“Alzheimer’s disease is a progressive disease of the human brain that is characterized by impairment of memory and a disturbance in at least one other thinking function” (Bronstein & Pulst, 2003). When we hear about Alzheimer’s disease we automatically think of older people. This is because this disease most often occurs in adults after the age of 65. Statistics show that one in eight individuals will have Alzheimer’s after they reach age 65 (Cavanaugh & Blanchard-Fields, 2002). Alzheimer’s disease is a form of dementia, which is any medical condition that affects the brain (Cavanaugh & Blanchard-Fields, 2002).
A diagnosis of Alzheimer’s is said to be a “diagnosis by exclusion” (Bronstein & Pulst, 2003). This means that there is no certain test just for Alzheimer’s, but many tests that rule out other diseases. The early stages deal with short-term memory loss. Examples of this include forgetting to turn off the stove, forgetting what medications were taken in a particular day, or forgetting which medications need to be taken. As the disease progresses there is more visibility in the declines in abstract thinking and intellectual function development (Bronstein & Pulst, 2003). As the disease enters the final stages, individuals become very confused and disorientated. At this point the individual’s health status has become severely deteriorated and this can cause them to develop pneumonia or other illnesses that may lead to death. Consequently, most people do not die from Alzheimer’s, but other health related problems. Alzheimer’s disease can last anywhere from six to eight years, however it can be present without obvious symptoms for two to twenty years. The on-set of Alzheimer’s disease is very slow (Bronstein & Pulst, 2003).
There are many factors that play a role in the cause of Alzheimer’s disease. This disease is also genetic—a person that has family members with the disease possesses an increased chance of being diagnosed with Alzheimer’s also. This disease supposedly caused by many effects on the brain. A mutation of a single gene is one condition that is found in the brain of Alzheimer’s patients (Bronstein & Pulst, 2003). There are also proteins in the brain that are linked to Alzheimer’s. They are the amyloid precursor and two presenilins, (Bronstein & Pulst, 2003) which are responsible in the early on-set of the disease (Brzyska & Elbaum, 2003). The number one indicator of Alzheimer’s is a gene called apolipoproteinE (apoE). There are three forms of this gene. ApoE 4 is the one that is most closely related to Alzheimer’s sufferers. This gene is inherited and when a child receives two of them, one from each parent. As a result, the child’s chances of developing the disease are largely increased. ApoE2 is another form of the gene but this one takes on the opposite route – this gene decreases one’s chances of getting Alzheimer’s disease.
There are not many prevention methods for Alzheimer’s; it’s a genetic disease, and it also depends on how your genes react to our environment. It has been thought that drinking out of aluminum cans can cause Alzheimer’s, but this has been proven to now be false. Many scientists believe that Alzheimer’s disease occurs from an increase in the production of a specific protein, beta amyloid, which leads to nerve cell death (Bronstein & Pulst, 2003).
Although there is no cure for Alzheimer’s disease, there are treatments that prolong the individual’s awareness and memory. Their medications can be taken in the early stages to minimize memory loss that the patient is experiencing. One drug that has a positive effect is tacrine, a drug that is used to increase acetylcholine, which helps to improve memory (Cavanaugh & Blanchard-Fields, 2002). Patients are also given anti-depressants and anti-anxiety medicines to address their mood (Cavanaugh & Blanchard-Fields, 2002). These drugs are called chiolinesterase inhibitors (ChEIs); the FDA has approved them for the treatment of Alzheimer’s disease. Along with tacrine, aricept is another drug that is commonly used and found to be very successful in delaying the effects of Alzheimer’s. These drugs have been found to help patients in most cases, but genetics dictate that each case is different; signs and symptoms for Alzheimer’s vary for each patient. These drugs are most effective when used in the earliest stages of the disease. When a patient is taking these drugs, doctors should not prescribe more than one because there are too many side effects when in taken in combination. Alzheimer sufferers do not have to take these medicines for their whole life, but when they are experiencing withdrawals from them they have to be monitored.
There are four principle disturbances in Alzheimer’s disease. They are agitation, depression, psychosis, and anxiety. Agitation occurs in about 70% of patients and is more common as the disease gets worse (Bronstein & Pulst, 2003). To calm a patient’s agitation doctors often prescribe them antipsychotic drugs. Psychosis is common among Alzheimer’s patients also, but not as often, occurring in about 50 % of cases. In another 50 % of the cases we find them suffering from depression–usually a mild depression that is treated with antidepressants. Anxiety is the last principle disturbance that is found in Alzheimer’s and it occurs in about 40-50 % of cases. Most patients do not require medication to treat their anxiety (Bronstein & Pulst, 2003). Finally, one last effect that may occur from time to time in the course of Alzheimer’s disease is difficulty sleeping.
There is not yet a cure for this disease but with all the continued research, hopefully in the future, researchers will find one. Having the knowledge about the brain and its abnormalities that occur with this disease will provide physicians with more treatment and maybe a cure. According to Bronstein and Pulst animal testing such as immunization of beta-amyloid antibodies have been showing very promising results in the next step for a cure.
The reason I choose to research this disease is because my grandmother is currently ailing from it. She is eighty-seven years old and along with some other health problems, Alzheimer’s disease has become a major concern. She is well into the latent stages of the disease, but the disease has not completely overtaken her. However, there are many things that the disease has done to her normal capabilities. When my family first noticed that she was becoming more and more forgetful, we did not think much about it. As the disease progressed, we became more concerned for her safety. My grandmother takes medications for her other illnesses, and like most other Alzheimer patients she was starting to forget to take them. My grandmother also drove up until her later years, which was not a safe idea for her or other drivers on the road. She once got lost and we had to go out searching for her. A major tragedy was averted after we had to call the police and she was discovered after she backed her car into the side of her home. When confronting her on with these situations, she was able to make up excuses or she just easily denied that she did that. She is not yet in the stage where she forgets who we are, but she does need to be reminded from time to time. The one good thing about my grandmother’s condition is that she is now aware that there is a problem.
A conversation with my grandma consists of a lot of repeating. Some times she will catch herself asking the same questions and her famous quote is, “my thinker is a stinker”. One thing that I do notice in my grandmother that coincides with my research is that a majority of her forgetfulness is short-term memory loss. When asking my grandmother about her childhood, or how she met my grandfather, she remembers it like it was yesterday. Not only does my grandmother have other health-related problems, she also lived alone for a while and has fallen causing great injury to her body. The worst occurrence of this happening is when she once fell in her kitchen and broke her hip. At this point in her life, she was more disorientated than ever. We now have a nurse that stays with her to make sure that she is safe, but this is another issue for her because she feels that there is a stranger in her house.
Alzheimer’s is an intimidating and threatening disease. Possessing the knowledge that I now have is an advantage in being a preventable measure for me. Being that this disease is genetic, my chances of having it are increased. Knowing all of this information about it will help me in the future to be able to detect it early so I can take the proper course of action that will delay the progression of this disease for me. If tragedy ever should strike, by then, hopefully, more curable treatments will exist.
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This section highlights some of the groundbreaking research and guidance documents published or presented by Alzheimer's Association professional staff, funded researchers or volunteer science advisors.
Review of Scientific Evidence Addressing Prevalence, Documented Needs, and Interdisciplinary Research: Persons in Early Stage Alzheimer’s Dementia (141 pages)
Prepared for the Alzheimer's Association Early Stage Advisory Group by Sandy Burgener, Linda Buettner and collegues
Comprehensive literature review of the scientific literature non-pharmacological interventions for people in Early Stage Alzheimer's disease and other forms of dementia.
Research Consent for Cognitively Impaired Adults - Recommendations for Institutional Review Boards and Investigators: Consensus Recommendations (5 pages)
Prepared by the Alzheimer's Association
This paper appeared in Alzheimer's Disease and Associated Disorders July-Sept. 2004. The document contains recommendations that Institutional Review Boards and investigators can use to operationalize the informed consent process for individuals with cognitive impairment.
Interventions to Improve Quality of Care: The Kaiser Permanente-Alzheimer’s Association Dementia Care Project (8 pages)
Prepared by Alzheimer’s Association Los Angeles chapter staff and Kaiser colleagues
This paper from the August 2004 American Journal of Managed Care describes an Alzheimer’s Association-Kaiser Permanente joint initiative to improve the quality of dementia care in the Kaiser Permanente Los Angeles area managed care network. The project developed dementia diagnosis and management guidelines for Kaiser physicians, proactively encouraged guideline use, and provided care management support through social workers. Individuals with dementia, their caregivers and Kaiser health care professionals all expressed higher rates of satisfaction with care quality provided by the project.
Dementia and Serious Coexisting Medical Conditions: A Double Whammy (19 pages)
Prepared by Katie Maslow, M.S.W., Alzheimer’s Association associate director, quality care
This paper from Nursing Clinics of North America 2004, vol. 39, discusses the widespread occurrence of other serious medical conditions in individuals with dementia; explores how coexisting conditions may worsen cognitive symptoms and create treatment challenges for care professionals and family caregivers; and analyzes the impact of coexisting conditions on use and cost of health care.
Alzheimer's Disease, the Alzheimer’s Association and Stem Cell Research (1 page)
Prepared by the Alzheimer’s Association
This document was prepared on June 14, 2005 to provide background information and address common questions about stem cell research and Alzheimer’s disease.
Guidelines for the Development of Community-Based Screening Programs for Cognitive Impairment in Older People (12 pages, guidelines begin on page 6)
Prepared by the Alzheimer’s Association Work Group on Screening for Cognitive Impairment and Alzheimer’s Disease
This paper in the June 21, 2001, issue of Alzheimer Insights, a peer-reviewed online journal, presents the recommendations of independent experts and Alzheimer’s Association senior science and public policy staff on issues and challenges related to community screening for dementia. The guidelines outline 21 questions that must be considered in the design of a community screening program. If many of these questions pose problems, the sponsoring group may wish to consider launching a community education initiative in place of a screening program.
The Use of MRI and PET for Clinical Diagnosis of Dementia and Investigation of Cognitive Impairment: A Consensus Report (15 pages)
Prepared by the Neuroimaging Work Group of the Alzheimer's Association
Posted June 1, 2004
This report represents the consensus of 22 independent experts assembled by the Alzheimer's Association on the current value and appropriate use of magnetic resonance imaging (MRI) and positron emission tomography (PET) in diagnosing Alzheimer's disease and related disorders, tracking disease progression, and monitoring response to experimental treatments. The report also recommends directions for future research.
End-of-Life Care for People with Dementia in Residential Care Settings (35 pages)
Prepared for the Alzheimer’s Association by Ladislav Volicer, M.D., Ph.D., School of Aging Studies, University of South Florida, Tampa
The Alzheimer’s Association commissioned this literature review on end-of-life care for nursing home residents with advanced dementia as part of its Campaign for Quality Residential Care. The goal is to document the current state of end-of-life care, provide an evidence base for practice and policy recommendations to improve care, and stimulate further research in this area.
University of North Carolina Institute on Aging's Online Bibliography on Alzheimer's Disease and Dementia in Diverse Populations
Comprehensive online bibliography of the social and behavioral research related to Alzheimer's disease and other forms of dementia.
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