Alzheimers disease: Tests With Proper Diagnosis Which Prevent the Diseases Fast-Paced Progress - Research Paper Example

I. Introduction Every time a person ages, he becomes more at risk of getting Alzheimer’s disease. However, several symptoms and signs of Alzheimer’s and aging are similar. Thus, it is a difficult task to tell if an individual has Alzheimer’s during the first stages of the condition. It is during the later stages when the symptoms get more recognizable. However, if an individual feels like he or she is undergoing the first stages of Alzheimer’s, they may opt to take tests that will provide them with proper diagnosis. Once diagnosed, they may start the needed practices to prevent the disease’s fast-paced progress. The first thing that should be done to get tested for Alzheimer’s is to contact your doctor and get a referral from him or her. Otherwise, the test may not be given since the doctor should be the main care giver. After receiving the referral, the next thing to be done is go to a hospital where the test will be carried out. You will go through a psychological test, which will determine if you are going through Alzheimer’s or a condition that is alike in nature. You may also consult your doctor regarding tests for beta amyloid and tau, proteins that may be tested by obtaining spinal fluids. These proteins are present in all individuals with Alzheimer’s. A SPECT test, which checks the brain function, may also be conducted by the hospital. It is comparable to a CAT scan or MRI. The test will show whether the patient has Alzheimer’s through the brain scan. These tests however, should only come after the early warning signs of Alzheimer’s or dementia are indeed shown and not just mistaken for memory loss caused by old age. This paper aims to clearly identify said differences and to make it easier for those involved in caring for elder people. Knowing the difference and learning the early signs of dementia/Alzheimer’s would be a big advantage since those involved will be able to get the maximum benefit from available remedies, help for both the patient and their loved ones may be done early and planning for the future may be put in place. II. An Overview on Memory Loss Every now and then, what was taken for dinner may be forgotten, or one may walk into a room without remembering why he went there or one may forget where he placed the remote control. The first thought that comes to mind by elders who starts experiencing these forgetfulness is that they may be having Alzheimer’s or dementia. The fact is, there are more than one hundred conditions that are quite similar to dementia or Alzheimer’s, particularly when it comes to memory loss. Most of these conditions are treatable, unlike Alzheimer’s. These are oftentimes known as “pseudodementia”, wherein the word “pseudo” means “false”. Simply put, these conditions show dementia-like signs and symptoms. Some examples are problems with vision and hearing (concealed problems of hearing or vision can bring improper answers and may be taken as dementia), brain tumors which can cause mental perplexity, response to medications (old people are primary consumers of both over-the-counter and prescriptions drugs, and studies show that a lot of these said drugs yield certain effects suggestive of cognitive decline), subdural hematoma, depression, endocrine abnormalities (confusion similar to that of dementia may be caused by hypothyroidism), stroke, nutritional deficiency, normal pressure hydrocephalus caused by interruption in the spinal fluid flow and infections, which may create impulsive start of confusion. The reason why the memory of an old person is not as sharp as opposed to his or her younger days may also be ensuing to the brain’s natural aging process. The brain and the body ages together. Therefore, as the body physically weakens, the performance of the brain weakens and becomes slower as well. The percentage of US citizens aged 65 and above is increasing rapidly. In fact, it is predicted that by 2030, 20% of the population will be older than 65 years of age. This boost in the population’s aging is likely to cause a rise in the prevalence of dementia. An estimated 10 – 20% of individuals with age 65 and above may experience chronic brain syndromes. This estimation may increase to 25% of the population if people aged 80 and above are counted separately. As much as 4 million individuals possess intellectual damages that are serious enough to be categorized as dementia. In the European Union, over 7 million are diagnosed to have dementia. The region’s aging population are expected to increase this (www.alzheimereurope.org), with rates from both Eastern and Western Europe expected to double by year 2040 (Ferri, et. al., 2005). Globally, the predicted rate would be one for every eighty five individuals will have Alzheimer’s by year 2050 (Boise, et. al., 1999). Alzheimer’s is the most prevalent type of dementia in Europe, i.e., 2/3 of all cases (Brookmeyer, 2007). Moreover, it is estimated that half of these cases of dementia are still not yet diagnosed (Ferri, et. al.; Alzheimer’s Europe Publication, 2006). There are also cases of misdiagnosis and under-diagnosis of the disease and they are in large proportion, i.e., up to 90% of patients having mild dementia (Cummings, 2004; Valcour, et. al., 2000). There are several explanations given for the lack of cognizance of the disease such as the lack of awareness or knowledge about Alzheimer’s dementia by caregivers and physicians and the late diagnosis of physicians of the disease due to late referral (Bond, et. al., 2005). Alzheimer’s is the result of a degenerative disorder. Its onset is insidious. Genetic risks and mutations are already present at birth in both familial and sporadic Alzheimer’s. However, other environmental factors are responsible in influencing the genetic vulnerability and ageing process which decides the age of the patient when the disease sets in. Dementia follows. When dementia is diagnosed, most commonly at the age of 60 or more, cell death and other pathological changes has already occurred. For a definite and accurate diagnosis, an autopsy needs to be done (Shaw, et. al., 2007). Clinical diagnosis can be performed through the use of neuro-imaging combined with neuro-psychological testing, as well plasma, urinary and cerebrospinal fluid markers. Despite these state-of-the-art procedures however, Alzheimer’s can never be really 100% accurately diagnosed unless it is done post mortem. Given the lack of a definitive and accurate tests for Alzheimer’s before its development, defining the early signs and manifestations of cognitive impairment that leads to Alzheimer’s relies mainly on certain changes in the function and cognition which are usually observed by the Alzheimer’s patient’s family or caregivers (Knox & Ritchie, 2009). III. Dementia Unknown to many, dementia is different from Alzheimer’s in the sense that Alzheimer’s is just one of its type, the most common one. Dementia is defined as a loss of emotional and cognitive function. This disorder is prevalent, especially among older people, and may remain unrecognized for some time. According to studies, over 20% of individuals who exhibit symptoms indicative of dementia end up having curable disease. Around half will have psychiatric disorders and the other half will have organic diseases. The more chronic the case of dementia and the older the population, the lower the fraction of curable cases is. However, there are still quite a number of individual within this group that may be cured. 5–10% of the population of individuals aged 65 and above has major cognitive problems. Over 89 years of age, the percentage grows to 15-20% and reaches around 40% by the age of 85. The occurrence o dementia is practically stable from age 65 onwards, but the number of people with dementia increases gradually with age because of accumulation. These statistics become highly significant, taking into account the aging population. During the late 1980’s, there were around 20 million Americans aged 65 and above. By 2030, an estimated 70 million Americans will be 65 and older. The socio-economic effects of this 5-10% of the population having dementia are confounding, especially taking into account the problems brought about by dementia on the person, their families and the whole society (Whitehouse, 1993). IV. Alzheimer’s Alzheimer’s disease is the fifth primary cause of deaths among Americans aged 65 and the sixth foremost cause of death in the country. While the number of death cases due to other main causes has lessened, deaths caused by Alzheimer’s have grown dramatically. According to preliminary data, between the years 2000 and 2008, Alzheimer’s-related deaths have risen to 66% whereas deaths caused by prostate cancer, stroke and heart disease have decreased by 8%, 20% and 13% respectively. Approximately 5.4 million Americans are suffering from Alzheimer’s disease. In United States, a person develops Alzheimer’s every 69 seconds. This is said to accelerate into a faster pace of every 33 seconds by the year 2050. Over the coming years, the growth of the population is expected to add 10 million individuals to the group suffering from AD. In the year 2050, occurrence of Alzheimer’s is predicted to reach about one million every year, having a total incidence of 11-16 million. In the year 2010, virtually 15 million families and unpaid caregivers presented a ballpark figure of 17 billion hours of care towards individuals with Alzheimer’s and other kinds of dementia, which is approximately worth over $202 billion. Medicare fees for services rendered to AD and dementia beneficiaries aged 65 years are roughly 3 times larger compared to beneficiaries who do not have AD and other dementias. The total payments for hospice services, long-term care, and health care for Alzheimer’s disease (and other dementias) patients aged 65 years in the year 2011 are projected to be an estimated $183 billion, apart rom the unpaid caregivers’ contributions (Alzheimer’s Association, 2011). Alzheimer’s disease, which most frequently occurs among people aged 65 and above, is a progressive and degenerative brain condition distinguished by changes in behavior and personality, memory loss and problems with judgment and reasoning, planning, organization, spatial abilities and language. As a person gets older, his or her chances of developing Alzheimer’s disease increase. People aged 85 and above have the highest cases of the condition. Dementia consists of several types with DAT or Dementia of Alzheimer's Type being the most commonly found in the elderly. Likewise, it is the form that happens to be the greatest reason for dysfunction in those more than 85 years of age. Research showed that about 360 thousand cases of DAT will be diagnosed yearly. There are currently 4 million cases of it in the United States alone it the number will triple in the next two decades given the baby boomers’ generation. Study also showed that women are more prone to having Alzheimer’s than men due mainly to the longer life expectancy they have. Needless to say, its early diagnosis is vital in order for the disease to be managed effectively. Patients with Alzheimer’s have an average life span of 8 to 10 years from the time it was diagnosed. It is therefore necessary that proper financial, legal and medical arrangement be made in favor of the patient’s care and estate. V. Human Brains as It Ages As a person ages, his body organs experience alterations in many different ways. The same goes with the brain. Presently, the literature on the effects of an aging brain abounds. Up to the age of 30, the volume of the brain is at its peak. However, the succeeding decades will see its gradual decline. Some of the structures of the brain may be affected less than the others. During the 40s, brain shrinkage related to decreased size and number of nerve cells, shows up. This is referred to as cortical atrophy. This will then be followed by ventricular size dilation for men at the age of 40 and women at the age of 50. To confirm above findings, and in a study made by Harvard Medical School neurology professor Bruce Yankner, human brains make certain changes starting the age of 26 up to the age of 106. He, along with some colleagues, studied the brain tissues of 30 individuals for some changes in the genes concerned with memory and learning. Likewise focused on in this study is the damage to these genes resulting from normal stress. Those between the ages of 26 to 40 had their brains show minimal gene damage as well as normal patterns of usual wear and tear. Greater damage however, is apparent for those in the age of 73 and older (Cromie, 2004). Research found that there are moderate changes in brains in the areas involved in retrieving memory and in storing information. These areas of the brains are the hippocampus, temporal lobe and the basilar-subcortical regions. The hippocampus will lose 5% of its cells each decade from the age of 40 (Mohs, 2007). Thus, the hippocampus is responsible with the brain’s ability to learn new and recent data, it retention and its recall. Other abnormalities of the brain related to Alzheimer’s are the presence of neurofibrilary tangles and senile plaques in the brains which is common among elderly. There is however a difference between Alzheimer’s and normal aging depending on those features’ distribution. In normal aging, the most common cognitive changes would be on the areas of reaction time, non-verbal memory and learning, verbal material retention, concentration and speed in visuospatial. If these changes in cognition do not affect the quality of daily life, it could simply be attributed to aging, not Alzheimer’s. Research show that these cognitive changes related to aging may be delayed by regular exercise since there is better brain oxygenation. Other activities that will result into mental exercise would also be beneficial in speeding up their reaction time. Playing video games is an example of such activities. Basically, living a healthy lifestyle promotes not only a healthy body but also an efficiently working brain (Cromie, 2004). VI. Early Warning Signs of Dementia/Alzheimer’s A German Study show finding that subjective memory impairment turns into Alzheimer’s or dementia is as soon as 3 years before it was diagnosed. Besides the subjective memory impairment itself, the worry brought about of having it, triples the possibility of converting the age connected memory impairment to Alzheimer’s/dementia after 18 months to 3 years, as shown by the same study (Jessen, 2010). Those suffering from baseline subjective memory impairment as well as mild cognitive impairment after eighteen months have ten times the risk having any forms of dementia after 3 years and twenty times the risk of having the Alzheimer’s dementia as compared to those at the first follow-up. Given these findings, it is imperative that the early signs of dementia/Alzheimer’s be recognized and proper steps be taken to ensure a better and longer life for those who may suffer it. Alzheimer’s will affect people differently in many ways but the most prevalent symptom pattern is the gradual deterioration of the memory or the difficulty in remembering new information. This is due to the disruption of the function of the brain cell that is responsible to the formation of new memories. More difficulties will begin to be felt as the damage starts spreading. Memory loss that causes disruption in one’s everyday life is not a common sign of aging. It could very well be an early sign of Alzheimer’s disease. For the most common early symptoms of Alzheimer’s dementia, the following warnings signs should be taken into close consideration (Alzheimer’s Association): 1. Foremost warning sign is memory loss that causes the disruption of daily life. Patient’s forgets recent information, significant events and important dates. Repetition of the same questions, dependence on memory aides and reliance on caregivers or family members to do things they used to do independently before. 2. Some may feel difficulty in solving problems and in planning or any work involving numbers. Examples of such activities would be problems in cooking based on a recipe previously familiar with or in tracking bills. Likewise, there may be struggle in concentration and usual activities are accomplished within a longer period of time. 3. Another warning sign of Alzheimer’s is the challenge in accomplishing usual tasks done at home, work or during recreation. Examples of such difficulty are driving to a familiar destination, failing to remember the rules of a game or forgetting how to properly budget. 4. Symptoms of confusion, particularly with the tracking of dates, place, seasons and time is a sign of Alzheimer’s/dementia. Comprehending something that is not actually happening is also a common sign. Another similar symptom is forgetfulness of their location and of how they got there. 5. Visual problem is an early sign of Alzheimer’s. This can be shown by reading difficulties, determination and contrasts of colors and judging distance. This would also include poor perception, e.g., thinking somebody else is present when what was actually seen was an image in the mirror. 6. Struggles in writing or speaking, including difficulty in joining a conversation, inability to continue on a conversation, failure to use the right words, using the wrong names when referring to some things or repetition of what they are saying. 7. Inability to retrace steps and constantly losing things are further signs of Alzheimer’s. They may be unable to retrace their steps when looking for something as they love putting it in unusual places. Accusing others of stealing the things they fail to find is common. Overtime, there will be frequency of such symptoms. 8. Show of poor or decreased decision-making or judgment, e.g., in grooming, in dealing with money-related transactions or with proper hygiene. 9. Leaving work and withdrawing from usual common activities is a sign of Alzheimer’s, along with their removal of themselves from other usual activities like sports and hobbies. The changes they are experiencing make them weary and want to withdraw from social, work and even family obligations. 10. Personality and mood change is the tenth most common sign of Alzheimer’s. Most show depression, confusion, anxiety, fear and suspicions. Those who may have the disease can be upset easily in places which they may consider to be out of their comfort zone, e.g., work or even their own home. One sign of this is when irritability sets in whenever there is disruption in routine activities. VIII. Evaluating the Strength of Data Used The subject of dementia, Alzheimer’s and even ordinary memory loss are far from being new in the medical world. This is why the literature about it abounds. The researches and studies made on its account are quite numerous. Though up to now, no known cure is found for Alzheimer’s, the amount of information about it is quite humungous. This could be due to the large amount of individuals being diagnosed with it. Thus, much of the researches and studies made on it have already gone through many stages of reviews and polishing and those that are available, such as those used for this paper, can be well trusted. The information and data used to create this study came only from reputable, peer-reviewed journals and online literature and researches. These are results of intense empirical studies both qualitative and quantitative in design. Therefore, the content of this paper can be trusted to contain only accurate and helpful information that may be used for future researches or studies. This paper can also be used to assist in determining the medical problem based on the symptoms of an elderly patient. This can also be used by caregivers and the families and loved ones of those who may be diagnosed of early signs of dementia or Alzheimer’s. IX. Conclusion The information contained in this paper clearly shows that Alzheimer’s or dementia is a dreaded disease that is a problem the world over. It has no cure and those who have it, as well as their families and love ones, are in for a difficult future ahead. It therefore becomes imperative that the disease be determined at its earliest stage and that it not be mistaken for other memory loss illnesses that can still be treated. With the enumeration and explanation in this paper of the earliest signs of dementia/Alzheimer’s accepted worldwide, readers and those involved with the care of an Alzheimer’s patient be guided and informed properly. This paper may also help them in preparing and planning for their future with their loved ones afflicted with the disease. The medical industry is continuously finding remedies and treatments for Alzheimer’s and dementia. At present, prolonging the life and making it as comfortable as possible to the patient is the goal of those taking care of Alzheimer’s patients. Hopefully, future studies may finally give them a longer lease in life by discovering the cure. References Alzheimer’s Association, (2011). 2011 Alzheimer’s disease facts and figures. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 7(2), 208-244, DOI: 10.1016/j.jalz.2011.02.004. Bankhead, C. (2010). Subjective Memory Loss Predicts Dementia. Reviewed by Dori F. Zaleznik and Dorothy Caputo. MedPage Today. Accessed on 28 from http://www.medpagetoday.com/Geriatrics/AlzheimersDisease/19407. Boise, L., et. al. (1999). Diagnosing dementia: perspectives of primary care physicians, The Gerontologist; 39(4), 457–64. Bond, J., et. al. (2005). Inequalities of dementia care across Europe: key findings of the Facing Dementia Survey, Int J Clin Pract; 59, 8–14. Brookmeyer, R., Johnson, E., Ziegler-Graham, K., et. al. (2007). Forecasting the global burden of Alzheimer’s disease, Alzheimer’s Dement; 3(3), 186–91. Cromie, W. (2004). Brain aging found to start at 40: Genes can begin to fail early. Harvard News Office. Harvard University Gazette. Accessed on 29 April 2011 from http://news.harvard.edu/gazette/2004/06.17/03-brainaging.html. Cummings, J. (2004). Alzheimer’s disease, N Engl J Med, 351, 56–67. Ferri, C., et al. (2005). Global prevalence of dementia: a Delphi consensus study, Lancet; 366, 2112–17. Jessen F, et al. (2010). "Prediction of dementia by subjective memory impairment. Arch Gen Psychiatry 67, 414-22. Knox, S. & Ritchie, C. (2009). Recognising early symptoms of Alzeimer’s disease in routine clinical practice. European Neurological Review, 14-16. Mohs, R. (2007). How Human Memory Works. HowStuffWorks.com. 29 April 2011. Shaw, L., et. al. (2007). Biomarkers of neurodegeneration for diagnosis and monitoring therapeutics, Nat Rev Drug Discov, 6, 295–303. Valcour, V., et. al. (2000). The detection of dementia in the primary care setting, Arch Intern Med, 160, 2964–7. Whitehouse, P.J. (1993). Dementia. Philadelphia, F.A. Davis Co. Who cares? The state of dementia care in Europe, Alzheimer Europe Publication, 2006. Available at: www.alzheimer-europe.org/?lm2=C5A5EF2EE10#. www.alzheimereurope.org/site/content/download/5670/53538/file/2009-07-08Newsletterforweb.pdf. Read More