Alzheimer’s disease is a form of dementia, “a brain disorder that seriously affects a person’s ability to carry out daily activities (Shenk 14)”. Alzheimer’s is a progressive and irreversible brain disorder that slowly destroys a person’s memory and ability to learn, make judgments, communicate, and accomplish daily activities. As Alzheimer’s progresses, individuals may also experience changes in personality and behavior, such as anxiety, suspiciousness or aggravation, as well as illusions or hallucinations.
Alzheimer’s disease is named after a German doctor, Dr. Alois Alzheimer. In 1906, Dr. Alzheimer became aware of changes in the brain tissue of a woman who had died of an unusual mental illness. Dr. Alzheimer found irregular clusters and tangled bundles of fibers. Today, these plaques and tangles in the brain are considered signs of Alzheimer’s (Shenk 12-14). Scientists have also found other brain changes in people with Alzheimer’s. Nerve cells die in areas of the brain that are vital to memory and other mental abilities.
There also are lower levels of some of the chemicals in the brain that carry messages back and forth between nerve cells. Although many things are known about Alzheimer’s, there are still many things that remain a mystery, such as causes, and how to cure Alzheimer’s. Alzheimer’s disease affects the brain cells which are called neurons. Neurons send messages from one to another, which allows us to think, remember and speak. In each of the neurons there is a branch like structure. Some carry impulses away from neurons (afferent), and some bring impulses to the neurons (efferent).
The relaying of impulses from neuron to neuron in the brain makes it possible for one to carry out physical and mental tasks. When plaques and tangles form in the brain, they disrupt the flow of messages to the neurons. This happens when people age, but with an Alzheimer’s patient there are many more that disrupt, which allows them to forget simple tasks. Plaques are abnormally sticky clusters of protein. They disrupt pathways that carry signals from neuron to neuron. Plaque is a deposit of protein mixed with fragments of dead or dying neurons found in the brains of patient who have Alzheimer’s.
A tangle is a set of twisted nerve cell fibers found in the cell bodies of neurons in the brains of the patients who have Alzheimer’s. Tangles clod the neurons and keep them from functioning properly. When neurons are clogged with tangles and spaces between neurons clogged with the plaques, the transmission of nerve impulses from one neuron to the next doesn’t happen properly. As a result, the brain has difficulty performing mental functions such as thinking and remembering. In times past many people thought that memory loss was a normal occurrence for elderly people.
This thinking was major reason for why Alzheimer’s disease was not caught until very later in the stages. Alzheimer’s disease is not a normal part of aging. After heart disease, cancer, and strokes, Alzheimer’s is the most common cause of death in adults in the Western world. “It is estimated that 4. 5 million Americans over the age of 65 are affected with this condition. After the age of 65, the incidence of the disease doubles every five years and, by age 85, it will affect nearly half of the population” (Robinson).
The beginning and symptoms of Alzheimer’s are usually very slow and gradual. Alzheimer’s hardly ever occurs before the age of 65. It occurs (according to the AHAF) in the following seven stages: In stage 1 There are no impairment- Unimpaired individuals experience no memory problems and none are evident to a health care professional during a medical interview. Stage 2 Is a very mild decline- Individuals at this stage feel as if they have memory lapses, especially in forgetting familiar words or names or the location of keys, eyeglasses, or other everyday objects.
But these problems are not evident during a medical examination or apparent to friends, family, or co-workers. Stage 3 is Mild decline- Friends, family, or co-workers begin to notice deficiencies. Problems with memory or concentration may be measurable in clinical testing or discernible during a detailed medical interview. Common difficulties include: forgetfulness, poor insight, mild difficulties with word-finding, personality changes, difficulties with calculations, losing or misplacing things, repetition of questions or statements and a minor degree of disorientation.
Stage 4 is a moderate decline (mild or early stage Alzheimer’s)- At this stage, a careful medical interview detects clear-cut deficiencies in the following areas: memory worsens, words are used more and more inappropriately, basic self-care skills are lost, personality changes, agitation develops, can’t recognize distant family or friends, has difficulty communicating, wanders off, becomes deluded and may experience hallucinations. Stage 5: is a moderately severe decline (moderate or mid-stage AD)- Major gaps in memory and deficits in cognitive function emerge.
Some assistance with day-to-day activities becomes essential. Stage 6 is a severe decline (moderately severe or mid-stage AD)- Memory difficulties continue to worsen, significant personality changes may emerge, and affected individuals need extensive help with customary daily activities. Stage 7 is a Very severe decline (severe or late stage AD)- This is the final stage of the disease when individuals lose the ability to respond to their environment, the ability to speak, and, ultimately, the ability to control movement. This is when the Alzheimer’s patient becomes bedridden, incontinent, uncomprehending and mute
There are several warning signs, 10 that this paper will bring out, that one should look for, when trying to diagnose whether or not the individual has Alzheimer’s disease. Early diagnosis of Alzheimer’s disease or other disorders causing dementia is an important step to getting appropriate treatment, care and support services. The signs to look out for are the following: memory loss, difficulty performing familiar tasks, problems with language, disorientation to time and place, poor or decreased judgment, problems with abstract thinking, misplacing things, changes in mood or behavior, changes in personality, and finally loss of initiative.
Alzheimer’s is a fatal disease. It begins with the destruction of cells in regions of the brain that are important for memory. However, the eventual loss of cells in other regions of the brain leads to the failure of other essential systems in the body. Also, because many people with Alzheimer’s have other illnesses common in older age, the actual cause of death may be no single factor. A person with Alzheimer’s disease will live an average of eight years and as many as 20 years or more from the onset of symptoms as estimated by relatives.
From the time of diagnosis, people with Alzheimer’s disease survive about half as long as those of similar age without dementia. Average survival time is affected by age at diagnosis and severity of other medical conditions. “The greatest known risk factors for late-onset Alzheimer’s are increasing age and a family history of the disease. The likelihood of developing late-onset Alzheimer’s approximately doubles every five years after age 65. By age 85, the risk reaches nearly 50 percent” (Choice Media).
These are only some of the reasons why Alzheimer’s occurs, but because there is still so much that scientist do not understand about Alzheimer’s, there is not a lot known about the risk factors. Family history is another risk factor. Scientists believe that genetics may play a role in many AD cases. For example, familial Alzheimer’s, a rare form of Alzheimer’s that usually occurs between the ages of 30 and 60, is inherited. The more common form of Alzheimer’s is known as late-onset. It occurs later in life, and no obvious inheritance pattern is seen. However, several risk factor genes may interact with each other to cause the disease.
The only risk factor gene identified so far for late-onset Alzheimer’s, is a gene that makes one form of a protein called apolipoprotein E (apoE). Everyone has apoE, which helps carry cholesterol in the blood. It is likely that other genes also may increase the risk of Alzheimer’s or protect against Alzheimer’s disease, but they remain to be discovered. Although scientists are learning more every day, right now they still do not know exactly what causes Alzheimer’s disease, and there is no cure. At this time, there is no medical treatment to cure or stop the progression of Alzheimer’s disease.
FDA-approved drugs may temporarily improve or stabilize memory and thinking skills in some individuals. It is important to remember that the number of Americans with Alzheimer’s disease will continue to grow – by 2050 the number of individuals with Alzheimer’s could range from 11. 3 million to 16 million. Increasing age is the greatest risk factor for Alzheimer’s. One in 10 individuals over 65 and nearly half of those over 85 are affected. Rare, inherited forms of Alzheimer’s disease can strike individuals as early as their 30s and 40s (Robinson).
Early diagnosis is very important. An early, accurate diagnosis of Alzheimer’s disease helps patients and their families plan for the future. It gives them time to discuss care while the patient can still take part in making decisions. Early diagnosis will also offer the best chance to treat the symptoms of the disease. Today, the only definite way to diagnose Alzheimer’s is to find out whether there are plaques and tangles in brain tissue. To look at brain tissue, how ever, doctors must wait until they do an autopsy, which is an examination of the body done after a person dies.
Therefore, doctors can only make a diagnosis of “possible” or “probable” Alzheimer’s while the person is still alive. At specialized centers, doctors can diagnose AD correctly up to 90 percent of the time. Doctors use several tools to diagnose “probable” AD, including: questions about the person’s general health, past medical problems, and the history of any difficulties the person has carrying out daily activities, tests of memory, problem solving, attention, counting, and language, edical tests-such as tests of blood, urine, or spinal fluid, and brain scans.
Some of these test results help the doctor find other possible causes of the person’s symptoms. For example, thyroid problems, drug reactions, depression, brain tumors, and blood vessel disease in the brain can cause AD-like symptoms. Some of these other conditions can be treated successfully. Recently, scientists have focused on a type of memory change called mild cognitive impairment (MCI), which is different from both Alzheimer’s disease and normal age-related memory change.
People with MCI have ongoing memory problems, but they do not have other losses like confusion, attention problems, and difficulty with language. Scientists funded by the NIA are studying information collected from the Memory Impairment Study to learn whether early diagnosis and treatment of MCI might prevent or slow further memory loss, including the development of Alzheimer’s disease. Alzheimer’s disease is currently incurable, and only two drugs–tacrine (Cognex) and donepezil hydrochloride (Aricept)– have been approved by the FDA for its treatment.
Several other drugs are being prescribed more often as their benefits are demonstrated in wider testing. Nonetheless, the mainstay of treatment for a person with Alazheimer’s continues to be good nursing care, providing both physical and emotional support for a person who is gradually able to do less and less for himself, and whose behavior is becoming more and more erratic. Modifications of the home to increase safety and security are often necessary. The caregiver also needs support to prevent anger, despair, and burnout from becoming overwhelming.
Becoming familiar with the issues likely to lie ahead, and considering the appropriate financial and legal issues early on, can help both the patient and family cope with the difficult process of the disease. Regular medical care by a practitioner with a non-defeatist attitude toward Alzheimer;s is important so that illnesses such as urinary or respiratory infections can be diagnosed and treated properly, rather than being incorrectly attributed to the inevitable decline seen in Alzheimer’s.