In the paper “Health Service Provision for Older Patients” the author examines dementia as one of the haunting problems that occurs frequently in the elderly. There are several causes for dementia and the most frequently encountered cause is Alzheimer's disease…
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The current rise in elderly population due to improvements in health care systems (WHO, 2006) has caused an increase in the number of patients suffering from dementia and hence more research, education, understanding and training with regard to management of dementia patients in hospital setting is warranted. In this essay, the most common cause of dementia in the elderly, Alzheimer's disease, will be discussed through review of literature. The signs and symptoms of the disease, the pathophysiology and various aspects of nursing intervention will be elaborated. Alzheimer's disease Alzheimer's disease (AD) is a common degenerative disease of the brain that leads to dementia (Anderson, 2010). Infact, it is the most common cause of dementia and is incurable. The disease is an acquired condition in which there is impairment of cognition and behavior of the individual that is severe enough to disrupt normal occupational and social functioning of the individual. AD is a major public health problem associated with significant morbidity, impairment and economic consequences (Anderson, 2010). More often than not, the disease is mainly diagnosed after 65 years of age, although, an early-onset variety of AD does exists which presents much early. According to Brookmeyer et al (2007), 1 in 85 people in the world are likely to suffer from AD by 2050. The course of the disease is different for different individuals and thus is the prognosis. The most common early symptom, which is often ignored as an aging feature or stress consequence is the lack of ability to acquire new memories. Other symptoms include changes in cognition and behavior of the individual like irritability, confusion, aggression, mood swings, breakdown in language, withdrawal and long-term loss of memory. As the age advances, various functions of the body are gradually lost, terminating in death. AD imposes severe burden on the caregivers and can influence various aspects of the life of the caregiver detrimentally. Diagnosis of AD is mainly established through tests for cognition and assessment of behavior. Brain scan is often used as an adjunct to establish the diagnosis. The mean life expectancy of the individual following the diagnosis is about 7 years (Molsa et al, 1995). Pathophysiology The exact cause of AD is still not understood well and there is no treatment which can either cure the disease or prevent the progression of the disease. Even the prevention of the disease is unknown although some researchers are of the opinion that regular exercise, balanced diet and mental stimulation prevent AD (Anderson, 2010). There is some evidence to tell that AD is associated with tangles and plagues in the brain (Ding et al, 2007). Previously, it was hypothesized that decrease in the synthesis of acetylcholine causes the disease. Infact, several treatments for AD were based on that. However, since patients did not respond well to those treatments, the hypothesis could not be maintained. Subsequently, the amyloid hypothesis was developed, according to which, deposits of amyloid beta were the cause for development of the disease.
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