Alzheimer’s Disease

Alzheimer’s Disease
Alzheimer’s Disease is a progressive and irreversible brain disease that
destroys mental and physical functioning in human beings, and invariably leads
to death. It is the fourth leading cause of adult death in the United States.

Alzheimer’s creates emotional and financial catastrophe for many American
families every year, but fortunately, a large amount of progress is being made
to combat Alzheimer’s disease every year. To fully be able to comprehend and
combat Alzheimer’s disease, one must know what it does to the brain, the part
of the human body it most greatly affects. Many Alzheimer’s disease sufferers
had their brains examined. A large number of differences were present when
comparing the normal brain to the Alzheimer’s brain. There was a loss of nerve
cells from the Cerebral Cortex in the Alzheimer’s victim. Approximately ten
percent of the neurons in this region were lost. But a ten percent loss is
relatively minor, and cannot account for the severe impairment suffered by
Alzheimer’s victims. Neurofibrillary Tangles are also found in the brains of
Alzheimer’s victims. They are found within the cell bodies of nerve cells in
the cerebral cortex, and take on the structure of a paired helix. Other
diseases that have “paired helixes” include Parkinson’s disease, Down’s
Syndrome, and Dementia Pugilistica. Scientists are not sure how the paired
helixes are related in these very different diseases. Neuritic Plaques are
patches of clumped material lying outside the bodies of nerve cells in the brain.

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They are mainly found in the cerebral cortex, but have also been seen in other
areas of the brain. At the core of each of these plaques is a substance called
amyloid, an abnormal protein not usually found in the brain. This amyloid core
is surrounded by cast off fragments of dead or dying nerve cells. The cell
fragments include dying mitochondria, presynaptic terminals, and paired
helical filaments identical to those that are neurofibrillary tangles. Many
neuropathologists think that these plaques are basically clusters of
degenerating nerve cells. But they are still not sure of how and why these
fragments clustered together. Congophilic Angiopathy is the technical name that
neuropathologists have given to an abnormality found in the walls of blood
vessels in the brains of victims of Alzheimer’s disease. These abnormal patches
are similar to the neuritic plaques that develop in Alzheimer’s disease, in
that amyloid has been found within the blood-vessel walls wherever the patches
occur. Another name for these patches is cerebrovascular amyloid, meaning
amyloid found in the blood vessels of the brains. Acetylcholine is a substance
that carries signals from one nerve cell to another. It is known to be
important to learning and memory. In the mid 1970s, scientists found that the
brains of those afflicted with Alzheimer’s disease contained sixty to ninety
percent less of the enzyme choline acetyltransferase(CAT), which is responsible
for producing acetylcholine, than did the brains of healthy persons. This was
a great milestone, as it was the first functional change related to learning
and memory, and not to different structures. Somatostatin is another means by
which cells in the brain communicate with each other. The quantities of this
chemical messenger, like those of CAT, are also greatly decreased in the
cerebral cortex and the hippocampus of persons with Alzheimer’s disease, almost
to the same degree as CAT is lost. Although scientists have been able to
identify many of these, and other changes, they are not yet sure as to how,
or why they take place in Alzheimer’s disease. One could say, that they have
most of the pieces of the puzzle; all that is left to do is find the missing
piece and decipher the meaning. If treatment is required for someone with
Alzheimer’s disease, then the Alzheimer’s Disease and Related Disorders
Association(ADRDA), a privately funded, national, non-profit organization
dedicated to easing the burden of Alzheimer victims and their families and
finding a cure can be contacted. There are more than one hundred and sixty
chapters throughout the country, and over one thousand support groups that can
be contacted for help. ADRDA fights Alzheimer’s on five fronts 1- funding
research 2- educating and thus increase public awareness 3- establishing
chapters with support groups 4- encouraging federal and local legislation to
help victims and their families 5- providing a service to help victims and their
families find the proper care they need.


Science

Alzheimers Disease

Alzheimer’s Disease Dementia is the loss of intellectual and social abilities severe enough to interfere with daily functioning. For centuries, people called it senility and considered it an inevitable part of aging. It is now known that dementia is not a normal part of the aging process and that it is caused by an underlying condition. People with this condition need special assistance to carry on with their normal lives. This paper will explain some of the social services that are helping to combat this disease and an analysis of the services effectiveness. More than four million older Americans have Alzheimer’s, the most common form of dementia.

And that number is expected to triple in the next 20 years as more people live into their 80s and 90s. Still, there’s reason for hope. There are as yet no cures, but researchers studying Alzheimer’s have made progress, especially in the last 5 years. New drugs that can temporarily improve mental abilities in some people with mild Alzheimer’s are now available, and more drugs are being studied. Researchers also have discovered several genes associated with Alzheimer’s.

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Furthermore, scientists are defining subgroups of dementias and their distinguishing characteristics in the hopes of refining treatments. Although Alzheimer’s disease is the most common of the dementias, there are many types, even hundreds, of dementias some reversible, and others, like Alzheimer’s disease irreversible. What is Dementia? Dementia is the loss of intellectual and social abilities severe enough to interfere with daily functioning. For centuries, people called it senility and considered it an inevitable part of aging. It is now known that dementia is not a normal part of the aging process and that it is caused by some underlying condition.

Symptoms of dementia vary in severity, order of appearance and with the type of dementia. But all dementias involve some impairment of memory, thinking, reasoning and language. Personality changes and abnormal behavior may also occur as dementia progresses. Of the diseases that produce dementia, Alzheimer’s is the most common. The disease was named after Alois Alzheimer, a German physician.

In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. He found abnormal clumps (plaques) and tangled bundles of fibers (tangles). Other changes in the brains of people with Alzheimer’s disease include a loss of nerve cells in the areas of the brain vital to memory and other mental functions, and lowered levels of chemicals in the brain that carry complex messages back and forth between billions of nerve cells important to thinking and memory. The first sign of Alzheimer’s disease may be mild forgetfulness. The disease progresses to affect language, reasoning, understanding, reading or writing. Eventually, people with Alzheimer’s disease may become anxious or aggressive, and may even wander from home.

The problem of Alzheimers disease is considered a growing problem in the United States. As our population gets older our need for elderly services increases dramatically. This means that healthcare costs are on the rise and we need more care facilities for our aging elderly. As we all know in this election year prescription drug prices are a hot topic. Prescriptions for the elderly are getting so expensive that they cannot afford them anymore, therefore relying on some other source to help buy the prescriptions. The toll is not only financial, but proves to cause emotional turmoil for the families dealing with an aging relative. Some of the goals and values of society that are affected by this problem are: the rising costs of healthcare, prescription drug prices, and the toll on the individual and their family.

This presents a problem for those who cannot afford it and therefore rely on society for help. It is also hard for a family to put a loved one in an institution. Alzheimers disease is non-discriminatory. It can affect any race or nationality. It does not matter if you are rich or poor, male or female.

It can happen to anyone, there are some younger cases of the disease but it remains most common in the elderly population. Alzheimer’s disease affects brain tissue directly, causing progressive brain deterioration in middle or late life. So far, only age and heredity are proven risk factors. But like cancer and cardiovascular disease, Alzheimer’s probably results from a combination of factors. Researchers are studying: Age: Alzheimer’s usually affects people older than age 65, but can, rarely, affect those younger than age 40. The average age at diagnosis is about 80.

Only one to two people in 100 have Alzheimer’s at age 65, but that risk increases to about one in five by age 80. By age 90, half of all people this age have some symptoms. The incidence of Alzheimer’s is about the same for all races, but women are more likely than men to develop the disease, in part because they live longer. Heredity: Family history plays a role in about 40 percent of people with early onset Alzheimer’s. If your parents or a sibling developed Alzheimer’s, you’re more likely to as well.

But, even in families with several people who’ve had Alzheimer’s, most members don’t get it. It’s clear that most Alzheimer’s involves some disease process in addition to a genetic vulnerability. Environment: Researchers are studying environmental factors to discover both possible causes and preventions of Alzheimer’s. For example, some people with Alzheimer’s have small deposits of aluminum in their brains. But scientists who’ve studied environmental aluminum sources from antacids and antiperspirants to cooking pots and drinking water haven’t found a link between aluminum and Alzheimer’s. On the other hand, some studies hint at a possible protective effect from estrogen, nonsteroidal anti-inflammatory drugs (NSAIDs), vitamin E and other factors, some studies even show that a lower calorie diet help reduce the chances of getting the disease. But more research is needed to confirm any benefit.

The service that is identified in this paper is the long-term care facilities which care for alzheimers patients. The purpose of long-term care facilities is to help with the daily living of patients while assisting and caring for them …

Alzheimers Disease

Alzheimers Disease Alzheimers Disease We are currently living in the age of technology. Our advancements in the past few decades overshadow everything learned in the last 2000 years. With the elimination of many diseases through effective cures and treatments, humans can expect to live a much longer life then that of their grandparents. The population of the United States continues to rise, and with the baby boom era coming of age, the number of elderly people is rising as well. This increase has brought with it a large increase in diseases associated with old age. Alzheimer’s dementia is one of the most common and feared diseases afflicting the elderly community. Alzheimers disease, once thought to be a natural part of aging, is a severely debilitating form of mental dementia. Although some other types of dementia are curable or effectively treatable, there is currently no cure for the Alzheimer variety.

A general overview of Alzheimer’s disease including the clinical description, diagnosis, and progression of symptoms, helps one to further understand the treatment and care of patients, the scope of the problem, and current research. The clinical definition of dementia is a deterioration in intellectual performance that involves, but is not limited to, a loss in at least 2 of the following areas: language, judgment, memory, visual or depth perception, or judgment interfering with daily activities. (Institute, 1996, p.4). The initial cause of Alzheimers disease symptoms is a result of the progressive deterioration of brain cells (neurons) in the cerebral cortex of the brain. This area of the brain, which is the largest and uppermost portion, controls all our thought processes, movement, speech, and senses.

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This deterioration initially starts in the area of the cortex that is associated with memory and then progresses into other areas of the cortex, then into other areas of the brain that control bodily functions. The death of these cells causes an interruption of the electrochemical signals between neurons that are a key to cognitive as well as bodily functioning. Currently Alzheimers disease can only be confirmed at autopsy. After death the examined brain of an Alzheimer victim shows two distinct characteristics. The first is the presence of neuritic plaques in the cerebral cortex and other areas of the brain including cerebral blood vessels. These plaques consist of groups of neurons surrounded by deposits of beta-amyloid protein.

The presence of these plaques is also common to other types of dementia. The second characteristic, neurofibliary tangles, is what separates Alzheimers disease from all other forms of dementia. Neurofibliary tangles take place within the disconnected brain cells themselves. When examined under a microscope, diseased cells appear to contain spaghetti-like tangles of normally straight nerve fibers. The presence of these tangles was first discovered in 1906 by the German neurologist Alois Alzheimer, hence the name Alzheimer’s disease. Although the characteristics listed above are crucial to the diagnosis of Alzheimers disease upon death, the clinical diagnosis involves a different process.

The diagnosis of Alzheimers disease is only made after all other illnesses, which may have the same symptoms, are ruled out. The initial symptoms of Alzheimers disease are typical of other treatable diseases. Therefore doctors are hesitant to give the diagnosis of Alzheimer’s in order to save the patient from the worsening of a treatable disease through a misdiagnosis. Some of the initial symptoms include an increased memory loss, changes in mood, personality, and behavior, (symptoms that are common in depression) prescription drug conflict, brain tumors, syphilis, alcoholism, other types of dementia, and many other conditions. The onset of these symptoms usually brings the patient to his family doctor.

The general practitioner runs a typical battery of urinalysis and blood tests that he sends off to the lab. If the tests come back negative, and no other cause of the symptoms is established, the patient is then referred to a specialist. The specialist, usually a psychiatrist, will then continue to rule out other possible illnesses through testing. If the next battery of tests also comes back negative, then the specialist will call on a neurologist to run a series of neurological examinations including a PET and CAT scan to rule out the possibility of brain tumors. A spinal tap is also performed to determine the possibility of other types of dementias.

The patient will also undergo a complete psychiatric evaluation. If the patient meets the preliminary criteria for Alzheimers disease, an examination of the patients medical history is also necessary to check for possible genetic predispositions to the disease. The psychiatric team finally meets with the neurological team to discuss their findings. If every other possible disease is ruled out, and the results of the psychiatric evaluation are typical to that of a person with the disease, the diagnosis of Alzheimer’s disease is given. The initial symptoms of Alzheimers disease are usually brushed off as a natural part of aging. The myth that a person’s memory worsens over time is just that – a myth (Myers, 1996, p.100-101).

Alzheimers disease victims are mostly over the age of 65 and many delay treatment by attributing their problems to age. A victim might forget a well known phone number or miss an important appointment. These symptoms eventually escalate to the total disintegration of personality and all patients end up in total nursing care. In descending order, the patient goes from (1) decreased ability to handle a complex job to (2) decreased ability to handle such complex activities of daily life as (3) managing finances, (4) complex meal preparation and (5) complex marketing skills. Next comes (6) loss of ability to pick out clothing properly, (7) or to put on clothing properly, followed by (8) loss of ability to handle the mechanics of bathing properly.

Then (9) progressive difficulties with continence and (10) toileting occur, followed by (11) very limited speech ability and (12) inability to speak more than a single word. Next comes (13) loss of ambulatory capability. Last to go are such basic functions as (14) sitting up, (15) smiling and (16) holding up one’s head (Brassard, 1993, p.10). The average time from diagnosis to inevitable death is 8 years. The family of the victim is usually able to care for the victim for an average period of about 4 years (Alzheimer’s, 1996, p.44).

During the progression of the disease between 10% and 15% of patients hallucinate and suffer delusions, 10% will become violent and 10% suffer from seizures (Alzheimer’s, 1996, p.46). Once a person is diagnosed as having Alzheimers disease, an assessment is made of the disease’s stage of progression and of the strengths and weaknesses of the victim and the victim’s family. There are different types of assessments available to evaluate the level of dysfunction of the patient. Based on one of these assessments a care plan is put together by a team consisting of a family member, a paid or unpaid care provider, and the victim’s physician. Throughout the progression of the disease, and depending on the needs of the patient, a wide range of expensive medication, such as psychoactive drugs to lift depression and sedatives to control violence may be required. Unfortunately, although a wide range of treatments have been tested, most prove to be ineffective. At the beginning of the disease the family is usually able to look after the patient without much effort.

Frequently families will hire a care giver in order to alleviate some of the work. Simple changes in the home can make life much easier for the sufferer, help them keep their self esteem, and prolong their stay at home. Examples of low-cost modifications to the environment include reducing the noise levels in the home (telephones, radios, voices, etc.); avoiding vividly patterned rugs and drapes; placing locks up high or down low on do …

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