Dementia of Alzheimer’s Type and Diagnostic Criteria

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Background

Alzheimer disease is one of the major debilitating brain diseases whose effects are loss of memory and important mental functions among patients, a consideration which impacts on their social skills, ability to think and make judgment. Crooks et al. (2008) indicate that this form of dementia has varied ways of developing on different people. As such, it is imperative to develop a clear understanding of the dementia of Alzheimer in terms of its meaning, causative factors, treatment and management. These are some of the aspects explored in this paper.

Alzheimer’s disease

Moretti et al. (2008) in their article Different responses to rivastigmine in subcortical vascular dementia and multi-infarct dementia define Alzheimer disease as a progressive brain disorder that slowly and irreversibly destroy important mental functions leading to inability of patients to carry out their daily activities. It also leads to memory loss. It is a disease that derived its name from Doctor Alois Alzheimer (1960) who first noticed an unusual mental illness on a woman who showed massive progressive changes in her brain tissues (Jakobsson et al., 2008).Besides, the disease manifested its symptoms in varied unpredictable behaviors, language problems and memory. Research revealed that the examination of her brain following her death revealed many neurofibrillary tangles and amyloid plaques which then become the main features of the disease (Jakobsson et al., 2008).

Age of onset and causes

Studies indicate that Alzheimer disease (AD) begins when an individual is past the age of 60 years (Moretti et al., 2008). According to Moretti et al. (2008), this may begin earlier or can be from 60 years with a majority of case being at 65 years and above. It is worth mentioning that referring to the age of 60 years and above does not quite indicate that the disease is for the old aged people. Relevant research shows that there is a younger on-set of the disease that when an individual is at the age of 40 or even 50 years (Moretti et al., 2008). In fact, the latter authors cite that early-onset of Alzheimer among individuals of ages between 30 and 50 years accounts for about 5% of the total AD burden.

The cause of the disease still remains unclear. However, studies show that the disease starts earlier in life as the brain is believed to begin to impair a decade before the exact symptoms show. Crooks et al (2008) indicate that toxic changes in the brain start earlier on in what is referred to as the preclinical stage due to the tau tangles and the amyloid plagues being deposited in the brain. The effect of the deposits is that it causes inefficiency of the healthy neurons. Loss of communication occurs and eventual damage of the hippocampus responsible for the formation of memories.

Besides, another believed cause of Alzheimer is genetics. Johnson and Stahl-Moncada (2008) indicate that changes in parental inherited genes (the autosomal dominant) may cause familial AD among individuals of the ages between 30 and 60 years. Johnson and Stahl-Moncada further note that senile plaques 42 protein is formed when mutational changes occur in the genes. This also has been determined among individuals with a late onset of the disease in relation to the apolipoprotein E (APOE) gene which occurs in the form of APOE ε4 allele. These may cause the disease.

The reduction of the neurotransmitter acetylchloline has been thought to be another cause of Alzheimer disease (Jakobsson et al., 2008). The cholinergic hypothesis though under investigation is based on medical therapies. Besides, it also indicates that the aggregation of amyloid in large scale may be a major cause of neuro-inflammations. Johnson and Stahl-Moncada (2008) are quite categorical that quite a n umber of hypotheses can be drawn from the aforementioned piece of literature

Crooks et al (2008) indicate that environmental and lifestyle patterns contribute to the development of AD. There are several factors that have been elaborated in the latter piece of literature that have been elaborated in the latter piece of literature. Examples include hypertension and overweight. Crooks et al. also cite that lack of activities like mental stimulation, social engagement, physical exercise as well as a nutritious diet may lead to the disease.

Signs and symptoms of Alzheimer

There are numerous warning signs that research has attributed to the development of AD. One of the signs is memory problems (Jakobsson et al., 2008). This, as indicated earlier, reflects a state of cognitive loss. A mild cognitive impairment may lead another sign which is the inability to perform normal daily activities. Other signs to watch out for include impaired judgment, diminished reasoning, spatial and vision problems and a decline in the ability to find words. The aforementioned signs may appear earlier stages of AD development. In some cases, Laforest et al. (2008) indicate that certain warning signs may reveal the development and progress of the AD. Such include inability to read or write, an individual not being able to recognize member of family, wandering off and getting lost and the tendency of being aggressive and anxious.

Stages

The AD occurs in three main stages namely the mild, moderate and severe Alzheimer stages (Laforest et al., 2008).Usually; symptoms are often visible when the process enters the middle level stage. As the AD progresses, an individual may begin to show poor judgment, inability to handle money, pay bills, and perform daily tasks. It is in this stage individuals get diagnosed (Jakobsson et al., 2008).

The second stage is the moderate stage. This stage is usually associated with myriads of activities in the brain (Jakobsson et al., 2008). Individuals in this stage may be unable to handle situations, dress on their own, and even recognize family and friends.

The final stage of severe AD as the name suggests puts an individual to the near end of life as most functions of his/her brain shuts down (Jakobsson et al., 2008). In this stage, the brain of an individual is fully plagued by tangles and plaques. Such a person may not be able to communicate and is left under the care of family or caregivers. This has posed an additional healthcare burden to both the care givers and close members of the family.

Risk factors

Johnson and Stahl-Moncada (2008) indicate that the main risk factor of the AD is advancing age. After the age of 60 years, reports indicate that with in every 5 years that follow, the chances of developing AD doubles with women being at risk than men. Besides, another risk factor is lifestyle practice and health factors like smoking, diabetes and hypertensions. These are believed to be the cause of the late onset of AD. Other risk factors include genetic factors of theAPOE4 and APOEε4 allele inheritance (Johnson & Stahl-Moncada, 2008).

Diagnostic criteria assessments and interventions

As indicated earlier, AD has no particular cure. Therefore, its diagnosis has largely been pegged to DSM-IV that calls for subjection of a patient to one month assessment and depiction of at least two symptoms, checking family history and running clinical trials. While this is not very effective, Laforest et al. (2008) note that diagnosis of AD can only be done after the death of an individual to examine brain tissue. When done earlier, it may aid in determining the causes and possible treatments. Even so, while there is no cure to the irreversible brain damage of AD, an early determination may help in making arrangement regarding finances, living arrangement, hiring caregivers and legal matters.

Based on crisis theory, the need to address the major problem of AD requires setting up key measures. The theory holds that for crises to occur, an individual will have tried to address the situation he is undergoing through without success that culminates to emotional blockage (Jakobsson et al., 2008). Therefore, this method entails bringing the victim to comprehending the problem and facilitating the correct coping skills. Besides, the process further involves enhancing the ability to employ alternative mechanisms in addressing various problems that encounters them at different times. From the above discussion, it can also be deduced that appropriate measures ought to be put in place in order to effectively deal with the devastating effects of AD. Moreover, additional research study can be undertaken so as to establish other variants of AD that are yet to be discovered.

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