk of developing AD doubles every five years over 65 years of age, nearly half of 85-year-olds do not get AD.
A rare inherited form, symptoms start as early as 30–60 years of age.

What are common risk factors for Alzheimer’s disease?

What are common risk factors for Alzheimer’s disease?

Unavoidable risk factors

  • Age is the highest risk factor. Alzheimer’s is more likely in older people. More people more that 85 years of have have the disease compared with people more than 65 years of age. However, patients as young as 30 years of age can get the disease.
  • A genetic (family) history of Alzheimer’s is the second highest risk factor
  • Having a certain gene called APO-E4 is a significant risk factor – three to eight times more risk than a person without the gene
  • Gender – being female is a risk factor because more women than men are affected
  • Trisomy 21 (Down’s syndrome) patients may develop histopathological brain changes indistinguishable from Alzheimer’s disease in their third and fourth decade, attributable to an extra copy of the APP gene.

    Potentially avoidable or modifiable factors

    • Major head injury and recurrent head injury are significant risk factors and the risk increases with the severity of trauma
    • Mineral toxicity (lead, mercury and aluminium) appears to increase the risk of Alzheimer’s but the exact role isn’t clear
    • Progressive oxidative damage appears to increase risk and is associated with brain tissue accumulation of amyloid-beta proteins
    • Dyslipidaemia, hypertension, excess cytokine production, and insulin resistance are also implicated as causal factors
    • Compromised microvascular circulation with accompanying impaired nutrient delivery and secondary cellular hypometabolism may be the basic causal mechanism for development of Alzheimer’s disease
    • Factors that increase vascular risk increase risk of Alzheimer’s, including diabetes, high cholesterol and high blood pressure
    • Low educational and occupational attainment
    • Sleep disorders, such as sleep apnoea
    • Oestrogen hormone replacement therapy.

    Researchers at Rutgers-Robert Wood Johnson Medical School, New Jersey, found that people with Alzheimer’s disease had four times higher levels of a DDT byproduct in their blood stream compared with control subjects. DDT is an organochloride pesticide used to control malaria and typhus during World War II and in general agriculture. When the environmental and health dangers of DDT were realised, the chemical was banned.

    DDT appears to promote the development of amyloid plaques, which clog the neurons and could be the cause of Alzheimer’s disease. The pesticide also might further increase the risk for people who already have a genetic predisposition toward developing Alzheimer’s.

  • How is Alzheimer’s disease diagnosed?

    How is Alzheimer’s disease diagnosed?

    An accurate diagnosis is critical for any disease that affects the brain. Consult a doctor early if you suspect you or someone you know has dementia, in order to obtain an early stage a diagnosis. A complete medical and psychological assessment may identify a treatable condition or confirm dementia, which will require further assessment and treatment.

    When a doctor suspects that a person has Alzheimer’s he or she will perform a thorough examination to assess:

    • Detailed medical history – to establish whether there is a slow or sudden onset of symptoms and the progress of symptoms
    • Thorough physical and neurological examination
    • Laboratory tests – blood and urine tests called a dementia screen to rule out other illnesses
    • Neuropsychological testing to assess comprehension, insight, and judgement
    • Diagnostic tests such as a chest x-ray, ECG, or brain CT
    • Mental status testing to assess memory, reading ability, writing and mental arithmetic
    • Psychiatric assessment to identify treatable disorders that can mimic dementia, such as depression and anxiety, and also to manage

    psychiatric symptoms, which may occur alongside dementia.
    Based on content from the Fight Dementia Campaign website

    Abnormal protein clumps in the brain tissue are characteristic of the disease. However, researchers and physicians believe that there could be another underlying process that is actually causing Alzheimer’s disease.

    How does a doctor diagnose Alzheimer’s disease?

    How does a doctor diagnose Alzheimer’s disease?

    Alzheimer’s begins with memory loss, but as the disease progresses other mental, emotional, and physical issues become evident.

    A person with Alzheimer’s is prone to agitation and aggression or may easily become anxious or upset. He or she might fidget, shout, throw things, or attempt to hit carers and family. Creating a quiet, stable environment can help calm a person and reduce these episodes.

    A person with Alzheimer’s is prone to bladder and bowel control problems, in particular in late stage disease. Planning for these difficulties and anticipating needs can make a difference to coping for patients and carers.

    Many people with Alzheimer’s disease become depressed in the early stages of the disease, as they come to terms with how much their lives will change. Antidepressant drugs may help a person to cope with this realisaiton. Taking regular exercise, spending time around other people, and keeping busy with hobbies and activities will help elevate mood.

    People with Alzheimer’s can lose their balance and take nasty tumbles, which can cause serious harm. To help prevent falls and injuries, encourage regular exercise to keep the musculoskeletal system strong and improve balance. Creating a safer environment at home will help.

    Remove any obstacles that someone could trip on or bump into, install at least one handrail in stairways, use non-skid strips in the shower, bathtub, and along slippery surfaces. Install night-lights to improve visability and stick easy-to-see motifs on large windows and glass doors.

    Many people with Alzheimer’s disease die from complications such as falls and infections, including bladder infections, flu, and pneumonia. Be vigilant for a fever or sudden changes in symptoms or behaviours, which could indicate an infection.

    Alzheimer’s disease key facts and statistics

    Alzheimer’s disease key facts and statistics

    More than 332,000 Australians and some 44 million people worldwide suffer with dementia. In the absence of a medical breakthrough, the number of Australians with dementia is expected to reach 900,000 by 2050. Each week, at least 1,700 Australians are newly diagnosed with dementia.

    Approximately 24,700 Australians have early-onset dementia, a type of dementia that develops between 30–60 years of age.

    An estimated 1.2 million people are involved in the caring for Australians living with dementia, which is among the top five causes of death in Australia. Families notice the symptoms of dementia on average three years before a clinical diagnosis is confirmed.

    Dementia is the greatest cause of disability in older Australians (>65 years of age) and the third leading cause of disability burden overall.

    Glossary – Alzheimer's disease

    Glossary

    Acetylcholine
– chemical in the brain (neurotransmitter) involved in learning and memory. Acetylcholine is greatly diminished in the brains of people with Alzheimer’s disease.

    Alexia – difficulty with reading text

    Alzheimer’s disease
– progressive, fatal disease in which nerve cells in the brain degenerate and brain matter shrinks, resulting in impaired thinking, behaviour and memory

    Ambulation
– ability to walk and move about freely

    Amino acids
– basic building blocks of proteins. There are 20 amino acids necessary for human growth and function.

    Amyloid
– protein deposited in plaques in the brain of a person with Alzheimer’s.

    Amyloid imaging
– PET scan showing amyloid-beta proteins in the brain.

    Amyloid plaque
– abnormal clusters of dead and dying nerve cells, other brain cells, and amyloid protein fragments, evident when a person has Alzheimer’s

    Antibodies
– specialized proteins produced by the cells of the immune system that counteract specific foreign substances. Antibodies may also be produced outside the body and infused as a treatment for Alzheimer’s disease.

    Anti-inflammatory drugs
– reduce inflammation by modifying the body’s immune response.

    Anxiety
– feeling of apprehension, fear, nervousness or dread accompanied by restlessness or tension.

    Apathy
– a lack of interest, concern or emotion.

    Aphasia
– difficulty expressing oneself verbally.

    Assessment – when a doctor or health professional evaluates a person’s mental, emotional and social capabilities.

    Associated disorders
– concurrent conditions that are present at the same time.

    Asymptomatic
- means no symptoms or no clear sign that disease is present.

    Atrophic
shrinking – describes the loss of brain tissue seen in Alzheimer’s disease on brain CT or during autopsy.

    Autopsy
– examination of a body’s tissues and organs after death.

    Axon
– part of a nerve cell that normally transmits outgoing signals from one cell to another.

    Basal ganglia
– part of the brain that controls movement, judgment, personality, and speech.

    Behavioural symptoms
– emotional symptoms, such as wandering, depression, anxiety, hostility and sleep disturbances.

    Biomarker
– indicate a specific disease. Alzheimer’s biomarkers are amyloid plaques and neurofibrillary tangles.

    Blood-brain barrier
– selective barrier that controls the entry of substances from the blood into the brain.

    Calcium channel blocker – drug that blocks the entry of calcium into cells, thereby reducing activities that require calcium, such as the transmission of nerve impulses. Primarily used primarily to treat heart disease but may be potential treatments for Alzheimer’s disease.

    Choline
– neurotransmitter that enables cells to communicate.

    Choline acetyltransferase (CAT) 
An enzyme that controls the production of acetylcholine. CAT is depleted in the brains of individuals with Alzheimer’s disease.

    Cholinergic system
– system of nerve cells that uses acetylcholine as its neurotransmitter and is damaged in the brains of individual’s with Alzheimer’s disease.

    Cholinesterase
– an enzyme that breaks down acetylcholine, an important chemical for learning and memory, which is low in people with Alzheimer’s.

    Cholinesterase inhibitors are used to stop the breakdown acetylcholine and increase levels in Alzheimer’s disease, and include the drugs Aricept, Cognex, Exelon, Razadyne.

    Cognitive abilities
– mental abilities, such as judgment, memory, learning, comprehension and reasoning.

    Cognitive symptoms
– symptoms that relate to loss of thought processes, such as learning, comprehension, memory, reasoning and judgment.

    Deficits
– physical or cognitive abilities that a person has lost, has difficulty with, or can no longer perform because of dementia.

    Delusion
– false idea that is firmly believed and strongly maintained in spite of proof or evidence to the contrary.

    Dementia
– irreversible disease characterised by severe loss of mental functions, including thinking, memory and reasoning that interferes with a person’s daily functioning.

    Disease stage –
disease progression defined by levels of severity: prodromal, early, mild, moderate, moderately severe, severe.

    Dysphasia
– inability to find the right word or understand the meaning of a word.

    Early-onset Alzheimer’s disease – Alzheimer’s disease in which individuals are diagnosed with the disease before age 65.

    Enzyme
– protein produced by living organisms that promotes or influences chemical reactions.

    Oestrogen
– sex hormone produced by the ovaries and testes, which stimulates secondary sexual characteristics and induces menstruation on women; important for maintaining normal brain function and development of nerve cells.

    Familial Alzheimer’s – genetic form of Alzheimer’s disease that runs in families.

    Fatty acids
– acids derived from the breakdown of fats.

    Free radicals
– highly reactive molecules capable of causing damage in brain and other tissues. Free radicals are common by-products of normal chemical reactions occurring in cells.

    Frontotemporal dementia – originally called Pick’s disease, caused by an accumulation of tau proteins in nerve cells. Results in dramatic changes to personality and social behaviour but typically does not affect memory until later in the disease.

    Gait
– an individual’s manner of walking. A person in the later stages of Alzheimer’s disease often can’t his or her feet as they walk known as a magnetic gait.

    Genetic susceptibility
– more likely than the average person to develop a disease as the result of genetics.

    Hallucination
– a person can see, hear, smell, taste or feel something that is not there.

    Inflammatory response
– immune system’s normal response to tissue injury or abnormal stimulation caused by a physical, chemical or biological substance.

    Late-onset Alzheimer’s disease
– most common form of Alzheimer’s disease, usually occurring after age 65.

    Lewy body dementia
– type of dementia characterised by protein deposits called Lewy bodies in the cortex of the brain.

    Mitochondria
components – found in cells; serve as primary energy sources for cellular functions.

    Monoamine oxidase B (MAO-B)
An enzyme that breaks down certain neurotransmitters, including dopamine, serotonin and noradrenaline.

    Monoamine oxidase inhibitor (MAOI)
A drug that interferes with the action of monoamine oxidase, slowing the breakdown of certain neurotransmitters; often used in treating depression.

    N- acetylcysteine

    Neurone – the basic working unit of the nervous system. The nerve cell comprises a cell body containing the nucleus, several short branches called dendrites, and one long arm called an the axon with short branches along its length and at its end. Neurones send signals that control the actions of other cells in the body, such as other nerve cells and muscle fibres.

    Neurodegenerative disease
– neurological disorder marked by the loss of nerve cells, such as Alzheimer’s disease and Parkinson’s disease.

    Neurofibrillary tangle
– accumulation of twisted protein (tau protein) fragments inside nerve cells. The two biomarkers characteristic of Alzheimer’s are amyloid plaques and neurofibrillary tangles.

    Neurological disorder – disturbance in structure or function of the nervous system due to either developmental abnormality, disease, injury or chemical toxin.

    Neurotransmission
– passage of signals from one nerve cell to another through chemicals called neurotransmitters or electrical signals.

    Neurotransmitter
– chemical in the brain that is necessary for communication between nerve cells, such as acetylcholine, dopamine, norepinephrine and serotonin.

    Parkinson’s disease
– progressive, neurodegenerative disease with an unknown cause charactersed by the death of nerve cells in a specific area of the brain. A person with Parkinson’s disease lacks the neurotransmitter dopamine. Symptoms include tremors, speech impediments, and movement difficulties. Dementia is often occurs late in the disease.

    Pick’s disease
– frontotemporal dementia caused by an accumulation of tau proteins in nerve cells. Results in dramatic changes to personality and social behavior but typically does not affect memory until later in the disease.

    Positron emission tomography (PET) scan – diagnostic imaging scan that measures functional activity of the brain and shows amyloid plaques

    Prodromal Alzheimer’s disease
– early stage disease characteristed by memory impairment and a biomarker (amyloid plaque or neurofibrillary tangles).

    Proteases
– enzymes that break down proteins in the body.

    Protein metabolism
– breakdown of proteins into amino acids, a process essential to human growth and metabolism.

    Pseudodementia
– severe form of depression resulting from a progressive brain disorder in which cognitive changes mimic those of dementia.

    Psychosis
– state of mind in which thinking becomes irrational or disturbed and refers to delusions, hallucinations, and other severe thought disturbances.

    Receptor agonist
– substance that mimics a specific neurotransmitter that is able to attach to that neurotransmitter’s receptor and produces the same action the neurotransmitter usually produces. Receptor agonists are used to treat diseases and disorders in which the original chemical substance is missing or depleted.

    Risk factor
– factor that increases a person’s likelihood of developing a disease or predisposes a person to a certain condition.

    Simultanagnosia – rare neurological disorder characterized by an inability to perceive more than one object at a time.

    Subcortical dementia
– impairment of the lower part of the brain that affects the speed of motor and mental processes; associated with disease of the basal ganglia, such as Huntington’s disease.

    Synapse
– junction between neurones (brain cells) where a signal is transmitted from one nerve cell to another, usually by a chemical called a neurotransmitter.

    Tau protein
– protein that makes up neurofibrillary tangles found in degenerating nerve cells.

    Vascular dementia
or multi-infarct dementia

    Wandering
– when a person with dementia strays and becomes lost in familiar surroundings

    What is arthritis?

    Arthritis is a chronic or recurrent inflammatory joint disorder caused by factors that trigger inflammation resulting in pain, swelling, joint effusion, restriction of movement, and culminating in cartilage destruction and joint deformity.

    At least one hundred different forms of arthritis have been identified, the most common being osteoarthritis. Different types of arthritis have different symptoms, but in general a person with arthritis will feel pain and stiffness in the joints, muscles, or soft tissues surrounding the joints. As is the case with most medical conditions, early diagnosis and treatment is important. A person who seeks early medical advice for arthritis has a better chance of reduced joint damage, and will be able to control the symptoms of arthritis more successfully.

    Common symptoms of arthritis:

    • Pain or tenderness in a joint
    • Joint stiffness, swelling, warmth, redness of the joint
    • Difficulty using or moving a joint normally

    ‘Rheumatism’ is a term people use to describe a number of problems affecting the joints, muscles or soft tissues of the body, rather than a specific disease. People often use ‘rheumatism’ to describe osteoarthritis, rheumatoid arthritis, bursitis, fibrositis, lumbago, sciatica or tendonitis.

    Types of arthritis

    Types of arthritis

    More than 100 types of arthritis have been classified, but the two most common are osteoarthritis and rheumatoid arthritis. Gout, psoriatic arthritis, lupus, and septic arthritis are other arthritic conditions.

    Osteoarthritis develops as part of the aging process and results from ‘wear and tear’ on joints. Obesity and injury, both acute and repetitive, contribute to early development of osteoarthritis, because joints are subjected to greater strain. Unlike rheumatoid arthritis and lupus, osteoarthritis does not affect other organs.

    Cartilage is a tough, flexible tissue, without blood or nerve supply, composed mainly of water and collagen. The amount of water in cartilage decreases as a person ages, from 85% to approximately 70% in the elderly. Chondrocytes, the only cells found in cartilage, generate and preserve the cartilage matrix.

    Bone joints contain a layer of articular cartilage at the end of each bone to cushion the joint and enable smooth sliding. Improper joint alignment, excess weight, overuse, or injury will cause articular cartilage to wear away.

    In the initial stages, pain occurs in the joints during and after activity, but as the condition progresses pain may be experienced from minimal movement or during rest. A person with severe osteoarthritis can suffer complete loss of cartilage and the friction of bone rubbing on bone, which causes pain, stiffness, limited range of movement, and functional disability of the problem joint.

    The symptoms of osteoarthritis vary from patient to patient and depend on which joints are affected. The amount of joint destruction on medical images doesn’t always directly correlate with the severity of symptoms. The most common symptom is pain in the joint after repetitive use, but can also involve swelling, creaking, redness, and warmth.

    Osteoarthritis of the fingers can cuase bony enlargement of the joints, called nodes (Heberden’s and Bouchard’s nodes), which can limit the movement and strength of the hands. Osteoarthritis of the big toe my cause a bunion deformity and osteoarthritis of the knees can cause bowed legs.

    Rheumatoid arthritis develops when the body’s immune system attacks bone joints, causing the synovial membrane that encloses the joint to become inflamed. Synovial fluid production then increases, which causes the capsule around the joint to swell. This causes further pain and leads to cartilage damage and erosion.

    Rheumatoid arthritis most commonly affects the hand joints and can lead to deformities of the hands, and to a lesser extent the feet, shoulders and knees, and usually affects both sides of the body. The disease usually starts during 25 to 50 age bracket.

    Juvenile idiopathic arthritis
    (JIA) develops during childhood, from the age of six months to 16 years of age. Usually only a few joints are affected, commonly knees, ankles, wrists and fingers. JIA can also affect the skin, tendons, muscles, and eyes. In Australia, the likelihood of developing JIA is one in 1000. The immune system confuses normal bone joints with a foreign body and attacks the joints.

    Gout is a joint disorder caused by increased uric acid levels in the blood. Gout presents as a recurrent, acute inflammatory arthritis that causes a red, hot, swollen, painful joint. The first metatarsophalangeal joint (base of big toe) is the joint most commonly affected. Gout can also present as deposits of urate crystals in the joints, kidney stones, or acute uric acid nephropathy.

    Systemic Lupus Erythematosus (SLE) or lupus is an autoimmune disease of unknown cause, which can affect the skin, joints, kidneys, brain, and other organs. While lupus can occur at any age, in either sex, in any race, women are more likely to be affected than men, and 15% of people develop lupus after 55 years of age.

    Most people with lupus suffer with joint pain and swelling, usually the fingers, hands, wrists, and knees. Approximately half have a facial rash across the cheeks called a ‘butterfly rash’.

    Psoriatic arthritis is an arthritic inflammation that occurs in about 15% of patients who have a skin rash called psoriasis. Any joint in the body can be affected and symptoms vary from person to person. As with other forms of arthritis, persistent inflammation from psoriatic arthritis can lead to joint damage, but fortunately effective treatments are available for most people.

    Septic arthritis means infection of a joint from a bacterial, viral, or fungal infection that has spread from another part of the body. Symptoms include intense joint pain, redness and swelling, chills and fever, and an inability to move the sore joint.

    What causes arthritis?

    What causes arthritis?

    Common causes of acute monoarticular arthritis:

    • Crystal arthritis – gout, pseudogout, calcific periarthritis – wherein deposition of crystals within the joint trigger an acute inflammatory reaction
    • Traumatic haemarthrosis – caused by traumatic bleeding into the joint and particularly common in patients with haemophilia or anticoagulation therapy
    • Septic arthritis – uncommon in modern society, though still common in undeveloped countries and following joint trauma
    • Immunological reactions – autoimmune disease and immune reactions following viral and bacterial infections, particularly Ross River virus, Barmah Forest virus, Yersinia enterocolitis, salmonella infections and with inflammatory bowel disease.

    Common causes of acute polyarticular arthritis:

      • Rheumatoid arthritis
      • Systemic lupus erythematosus
      • Psoriatic arthritis and associated spondylarthropathies
      • Reactive arthritis – Reiter’s disease, rheumatic fever
      • Acute palindromic arthritis – associated with severe infectious disease
      • Post-viral arthritis – rubella, polio virus, hepatitis B

     
    Osteoarthritis of the digits (fingers and the toes) may have a genetic basis and is found in many female members of certain families, with a familial disposition for osteoarthritis.

    What are the risk factors for arthritis?

    Researchers have identified certain factors that increase a person’s likelihood of developing arthritis. These factors include:

    • Family history
    • Genetic factors
    • Gender – women account for 60% of cases
    • Environmental triggers – being overweight or repeat joint injury

    Arthritis Australia provides an online tool to enable a person to measure his or her risk of developing osteoarthritis at www.myjointpain.org.au

    Australian facts and statistics for arthritis

    During 2004 to 2005 in Australia, 15% of the population reported having some form of arthritis. Arthritis is more prevalent among the socially disadvantaged (16%) compared with people who are financially comfortable (12%).
    Symptoms of osteoarthritis may include joint pain and progressive stiffness that develops gradually.

    Chronic pain, joint inflammation

    Chronic pain, joint inflammation

    A doctor will clinically examine the sore joint to assess for swelling, redness, and range of movement. Blood tests will show whether a person has antibodies called rheumatoid factors or anti-CCP antibodies in their blood. The presence of anti-CCP antibodies can predict which patients will develop more severe rheumatoid arthritis.

    Medical imaging, such as X-ray, CT, or MRI will provide information about loss of cartilage and joint destruction. Ultrasound is also used to assess hand joints for rheumatoid arthritis recurrence. An aspiration of joint fluid can be used to rule out infectious and other types of arthritis.

    How can arthritis be prevented?

    How can arthritis be prevented?

    Arthritis is a term used broadly for more than 100 conditions, disorders and diseases, so a simple ‘cure all’ isn’t possible. However, some important guiding principles will enable a person at risk for osteoarthritis to delay or prevent disability.

    Improving your knowledge about the causes of pain for the type of arthritis that affects you will enable you to better manage your symptoms. Find out more about the arthritis medication your doctor has prescribed and find practical solutions to enable you to continue with everyday activities.

    Keep physically active to reduce joint pain and stiffness and try to stay motivated. Maintaining an ideal weight means less stress on joints. If a person with arthritis is overweight, losing weight can significantly reduce symptoms.

    Daily exercise helps to keep joints mobile, reduces weight, and improves general well being. Walking is easy to do and offers many benefits. Take time to properly warm up before exercise and gently stretch the leg muscles afterwards.

    Because repetitive joint injury can worsen arthritis, adopt sensible strategies for gardening and housework to minimise joint trauma, for example when lifting something ‘bend with you knees, not your back’. When dusting, reaching overhead, cleaning walls and windows, and lifting object try to keep the arms close to the body to minimise strain. Try not to kneel on both knees at once. If you must then wear kneepads or place a towel under the knees to reduce the pressure on knee joints.