Analysis of Alzheimers Disease - Research Paper Example

? Alzheimer's Disease Alzheimer's disease is a degenerative disease appearing at an old age and encompassing many symptoms that affect the person emotionally, cognitively, socially and intellectually. There is no area in one's life that isn't affected tremendously by the disease. This disease can remain undetected for years, as the initial ones, mainly some forgetfulness, are typical for older ages and do not raise a red flag at first. The signs aren't clear and apparent to people at first, and are sometimes even missed by clinicians. In order to diagnose the disease, there are cognitive tests that examine whether or not the person may have it, but to confirm it, doctors need to perform some sort of imaging test on the brain to see if the signs of Alzheimer's, called plaques and tangles, are apparent. Then and only then can a disgnosis of the disease be given. The disease is at the moment incurable, and medications can also delay the symptoms. There are several things that can perhaps help with it, including mental stimulation and some recreational activities that involve the brain. Given the tremendous strain put on both sufferers and caretakers and the fact that in the last stages of the disease people become completely reliant on others, it is important to find a cure. The good news is that there are many clinical trials at the moment which hope to do so. Alzheimer's disease (AD) is a progressive disease which occurs in elderly people, and is the most common form of dementia, a major loss of global cognitive ability in an individual that is not a cause of anything else and is beyond what is expected from a normal aging of a person. The disease is incurable and eventually leads to death. Although developing somewhat differently in every individual, there are common symptoms that occur across the board for all Alzheimer's patients. The earliest noticeable symptom is loss of short-term memories, as the person starts forgetting recent events. This is followed by confusion, trouble with language, long term-memory, and also irritability, aggression and mood swings (Brookmeyer, Gray & Kawas, 1998). The latter are not difficult to understand- the person is confused and forgetful, unable to do things that have previously been routinely achieved. This inability and sense of helplessness lead to frustration that manifests in the aforementioned emotional and physical responses. The previously independent person now becomes extremely reliant on others and needing special care. Other than the relationship with the caregiver and perhaps the closest people to him, the patient gradually loses social contacts with others, due to the circumstances (Alliance, 2001). Taking care of an Alzheimer's patient is a great burden, and sufferers may be even more upset about burdening others, especially if they are friends or family. Their burden is widespread, consisting of physical, social, psychological and economic . If the caregiver is a stranger, it can also add to their annoyance of accepting a stranger to their lives and having him being with them in their most fragile and intimate situations (Alliance, 2001). Alzheimer's can go undetected for years, as it is at first invisible to doctors or family and friends, partly because of the fact that some early behaviors are common among old people in general (like forgetfulness). It is difficult to predict how it will affect each individual or the rate of progress of the disease. It is depended on the stage of the condition and how soon it is detected. On average, the life expectancy after receiving a diagnosis is about 7 years, with only a very small percentage surpassing 14 years (merely 3%) (Brookmeyer, Gray & Kawas, 1998). AD has four stages. The first one is Pre-Dementia (also called "mild cognitive impairment" stage ), in which it is very difficult to diagnose the condition, as symptoms are thought of as emanating from age or stress. These include difficulty in remembering information that's been learned recently and an inability to acquire new information, subtle problems in attentiveness, ability to plan well, flexibility of thinking, abstract thinking and semantic memory- the meanings of things and the idea of relationships. Emotionally, the main thing that stands out is apathy, which will remain for the entire duration of the disease (Backman, Jones, Berger, Laukka & Small, 2004). The second stage is called the Early Stage. The cognitive impairments become more apparent, and include problems in language, perception, executive functions and the execution of movement, and a worsening of the memory loss (to older memories). (Backman, Jones, Berger, Laukka & Small, 2004). Problems in the third stage, called the Moderate Stage, make it difficult to function independently. These include decreased ability to talk (due to a decreased vocabulary, ability to sound clear syllables, etc.), inability to perform daily tasks or regular movements, failure to recognize even relatives, increased risk of falling and more. Behaviorally and emotionally, sufferers may wander on the outside, become irritable, start crying, sudden and unexpected aggression or resistance to care-giving. Patients are confused, upset and lose insight of the fact that they have a disease. This is typically where most AD patients are moved to long-terms care, because treating them at home becomes too difficult and stressful, especially to family members (Molsa, Marttila & Rinne, 1986). In the fourth and final stage of the disease, the Advanced Stage, the person can no longer function without his caregivers. He is entirely dependent on them. Speech is diminished and finally gone entirely, aggression is replaced by apathy and exhaustion and the person is restricted to the bed, unable to perform the simplest task alone. Death is usually caused by an external factor like an infection or another condition that worsens (Molsa, Marttila & Rinne, 1986). Causes and progression of the disease aren't understood well. What is known is that it is associated with plaques and tangles in the brain. The former are deposits of a substance called beta amyloid that grow outside of cells within the gray matter of the brain. The latter, also known as NFT (Neurofibrillary Tangles), are clusters of a substance called Hyperphosphorylated tau protein (Tiraboschi, Hansen, Thal & Corey-Bloom, 2004). Current treatments can only lessen the symptoms of the disease, but not stop or improve the condition a patient faces (i.e, reverse the effects). Some suggested factors that have been raised as possibly helping against Alzheimer's are mental stimulation, exercise and a balanced diet. These are thought to perhaps delay the cognitive symptoms. However, they do not delay the brain pathology. These factors have not been conclusively proven to be helpful, but there is some evidence that they do indeed work (Brookmeyer, Gray & Kawas, 1998). In order to diagnose the disease, the patient's history and that of his relatives are obtained and clinical observations are made. These have to be verified by a scan of the brain to be sure. This can either be a computed tomography (CT), a magnetic resonance imaging (MRI), a single photon emission computed tomography (SPECT) or a positron emission tomography (PET). (Schroeter et al., 2004) Treatments are pharmacological, psychosocial and care-giving. Five medications are used to treat AD: Tacrine, Rivastigmine, Galantamine, Donepezil and Memantine. Psychosocial interventions include a wide array of therapies that are emotion-oriented (aim to deal with the emotional fallout of the disease); behavioral ones that try to discover the causes of the harmful behaviors and reduce them; cognitive ones like reminding the patient over and over about the time, date and other facts he needs to know; and ones related to stimulation, such as exercise, music, art and animal therapies (Brookmeyer, Gray & Kawas, 1998). Alzheimer's is undoubtedly a terrible fatal disease whose course is difficult on both sufferer and care-givers. It affects all aspects of the sufferer's life as well as the care-givers' lives. Coping with the disease is tremendously challenging for all those involved. However, it is important to note that there are a great many clinical trials regarding the disease, and that one day a cure may be found (Brookmeyer, Gray & Kawas, 1998). References Alliance, F. C. (2001). Fact sheet: Selected caregiver statistics. San Francisco, CA: Family Caregiver Alliance. Retrieved October, 19, 2011. Backman, L., Jones, S., Berger, A. K., Laukka, E. J., & Small, B. J. (2004). Multiple cognitive deficits during the transition to Alzheimer's disease. Journal of internal medicine, 256(3), 195-204. Brookmeyer, R., Gray, S., & Kawas, C. (1998). Projections of Alzheimer's disease in the United States and the public health impact of delaying disease onset. American journal of public health, 88(9), 1337-1342. Molsa, Pekka K., R. J. Marttila, and U. K. Rinne. "Survival and cause of death in Alzheimer's disease and multi?infarct dementia." Acta Neurologica Scandinavica 74.2 (1986): 103-107. Schroeter, M. L., Stein, T., Maslowski, N., & Neumann, J. (2009). Neural correlates of Alzheimer's disease and mild cognitive impairment: a systematic and quantitative meta-analysis involving 1351 patients. Neuroimage, 47(4), 1196-1206. Tiraboschi, P., Hansen, L. A., Thal, L. J., & Corey-Bloom, J. (2004). The importance of neuritic plaques and tangles to the development and evolution of AD. Neurology, 62(11), 1984-1989. Waldemar, G., Dubois, B., Emre, M., Georges, J., McKeith, I. G., Rossor, M., ... & Winblad, B. (2007). Recommendations for the diagnosis and management of Alzheimer's disease and other disorders associated with dementia: EFNS guideline. European Journal of Neurology, 14(1), e1-e26. A regular day for an Alzheimer's patient: It is becoming more and more difficult to do things. Everything has become a challenge. Remembering things, even simple things, seems to be more and more difficult with each passing day. It is incredibly frustrating to start to forget the most trivial things such as where you live, what you like, who your family and friends are or even who you are. It is a scary, frightening situation. Today, like every other day, begins with waking up, being helped out of the bed and into the bathroom, bathing and teeth brushing, taking pills and then sitting down for breakfast. Independent eating is still possible, so this is a bright spot. There is still a feeling of usefulness, the ability to do things independently. It is fun to go outside for a while. It can never be alone and it must be in a wheelchair as operating the muscles and proper movement are becoming more difficult, but it is still an enjoyable time. Other than that, most of the time is spent at home. After the morning tour, which tends to vary in length from day to day, it's back to the house to watch television for a few hours. It is sometimes accompanied with reading a book to train the memory as much as possible and to exercise and stimulate the brain. When fatigue takes in, it's time for a nap, generally lasting between one and two hours. After that, lunch is prepared and eaten. Following that, an afternoon nap is taken. In the evening some friends or family tend to stop by and keep company. Finally, in the evening, after brushing the teeth and taking the pills, it's off to bed. Read More