Alzheimers Disease: Causes, Diagnosis, and Treatment - Research Paper Example

Alzheimer’s Disease By: Sheri Dos Santos SOC 313 Social Implications of Medical Issues Tara Jempty October 16, Alzheimer’s Disease Introduction Over the years, there have been several diseases that have developed due to a number of factors. Some, like AIDS, Cancer, Cardiovascular Disease, Diabetes and the like, have summoned the attention of the medical community because of its widespread prevalence and great impact on the state of health of a nation. To add to this growing list of diseases is Alzheimer’s Disease (AD), which mostly affects the elderly population from sixty years and above. However, there have been reported cases of early onset, affecting younger adults. The families and people that care for those suffering from Alzheimer’s are affected mentally, physically, and financially by this devastating disease. There are many challenges when dealing with the disease. Those who are affected, however, may find comfort in some outreach programs offered to both the patient and his or her family. This paper explores the causes, diagnosis and treatment of Alzheimer’s disease as well as its devastating effects on the individual who has it and on the people around him or her, usually members of the family, and recommendations on how it can be prevented or at the least, delay its adverse effects. What is Alzheimer’s Disease? Alzheimer’s Disease (AD) is a neurodegenerative disease that progressively destroys memory and thinking, eventually leading to dementia and the inability to do the simplest of tasks. It occurs mostly among older people above the age of sixty years (Singh et al., 2011). It is the most common form of adult-onset dementia which affects over 5 million people in America alone. Thus far, there has been no known cure for this disease, although research on at least delaying the adverse effects of the disease has been very promising (Trends e-Magazine, 2012). Alzheimer’s Disease Facts in the State of California The World Health Organization (WHO) estimates that currently 35.6 million people currently have Dementia and will increase to 65.7 million by the year 2030 and further increase to 115.4 million in the year 2050 (Wimo & Prince, 2010). Of the 5.4 million people in America living with Alzheimer’s disease, 5% are men and 6% are women over sixty years. Unless the prevalence of Alzheimer’s Disease controlled, as many as 16 million Americans will be afflicted by it by the year 2050. As of 2012, the cost of caring for people with Alzheimer’s and other dementias sum up to about $200 billion, which is expected to balloon to $1.1 trillion per year by mid-century (Alzheimer’s Association, 2012). In the state of California, the following estimates of people aged 65 and older have Alzheimer’s Disease from 2000 and 2010 with projections for the years 2020 and 2025: (from: Alzheimer’s Association California Alzheimer’s Statistics 2012) In 2008, there have been 10,098 deaths due to Alzheimer’s Disease in the state of California. It has been noted to be the sixth leading cause of death in the state. Alzheimer’s disease had the largest leap in number (58.3% from 2000-2004) compared to other causes of death. In the executive summary of the Alzheimer’s Association (2009), there were 588,208 Californians aged 55 and above who were suffering from the disease making it one-tenth of the nation’s Alzheimer’s population. Due to the high number of people afflicted with Alzheimer’s Disease, 11% of the nation’s caregivers are in California, making them about 1.1 million people. Most care is delivered at home by the family members of the patient. Since the disease is progressive, it becomes more and more difficult to care for the patient because he becomes more and more dependent on others to do tasks for him. It greatly affects the lives of these caregivers because they adjust their own personal schedules to accommodate the patient. This has consequences in their social, emotional and economic lives and they report “financial hardship, health difficulties, emotional stress, and sleep disturbance” (Ross et al., 2009, p.III). Health care costs consequently rise with the increase of the prevalence of Alzheimer’s Disease. The Medi-Cal program spends 2.5 times more on an individual with AD than for a person without. These costs usually account for nursing home expenditures which has been found to be three times greater with AD. Families usually commit their member with AD to long-term care, and this pattern has increased 44% from 2004 to 2008 alone. Because of this high prevalence in California, there is more loss in productivity from caregivers and patients of Alzheimer’s due to their inability to render full-time and high quality work in their employment. It is reported that $1.4 billion annually is lost in terms of productivity of employees affected by the disease (Alzheimer’s Association, 2009). What Causes Alzheimer’s Disease? Since it is the brain that is usually affected by Alzheimer’s Disease, research has focused on causes of neurodegenerative disorders. Toxic chemicals or xenobiotics from pesticides, herbicides and other chemicals in the production of food which produce neurotoxins affect the order of transmission of chemical signals between neurons in the nervous system (Singh, et al., 2011). These chemical substances have been suspected to contribute to the development of neurodegenerative diseases. Rauk (2009) explains that the massive loss of neurons of the individual affected by Alzheimer’s also impacts the signaling between cells, thus, transmission of information is disrupted. An amino acid peptide called amyloid beta (Aβ) has been identified as the causative agent in Alzheimer’s and these have been seen in plaques outside the cells in the brain. The presence of these peptides in the brain render the patient to be highly dysfunctional (Singh et al., 2011). Apart from these biological causes, lifestyle factors also contribute to the development of this disease such as “low education, smoking, physical inactivity, depression, mid-life hypertension, diabetes, and mid-life obesity” (Barnes & Yaffe, 2011, p.14). Psycho-social Challenges for People with Alzheimer’s Disease Individuals with Alzheimer’s Disease undergo challenges in their psychological and social functions due to the cognitive deficits they incur with the disease. The Diagnostic and Statistical Manual of Mental Disorders -IV-TR’s (DSM 4th Edition, TR) is the basis of determining if an individual has some type of mental disorder. Its criteria for Alzheimer’s Disease, enumerates the following: 1. The individual develops several “cognitive deficits as manifested by both memory impairment and one of or more of the following conditions: Aphasia; Apraxia; Agnosia; and disturbances in executive functioning” (Firman, 2009, para.5) 2. The cognitive deficits result from a decline in the individual’s previous functioning and consequently, cause social or occupational impairments. 3. There is no improvement in the course of the cognitive impairment . There is gradual onset and continuous decline. 4. The “cognitive deficits are not due to other central nervous system, systemic, or substance-induced conditions which may cause progressive impairments in memory and cognition” (Firman, 2009, para 5). 5. There is no other psychiatric disorder affecting the cognitive impairment. (Firman, 2009) Pocnet et al (2011) report that AD is one of the leading causes of cognitive decline in old age which is accompanied by personality changes. This means that there is an obvious shift in the demeanor of the individual, like from someone with a naturally jolly and affectionate personality, the individual suddenly turns to be cold and unemotional towards others. Memory lapses occur making it difficult for the individual to remember events even those that happened just a few minutes or hours ago. Difficulty in recognizing people especially their loved ones is usually heartbreaking especially for the one not remembered. Research on Alzheimer’s Disease Trends e-Magazine (2012) recently reported two different approaches for early detection of the physical manifestations of Alzheimer’s. One is from the University of Medicine and Dentistry of New Jersey and the Northwestern University in Ilinois. Their findings link diabetes to the onset of AD. They discovered that there was a substantial increase in amyloid beta peptides in the brain cortex and hippocampus when an individual has diabetes (Kasinathan et al., 2012). Apart from the assembly of amyloid beta “oligomers”, insulin has likewise been identified as having a role in the development of AD. Insulin plays an important part in the formation of memories. The researchers found that the oligomers impair memory formation by causing the elimination of insulin receptors from the surface membranes of the brain. Trends e-Magazine (2012) explains that a vicious cycle begins wherein the brain becomes insulin-resistant while the diabetes contributes to more oligomer accumulation. The neurons become more insulin-resistant, hence it is the memory formation that suffers. The researchers found that it is minimally invasive to test for amyloid beta pathology by checking the retinas of individuals suspected of having AD since this part of the eye is considered an “extension of the brain” (Trends e-Magazine, p. 29). Another breakthrough in the early detection of possible AD was found by researchers from the Instituto de Estructura de la Materia in Madrid. The technique analyzes fluid around the brain and spinal cord for levels of amyloid-beta peptide through infrared spectroscopy. This measures infrared radiation emitted or absorbed by white blood cells, and different stages of formation of the peptide in the blood cells result in different stages of AD. Community Based Programs for People with Alzheimer’s Disease The Alzheimer’s Association supports families with the disease with its advocacies. Statewide support comes in terms of implementation of evidence-based guidelines in the early detection of the disease, increase “access to accurate and complete diagnosis, comprehensive care management” and linkages to community-based services and supports (Ross et al., 2009, p. VI). Such community-based programs provide quality care and caregivers to support the families in the transitions between home to hospital and residential nursing home care settings and vice versa. Both publicly and privately funded services include: “assessment of caregivers in addition to the patient with the disease; increased availability of respite care; inclusion of the family caregiver in developing a family and patient care plan; increased availability of caregiver education on issues such as managing challenging behaviors, and; development of financial incentives, such as tax credits, that would support families in their efforts to keep their loved one at home” (Ross et al., 2009, p. VI). Alzheimer’s Disease Interventions In its early stages, it would be good to keep the patient’s mind well-stimulated with activities that deal with cognitive skills such as doing crossword puzzles, engaging in stories about his or her life, participating in games such as Bingo and other memory-enhancing activities. It would also greatly help if he or she is provided with enough social and emotional support by her loved ones by keeping her feeling loved and valued. Current developments on treatment and interventions for Alzheimer’s Disease have been positive and hopeful. One of this is the development of prescription drugs (Bullock, 2001). Oddo et al. (2010) report a treatment using a protein called CBP which restores the damage done by the accumulation of the amyloid protein. Another effect of this protein is the triggering of the production of other proteins necessary for memory creation. Still another treatment recently discovered at the Northwestern University Feinberg School of Medicine is the use of a therapy drug that was also found to treat Parkinson’s disease, Multiple Sclerosis and Traumatic Brain Injury which share the same symptom with AD, which is neuroinflammation. It is a drug that binds to and decreases cytokine molecules which attack the brain and causes synapses to misfire. When cytokine attacks, connections between neurons are lost, damaging the cortex and hippocampus directly affecting memory and decision making abilities of the individual (Watterson, 2012). For this drug to work with Alzheimer’s patients, it should be administered before the disease has reached its late stage. Dr. Pasinetti of the Mount Sinai School of Medicine in New York also recommends the use of immunoglobulin to keep synapses flexible. This doctor claims that immunoglobulin protects Alzheimer’s patients from memory loss and other symptoms of the disease (Trends e-Magazine, 2012). Aside from these newly-developed drugs, herbal remedies have also been discovered in slowing down the brains degeneration (Singh et al., 2011). These herbal medicines have been found to be as effective as prescription drugs and have fewer side effects. Some examples of these herbal medicines are Ginkgo Biloba, Galanthus Caucasicus, Huperzia Serrata, among others. Conclusion Dealing with Alzheimer’s disease is a difficult task for the patient as well as family and loved ones of the patient. There may never be a cure for Alzheimer’s disease because of the devastation it causes in one’s brain and eventually all the major organs in the body. By funding research of this devastating disease can help to find an answer to “treat” the disease. Providing counseling to Alzheimer’s patients, his or her family, and caregivers will help everyone involved to cope with the progression of Alzheimer’s disease. This paper has explored its causes, diagnosis and treatment interventions as well as its effects on the individual who has it and on the people around him or her, usually members of the family. It is one with the advocacy of the Alzheimer’s Association to support people with the disease and hope for the best in terms of its cure and management to ease the heavy burden that it causes a growing number of people. References Alzheimer’s Association (2012) Alzheimer’s Disease Facts and Figures, Alzheimer’s & Dementia, Volume 8, Issue 2 Alzheimers Association (2012) California Alzheimers Statistics, Retrieved on October 15, 2012 from http://www.alz.org/cacentralcoast/documents/statesheet2012_california.pdf Barnes, D.E. & Yaffe, K. (2011) The Projected Effect of Risk Factor Reduction on Alzheimers Disease Prevalence, The Lancet Neurology, September, 2011 issue Bullock, R. (2001) Drug treatment in dementia. Curr Opin Psychiatry Vol.14: 349-353. Firman, G. (2009) Diagnostic Criteria for Alzheimers Disease (AD), Medical Criteria.com, Retrieved on 14 October 2012 from http://www.medicalcriteria.com/site/index.php?option=com_content&view=article& id=52%3Aneuroalzheimer&catid=76%3Apsychiatry&Itemid=80&lang=en Kasinathan, C., Klein, W. & Frederikse, P. (2012) Amyloid-ß and Tau Pathology of Alzheimers Disease Induced by Diabetes in an Animal Model, Journal Of Alzheimers Disease, Vol, 31, No. 2, Oddo, S. et al. (2010) "CBP Gene Transfer Increases BDNF Levels and Ameliorates Learning and Memory Deficits in a Mouse Model of Alzheimers Disease," Proceedings Of The National Academy Of Sciences, December 28, 2010 Pocnet, C., Rossier, J., Antonietti, J.P. & von Gunten, A. 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