Health for All

Alzheimer’s Disease

Alzheimer's Disease

Alzheimer’s disease is a very severe brain disease which is affecting around 5.5 million people in the United States today. Most of these are people over 60 years old. According to statistics, every 67 seconds someone in the United States develops the disease. In fact, Alzheimer’s disease is the 6th leading death cause in the United States. 1 out of 3 seniors die of Alzheimer’s disease or dementia. Two-thirds of people who suffering with from Alzheimer’s are women and the disease affects blacks about twice as commonly as whites. The number of persons with Alzheimer’s will grow as the population of those over the age of 65 rises. This is the only disease in America in the top 10 that cannot be prevented, cured, or slowed. According to statistics in 2015, Alzheimer’s disease and other dementia will cost the nation 226 billion dollars. Moreover, by 2050 this may increase to 1.1 trillion dollars.

Alzheimer ‘s disease is the most common type of dementia, a general term that describes a group of symptoms including: loss of memory and other mental abilities. It accounts for about 60 to 80 percent of the dementia causes. Alzheimer’s disease is an irreversible progressive brain disease that slowly corrupts mental and thinking skills until ultimately the impacted person loses the capacity to complete or carry out the simplest task of daily living. In a majority of cases, Alzheimer’s clinical manifestations first appear after the age of 65. However, Alzheimer’s and dementia are not a normal part of aging, even though the biggest risk factor of developing the disease is increased age. The term Alzheimer’s was named after the German psychologist Dr. Elias Alzheimer in 1901. Dr. Alzheimer carefully navigated his client with an unusual mental disorder her manifestations consisted of memory loss, language problems and unpredictable behavior.

After the patient’s death Dr. Alzheimer took a serious examination of his client’s brain and he discovered the presence of plaques, which are abnormal clusters of protein fragments build up between nerve cells now known as amyloid plaques, and dead and dying nerve tangles which are made up of twisted strands of another protein known as neurofibrillary tangles. Pathophysiology nerve cells or neurons do the actual work in the brain. An adult brain consists of around a hundred billion nerve cells that connect to one another at the synapses. When a charge reaches a synapse it will trigger a release of a tiny burst of chemicals called neurotransmitters. The neurotransmitters will travel across the synapse carrying the signals to other cells. These signals that travel through the neuron branches or forests form a basis of memories, thoughts and feelings.

Regrettably, neurons are the sheath type of cells destroyed by Alzheimer’s disease. Recent experts still do not have the knowledge of what actually causes Alzheimer’s disease and how does the process begin. However, according to scientists, it appears to be possible that brain damage begins a decade or more before the issues become obvious. Among the preclinical phase of the Alzheimer’s illness, individuals are free of the Alzheimer’s manifestations but harmful changes are already occurring in the brain. Alzheimer’s causes an abnormal structure called beta amyloid plaques and neurofibrillary tangles to form. These are the classic biological hallmarks of the disease. Plaque is formed when specific protein in the neurons cell’s membrane are processed differently releasing small fragments called beta amyloid. Beta amyloid is chemically sticky so when these fragments clump together they become toxic and hinder the function of neurons. As more fragments are formed, it the size increases and finally, forms beta amyloid plaques.

Neurofibrillary tangles on the contrary are made when protein called tau is modified in the normal brain cell. The cell’s internal transport system is arranged in orderly parallel strands, something similar to railroad tracks. Fueled molecule cell parts and other key materials are carried up and down the tracks which are called microtubules, a protein called tau helps the microtubules stay straight and stabilize in Alzheimer’s disease. Abnormal tau separates from the microtubules which causes them to fall apart. Strands of this towel combine to form tangles inside the neuron disabling the transport system causing nutrients and other essential supplies to no longer move through the cells, destroying the cell. The ones neurons start to function less efficiently after a period of time, neurons lose the capacity to function and correspond with one another and in the end they die after some duration. The damage may spread to another closed structure in the brain known as the hippocampus, which is vital in framing memories, hence the loss of memory. As these processes continue, the brain shrinks and significant brain functions are lost.

Risk factors connected to Alzheimer’s disease consist of:

Age

This is the biggest recognised risk factor for developing Alzheimer’s disease. However, as we have already mentioned, Alzheimer’s is not a standard part of aging. It is more probable to impact older people and in a greater proportion of those 85 years or old have it.

Family history

Having Alzheimer’s disease in the family is connected with higher risk. Family history is second greatest risk factor after age. This is because having certain genes, for instance a poly protein E gene puts an individual at three to eight times more risk than an individual without this gene.

Being female

A great number more women compared to men are affected by this disease.

Following are some signs and symptoms of Alzheimer’s disease: changes occur in the brain of those with Alzheimer’s disease years before any signs of the disease are evident. This time period which can keep on going for quite a long time over years is referred to as the preclinical Alzheimer’s disease phase. Over time the symptoms of Alzheimer’s disease develop gradually in three general stages: mild, moderate, and severe stage.

Mild stage

In the mild stage which is the early stage, the client can still function independently, however there may be instances where the client and his significant others may notice the memory and concentration problems with the client which may include difficulty coming up with the right word or name problems, remembering the name when introduced to new people, taking longer to perform a task in social or work settings,  forgetting material that one has just read, losing or misplacing a valuable object, variance in an increase in problem with planning and organizing.

Moderate stage

This is the middle stage, this stage is generally the longest which can last for many years. In this stage, damage to the brain may include areas that control reasoning, language, sensory, processing and conscious thought. The client may need a greater level of care and symptoms may be obvious to others. The symptoms might be: forgetfulness of events or about one’s own personal history, feeling moody or withdrawn especially in socially or mentally challenging situations, being unable to recall their own addresses, telephone numbers or high school or college from which they attended, confusion about where they are or what day it is, needing assistance with choosing proper clothing for whatever the occasion or reason. Trouble controlling bladder and bowels and some individuals changes in sleep patterns such as sleeping during the day and becoming restless at night, hence increasing the wandering risk and becoming lost personality. Moreover, behavioral changes including suspiciousness and delusions or compulsive and peculiar behavior like hand wrinkling or tissue shredding.

Severe stage

This is the late and final stage of Alzheimer’s disease. In this stage the clients memory and cognitive skills continue to get worse, near the end the client may be in bed most or all of the time. In this advanced stage, the body shuts down and the client may need full-time assistance all the time with daily or personal care. They might lose awareness of recent experiences as well as their surroundings require high level of assistance with daily activities and personal care. They might also go through changes in physical abilities including the ability to walk, sit and eventually swallow, having growing difficulty communicating, becoming vulnerable to infections especially pneumonia.

These three stages can give you a basic idea of how skills change once indicators appear and should only be used as guidelines since each Alzheimer’s client may develop symptoms differently so the rates at which the disease develops from person to person depends on many things. On average a person with Alzheimer’s lives about four to eight years after diagnosis. On the contrary, some have even survived 20 years or more. Do note that it may be difficult to place a client with Alzheimer’s in a certain stage as stages may have similar diagnosis. Alzheimer’s disease is not straightforward to diagnose because there is no one test for it. Diagnosing Alzheimer’s calls for cautious therapeutic assessment including a careful rest rate of history mental status testing and neurologic exam. A series of tests including blood work and brain imaging to preclude different reasons for dementia like manifestations may also be done.

Treatment for Alzheimer’s disease

Treatment until now there is no ultimate cure for Alzheimer’s disease. Due to this, current approaches for treating Alzheimer’s disease are focused more on therapeutic interventions to help the client improve their quality of life to include helping them maintain their mental function,  manage behavioral symptoms and slowing or delaying the symptoms of the disease as much as possible. In terms on medications, there are four medications under the cholinesterase inhibitors class that can be given to help momentarily improve some symptoms and slow down the progression of the disease. Drugs for Alzheimer’s used in the U.S. include:

Aricept, Reminyl, Exelon, and Cognex. Namenda is an additional kind of drug known as NMDA receptor antagonist. It might also be taken alone or in combined with a cholinesterase inhibitor and may be prescribed for mild stage Alzheimer’s or for those who cannot take the others recommended for any reason, or for those with a late stage of Alzheimer’s.

Supportive measures

Besides medication, a wide variety of supportive measures and treatments may assist the client live as independently as possible. Psychological treatments such as cognition stimulation may be given to improve memory problem-solving skills and language ability. Relaxation therapies may also be suggested to assist in reducing depression, anxiety, agitation and other challenging behaviors that are many times present along with Alzheimer’s disease. Some practical tips for people with Alzheimer’s may consist of: keeping a diary and writing down things that are important, mounting a weekly timetable to the wall, putting keys in an obvious place such as a large bowl in the living room, putting labels on cupboards and drawers, keeping useful telephone numbers by the phone, having the patient write reminders and post it notes in obvious places, setting an alarm clock to act as reminders, installing safety devices such as gas detectors and smoke alarms throughout the house.

Similar different types of dementia and neurodegenerative diseases, a real piece of the treatment for patients with Alzheimer’s comes from the assistance provided by caregivers, to give the client quality of life care which gets to be more critical as needs increase with declining independence for clients nearing the ends of life. The healthcare team should analyze the needs, making sure the client is comfortable and enable them to die with dignity in a place of their choosing.

In conclusion, what’s to look forward to for the science of Alzheimer’s? Well, there is developing research being carried out to help those suffering with this terminal disease. Worldwide quest is ongoing to stop, slow or maybe even prevent Alzheimer’s disease. A company called the Alzheimer’s Association funds research as they look for new strategies to find a cure.

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