The case history (medical history) represents an important component in the diagnosis of Alzheimer’s disease.
Usually, it is an extraneous history (family members).
Family history
- Is there frequent dementia in your family?
Social history
- What is your profession/have you practiced?
- Is there any evidence of psychosocial stress or strain due to your family situation?
Current medical history/systemic history (somatic and psychological complaints).
- Have you noticed any symptoms such as memory problems, restlessness, or irritability?
- How long have these symptoms been present?
- Are there additional mood swings, delusions* * , hallucinations* * , or sleep disturbances?
- Is there a loss of appetite and/or weight loss?
- Are there additional neurological disorders such as paralysis?* * .
Vegetative anamnesis incl. nutritional anamnesis.
- Are you overweight? Please tell us your body weight (in kg) and height (in cm).
- Do you have a balanced diet?
- Intake of saturated or trans-saturated fats (the fats are found in margarine, for example)?
- Low consumption of fruits, vegetables, fish, and omega-3-rich oils leads to increased risk of dementia and Alzheimer’s disease in non-ApoE subjects
- Do you get enough exercise every day?
- Do you smoke? If so, how many cigarettes, cigars or pipes per day?
- Do you drink alcohol? If yes, what drink(s) and how many glasses per day?
- Do you use drugs? If yes, what drugs and how often per day or per week?
Self history incl. medication history.
- Pre-existing conditions (neurological, psychiatric diseases).
- Operations
- Allergies
Medication history
- Benzodiazepines – are associated with a 51% increased rate of Alzheimer’s disease when prescribed at > 91 daily doses.In a cohort study of over 4700 participants, medication use in the 10 years prior to study entry was reliably determined from prescription data, and participants’ cognitive performance was assessed every 2 years. Study participants were on average 74 years old at baseline. The study design suggests that dementia is driving benzodiazepine use, rather than the other way around.
- ACE inhibitor*
- Antiepileptic drugs*
- Diuretics*
- Hormone ablative therapy (HAT; synonyms: Hormone ablation; androgen deprivation therapy, ADT; hormone therapy that withholds the male sex hormone testosterone); multivariate analysis: risk increased by 66%.
- Proton pump inhibitors (PPIs; acid blockers) in elderly patients.
Environmental history
- Aluminum?; contra
- Air pollutants: particulate matter (PM2.5) – 13% increased risk of disease per 5 µg/m3 increase in particulate matter at residence (hazard ratio 1.13; 1.12 to 1.14); association was dose-dependent up to a PM2.5 concentration of 16 µg/m3.
- Copper.
- Manganese
* These can lead to drug-induced hyponatremia (sodium deficiency), resulting in secondary dementia. * * If this question has been answered with “Yes”, an immediate visit to the doctor is required! (Data without guarantee)
