Category: Alzheimer’s Disease

Abstract

Alzheimer’s disease (AD) is an progressive brain neurological disorder which destroys brain cells causing people to lose their memory, mental functions and ability to continue daily activities. Diagnostic symptoms are experienced by patients usually at later stages after irreversible neural damage occurs. Detection of Alzheimer’s Disease is challenging because sometimes the signs that distinguish Alzheimer’s Disease MRI data, can be found in normal healthy brain MRI data of older people. Even though this disease is not completely curable,earlier detection can help for proper treatment and to prevent permanent damage to brain tissues. Age and genetics are the greatest risk factors for this disease.

This paper reviews the latest reports on Alzheimer’s Disease detection based on different types of Neural Network Architectures.

Introduction

Alzheimer’s disease is a condition that affects the brain, even though the symptoms are mild at first it becomes more severe over time.Common symptoms of Alzheimer’s disease include memory loss, language problems, and impulsive or unpredictable behavior.As the symptoms get worse, it becomes hard for people to remember recent events and to recognize people they know. Alzheimer’s disease can range from a state of mild impairment, through to moderate impairment, before eventually reaching severe cognitive decline.

People with Mild Alzheimer’s disease develop memory problems and cognitive difficulties that may take longer than usual to perform daily tasks, wandering and getting lost. In Moderate Alzheimer’s disease, the parts of the brain responsible for language, senses, reasoning, and consciousness are damaged. In Severe Alzheimer’s disease, plaques and tangles are present throughout the brain, causing the brain tissue to shrink substantially.

Hippocampus is the responsible part of the brain for episodic and spatial memory.The reduction in hippocampus causes cell loss and damage specifically to synapses and neuron ends. So neurons cannot communicate anymore via synapses.

As a result, brain regions related to remembering (short term memory), thinking, planning, and judgment are affected.In elderly individuals over the age of 75, identifying differences between Alzheimer’s Disease brain and a normal functioning brain is difficult as they share similar brain patterns and image intensities.

As per the reports, the below pie chart gives us a clear picture of the people who are mostly affected by Alzheimer’s Disease considering Age as a factor :

Types of Neural Networks

Deep learning methods are used for classification and prediction have been applied in various fields, including computer vision and natural language processing, both of which demonstrate breakthroughs in performance. Although hybrid approaches have yielded relatively good results, they do not take full advantage of deep learning, which automatically extracts features from large amounts of neuroimaging data.

Artificial Neural Network (ANN)

Artificial Neural Network(ANN), is a group of multiple perceptrons/ neurons in every layer. ANN is also known as a Feed-Forward Neural network because the inputs are being processed in the forward direction only.

ANN consists of 3 layers – Input, Hidden and Output layers. The input layer takes the inputs,hidden layer processes and analyses the inputs, and then further the output layer produces the result. Essentially, each layer tries to learn certain weights.

Recurrent Neural Networks (RNN)

Recurrent Neural Networks (RNN) is a special type of network, which unlike feedforward networks has recurrent connections.RNN has a recurrent connection in the hidden state. This looping constraint makes sure that sequential information is captured in the input data.

Therefore, A looping constraint on the hidden layer of ANN turns to RNN.

Convolutional Neural Network(CNN)

Convolutional neural network (CNN) is a deep feed-forward neural network (FNN) composed of multi-layer artificial neurons, with excellent performance in large-scale image processing, classification, segmentation and also for other auto correlated data.

The building blocks of CNNs are filters i.e,. kernels. Kernels are used to extract the relevant features from the input using the convolution operation. Let’s try to grasp the importance of filters using images as input data.

Though convolutional neural networks were introduced to solve problems related to image data, they perform impressively on sequential inputs as well.

Survey Study

In our survey, we noticed that ADNI and OASIS open-access datasets were used. Alzheimer’s Disease Neuroimaging Initiative (ADNI) is a multisite study that aims to improve clinical trials for the prevention and treatment of Alzheimer’s disease. This cooperative study combines expertise and funding from the private and public sector to study subjects with AD, as well as those who may develop AD and controls with no signs of cognitive impairment and has made a global impact.

The primary goal of ADNI is to

• Detect the earliest signs of AD and to track the disease using biomarkers.
• Validate, standardize, and optimize biomarkers for clinical AD trials.
• Make all data and samples available for sharing with clinical trial designers and scientists worldwide.

Open Access Series of Imaging Studies (OASIS) is aimed at making neuroimaging datasets freely available to the scientific community and is hosted by the central.xnat.org provide the community with open access to a significant database of neuroimaging and processed imaging data.OASIS-3 is a longitudinal neuroimaging, clinical, cognitive, and biomarker dataset for normal aging and Alzheimer’s Disease.

In paper [1], an ensemble of three DenseNet styled models – DenseNet-121, DenseNet-161, and DenseNet-169 is used. For each MRI data, they’ve created patches from three physical planes of imaging : Axial or horizontal plane, Coronal or frontal plane, and Sagittal or median plane. These patches are fed to the proposed network as input. They’ve applied transfer learning and the three models have been pre-trained with ImageNet dataset. The individual models are optimized with the Stochastic Gradient Descent (SGD) algorithm to achieve 83.18 overall accuracy.

In paper [2], Two independent datasets are used ADNI-1 as training, ADNI2 as testing, to yield accuracy. The back-propagation algorithm is used to calculate the error between the network output and the expected output in Gradient Computation. After the initial error value is calculated from the given random weight by the least squares method, the weights are updated until the differential value becomes 0.

To improve the performance, multimodal neuroimaging data such as MRI for brain structural atrophy, amyloid PET for brain amyloid-β accumulation, and FDG-PET for brain glucose metabolism have been used. Deep learning approaches have yielded accuracies of up to 86.0% for AD classification and 84.2% for MCI conversion prediction.

In paper [3], This architecture is built using Keras with TensorFlow backend. In Data preprocessing all the data are transformed into a standardized structure by performing co-registration with a standard template and skull stripping.

A 3D CNN model is created inspired by VGG-16 architecture. The model has been trained with categorical cross-entropy loss and the Adam optimizer. 3D models are used here to avoid information loss. The average accuracy of the model achieves 73.4% on ADNI dataset and 69.9%classification accuracy on the OASIS dataset.

In paper [4], First the “Data Type Analysis” is done, where the proper types of data and ROIs are determined. To verify the effect of segmentation, they segmented the AD and cognitively unimpaired subjects of T1-MR images with the MALP-EM algorithm and obtained the Segmented datasets.

Then, a set of VGG-like Multi-Modality AD classifiers is constructed, which considers both T1-MRI and FDG-PET data as inputs and provides predictions. Then they’ve trained and tested the networks with the pMCI and sMCI data.

This network is then programmed based on TensorFlow. Training procedures of the networks are conducted on a personal computer with a Nvidia GTX1080Ti GPU.

In paper [5], the first step is data preprocessing and augmentation, the second stage is feature extraction from input images, and the third step is the classification of dementia classes. They have developed a CNN – based approach inspired by VGG-16 for the classification of dementia stages.

In paper [6], they have used a very deep CNN structure adopted for binary classification method. The shift and scale invariant features are extracted from different layers of CNN architecture resulting in the highly accurate trained model. Furthermore, extensive and unique preprocessing strategies utilized in this work improved the quality of the data fed into LeNet and GoogleNet which ultimately positively impacted the classifier performance.

In paper [7], the random datasets were marked for binary classification and the percentage data 75% for data training and 25% for data testing purpose. The dataset was preprocessed before through training and testing. The architecture of neural networks is using Alexnet architecture with ve layer of convolution. Compared to other journal results, the study method mostly uses ADNI database and LeNet or GoogleNet architecture.

In paper [8], MRI scans are provided in the form of 3D Nifti volumes. At first, skull stripping and grey matter(GM) segmentation is carried out on an axial scans through spatial normalization bias correction and modulation using SPM-g* tool. GM volumes are then converted to JPEG slices using the Python Nibabel package. Slices from start and end which contain no information and discarded from the data set.

Conclusion

From the survey, we can draw a conclusion that there are various technologies and methodologies used for detection of Alzheimer’s disease at an earlier stage where each individual methodology has a variable precision and accuracy. The two primary datasets, namely ADNI and OASIS are being used where each dataset.Convolutional Neural Network (CNN) based Classification model is used to predict Alzheimer’s Disease affected-brain v/s a normal aging brain and was able to do so with higher accuracy.This could be used for clinical decision making processes to detect and classify different stages of Alzheimer’s Disease.

References

1. Islam, Jyoti, and Yanqing Zhang. ‘An ensemble of deep convolutional neural networks for Alzheimer’s disease detection and classification.’ arXiv preprint arXiv:1712.01675 (2017).
2. Jo, Taeho, Kwangsik Nho, and Andrew J. Saykin. ‘Deep learning in Alzheimer’s disease: diagnostic classification and prognostic prediction using neuroimaging data.’ Frontiers in aging neuroscience 11 (2019): 220.
3. Yagis, Ekin, et al. ‘3D Convolutional Neural Networks for Diagnosis of Alzheimer’s Disease via structural MRI.’ (2020).
4. Huang, Yechong, et al. ‘Diagnosis of Alzheimer’s disease via multi-modality 3D convolutional neural network.’ Frontiers in Neuroscience 13 (2019): 509.
5. Mehmood, Atif, et al. ‘A Deep Siamese Convolutional Neural Network for Multi-Class Classification of Alzheimer Disease.’ Brain Sciences 10.2 (2020): 84
6. Sarraf, Saman, and Ghassem Tofighi. ‘Classification of alzheimer’s disease structural MRI data by deep learning convolutional neural networks.’ arXiv preprint arXiv:1607.06583 (2016).
7. Al-azdi, Faransi, et al. ‘Design of A Convolutional Neural Network System to Increase Diagnostic Efficiency of Alzheimer’s Disease.’ IOP Conference Series: Materials Science and Engineering. Vol. 648. No. 1. IOP Publishing, 2019.
8. Farooq, Ammarah, et al. ‘A deep CNN based multi-class classification of Alzheimer’s disease using MRI.’ 2017 IEEE International Conference on Imaging systems and techniques (IST). IEEE, 2017.
9. Liu, Sheng, et al. ‘On the design of convolutional neural networks for automatic detection of Alzheimer’s disease.’ Machine Learning for Health Workshop. PMLR, 2020.
10. Islam, Jyoti, and Yanqing Zhang. ‘Brain MRI analysis for Alzheimer’s disease diagnosis using an ensemble system of deep convolutional neural networks.’ Brain informatics 5.2 (2018): 2.
11. Khvostikov, Alexander, et al. ‘3D Inception-based CNN with sMRI and MD-DTI data fusion for Alzheimer’s Disease diagnostics.’ arXiv preprint arXiv:1809.03972 (2018)
12. Oh, Kanghan, et al. ‘Classification and visualization of Alzheimer’s disease using volumetric convolutional neural network and transfer learning.’ Scientific Reports 9.1 (2019): 1-16.
13. Sarraf, Saman, Ghassem Tofighi, and Alzheimer’s Disease Neuroimaging Initiative. ‘DeepAD: Alzheimer’s disease classification via deep convolutional neural networks using MRI and fMRI.’ BioRxiv (2016): 070441.
14. Wang, Michael. ‘Interpretable 2D and 3D Convolutional Neural Networks for Alzheimer’s Disease in Brain Scans.’
15. Jain, Rachna, et al. ‘Convolutional neural network based Alzheimer’s disease classification from magnetic resonance brain images.’ Cognitive Systems Research 57 (2019): 147-159.

Alzheimer Disease is a continuous neurodegenerative disorder and most common cause of dementia, challenge many lives all over the world. Alois Alzheimer a psychiatrist had an interesting discussion about a, women, just over 50 years, called Auguste D, whom had symptoms of this disease. She had focal symptoms, hallucinations, delusions and psychosocial incompetence, which she died of. In the early stages, of mild cognitive impairment (‘pre – MCI”) people object to loss of memory before it, and move to a much higher level of Alzheimer Disease (AD). As time progress they will be more equipped on making changes on medicine. Alzheimer’s disease has a broad history, magnitude and stigmas attached to it.

Further research has shown that this disease is commonly found in people 65 years and older, touching 15 million lives all over the world. There is a number of symptoms such as mental decline, difficulty thinking and understanding, confusion in the evening hours, delusion, disorientation, forgetfulness, making things up, mental confusion, difficulty concentrating, inability to create new memories, inability to recognise common things, or to do simple maths. Behavioural changes such as aggression, agitation, difficulty with self – care, irritability, meaningless repetition of own words, personality changes, restlessness, lack of restraint, or wandering and getting lost. Mood changes such as, anger, apathy, general discontent, loneliness, or mood swings. Psychological; depression, hallucination, or paranoia, last but not least is their inability to combine muscle movements, they jumble speech, or they have loss of appetite. Alzheimer’s disease is typically the reason for dementia existence as it describes more or less the same symptoms and 75% people suffers from dementia.

According to studies in 2000, statistics of Dementia in the elderly, globally, were roughly calculated from 1950 – 2050. They used different sources to investigate the value and sensitivity on Dementia in the elderly. In 2000, calculations were made on 25 million people over the world with dementia and according to statistics (46%) lived in Asia, 30% lived in Europe, and 12% in North America. An estimation was made that approximately 6.1% of people aged 65 years and older are experiencing dementia and about fifty-two percent lived in low – income countries. Above all are 59% women and people globally about 0.5% and new cases in 2000 were calculated at about 4.6 million with dementia. It has been predicted that a large number of elderly demented people will be increasing in 2000 from 25million to 63 million in 2030. Forty – one million people in low – income countries to 114 million predicted in 2050 and eighty – four million in low – income countries and a definitive increase will follow in the near future and most of the demented elderly lives in low – income countries. According to research, new tests have been done over a few decades on new medication to determine how it will affect AD sufferers lives and the strategies that needs to be followed according their health benefits.

Its important to understand that aging in people has an increasing impact on Alzheimer’s disease and it’s becoming a universal fact. According to Hei, from the UN Aging Program and the Us Centres for Disease Control and Prevention, reported that as aging progresses in people we can regard this disease to escalate from (7% – 12%) in the near future. Increasing levels in age can take off from 59% to 71% all over the world and we will be confronted by extremely high rates of dementing disorders. In studies in the Us shown that Alzheimer’s disease in 70 year, olds commonly stopped at 9.7%, whereas the worldwide number in dementia were calculated at 3.9% in 60 plus year old people. There is a frequency in Africa of 1.6%, China 4.0%and Western Pacific countries, 4.6% in Latin America, 5.4% in Western Europe, and 6.4% in North America. About five million people happen to be confronted by dementia but in most cases of AD each year and in surveys across the world they come to one conclusion on the age group of people with Alzheimer disease

Further in this study it is believe that Alzheimer’s disease doubles every five years later in the age of 65 years and in older people. People 85 years and older seem to have symptoms of dementia and at a certain point there is lead to believe that one in ten people will be affected by this disease. In this instance is Alzheimer disease and vascular dementia mostly found in dementia and the same apply all over the world with numbers of 50% to 70% and 15% to 25% in cases of dementia. The Cache county studies found, however that there is no certainty of the condition on certain levels than the normal age group given, but it is believed that there is a decrease at a certain age. Which they not sure if their chances are less being exposed to the disease or if it’s caused by their genes or their surroundings. In studies of Europe has been found that Ad comes forth in both men and women on a much older age, where as in studies of North America there is no certainty in either sexes. Furthermore, are higher Alzheimer levels found in north – western countries than southern countries and last but not least, countries need to be educated according this disease to make plans to control this disease.

Countries like Australia, South Korea, France, UK, and USA have been putting plans together in learning more about Alzheimer’s disease and other dementias as they see it’s becoming a growing concern all over the world. These diseases need to be controlled like HIV/AIDS or diabetes and other diseases, making national plans in order to measure and observe its growth. It is led to believe that it is the most common problem in the twenty- first century of health and social circles and the fact that the disease is escalating enormously need countries to be prepared for this growing pandemic. The cost of the disease was roughly calculated at US$604 billion or 1% of worldwide household income and there are other countries still working on their national plan to control this disease. The French government recently communicated publicly on the research done and how they going to assist their country with the challenges of the disease. Therefore, Alzheimer’s Disease International, the Global Federation of national Alzheimer’s Associations implemented these structures for other countries to take note of the epidemic at hand and to continue with research and to put national plans in place to better handle the disease. To make comparisons between countries a plan of action and to include everyone involved in this situation.

Studies in the UK found that Alzheimer’s Disease rates are lower in North America and in Europe, where evidently no difference in the condition of dementia were found in England and Wales. However, persons at the age of 65 plus years rated 7.7 per 1000 person – years in Brazil and 3.2 per 1000 person – years in India.

People at the age of 60 years, duration of life are shorter and they are crippled, hospitalized and AD impacts their standard of living. However, has dementia an impact of 11. 2% years living with disability, comparing stroke with 9.5%, musculoskeletal disorders with 8.9%and 5.0% for cardiovascular disease. Studies in Sweden have shown that dementia and Alzheimer disease is the cause why people over seventy – five years over a time frame of three years are functional dependent and in the case of dementia is the reason why older people live in nursing homes and institutions. Malignant nature in Alzheimer’s similarly to malignant tumours can lead to death in older people and community-based studies have shown that AD was connected to the multiple death risk. People who newly discovered they have the disease of AD have a 3 to 6 year living period and the same apply to older age people with different chronic diseases living with AD have a shorter life span. Older people with chronic diseases as hypertension, diabetes, heart disease, physical disability, poor cognitive function and older age male sex, white race with low education and other related conditions is risk factors, which add to a shorter life in Alzheimer’s disease together with dementia.

Living with Alzheimer’s disease or having family with this disease can have a negative impact on one’s life as society are not educated in this regard. In regards to a diagnosis of AD given they are categorized and it can lead to disengagement with everyone including family members. People are likely to be standardized and disregarded by society or friends and family, which can lead to psychological damage, being stigmatized. The World Health Organization claimed that stigmatization in older age people of 65 years have more negative effects as the dilemma with dementia where it becomes a growing pain. Feelings of abandonment, social isolation, depression are all symptoms attached to stigmatization of society. According to Report of World Alzheimer’s 2012, they were adamant at overcoming the stigmas of dementia. There seem to be an enormous amount of stigmatization around the caregivers. It has been reported that 24% of caregivers experience bad stigma. The public needs to be educated around AD and Dementia. People with dementia are nothing other than human beings, so, give them a voice. Recognition should be given to people with dementia and their caregivers. People with dementia need to be involved in their community. Informal and paid caregivers need more education in this regard. Upgrade standards of care at home and facilities. Upgrade and give better understanding of dementia training to primary health care physicians. Cry out to government to create national plans and expand research into how to address stigma and to stop it from escalating.

According to research done by UK Prime Minister’s Dementia Disease, together with USA and Dutch commenced with a new plan stating that it could save multiple lives. However, a French plan was also set up to monitor the outcome of adults having AD and dementia. Training to healthcare staff was given, educating them on how to assist these patients. Technology also play a big role in assisting them through different devices. Further more did the Dutch plan point out that coordinators and managers should be put in place in order to liaise with families. The French plan on the other hand encouraged stakeholders to work more closely together to stay up to date on integration of pathways. More attention was given to families at home and communities to help them or relieving them on their duties. Plans were given about activities to stay active on a daily basis. In France and UK action plans to early diagnosis and to decrease the use of drugs on these patients. Centres for Disease Control and Prevention (CDC) and Alzheimer’s Association initiated – The Health Brain Initiative: The Public Health Road Map for State and National Partnerships, 2013 -2018. Action plans similarly to others, were put in place on assisting Alzheimer’s and Dementia patients. In 2012 a survey was done by Alzheimer’s Disease International where 2 500 people from 54 countries response on stigma was “yes” on a scale of 75% and 42% gave negative examples on how they were treated with people living with dementia. They (28%) of people felt they were degraded and not recognized and at the same time people do not know how and when to communicate with them. Which brings us to 24%of people with that feeling, Cited by Nicole L. Batsch, Mary S Mittelman. Alzheimer’s disease history, magnitude and stigmas attached affects each country differently and with the knowledge given action should be taken in order for those statistics to change.

Introduction

Brain is one of the most important body organs. Its failure or malfunctioning usually results into fatal cases that are complicated and costly to treat. Like any other disease of the human body, brain diseases manifest into different ways, displaying varying signs and symptoms together with diverse risk levels. Medical practitioners describe the loss of brain function as dementia, a condition caused by certain diseases, which affect the brain. In discovering diseases, which lead to this condition, Alzheimer’s disease is among them.

Abbreviated as AD, the disease starts mildly before worsening with time. Its greatest effects are that it affects the overall memory ability of a patient, thinking and ultimately behavior. Alzheimer’s disease results into a wide range of diagnosis features, including memory impairment, poor judgment ability, personality problems, improper decision-making and language problems (Turkington & Mitchell, 2009).

According to documented research, Alzheimer’s disease is the primary cause of dementia affecting close to half a million people in the United Kingdom and five million in the United States. Importantly, dementia is a general term which refers to a collection of symptoms, which may include poor reasoning, problematic communicating ability, mood changes and impaired memory among others.

These symptoms mainly occur following brain damage that could be caused by Alzheimer’s disease or other related infections. The disease is believed to have been first described by Alois Alzheimer, a German neurologist as a physical disease which predominantly affects the brain (Cohen, 1999).

As a practicing doctor, Alois Alzheimer noticed unusual symptoms manifested by one of his dead patients in 1906. Alzheimer’s disease is well known to affect the normal structure of brain, which may result into the death of some important cells. It is important to double emphasize that the disease is progressive and may lead to continuous damage and death of more brain cells. As a result, patients with Alzheimer’s disease worsen with time.

Like in other known cases, scientists have devoted their time discovering the treatment of the disease with results indicating that there is no exact cure for the disease yet (Brill, 2005). This research paper, therefore, gives an analysis of the treatment of the disease. Several segments covering the chemistry of the disease have been incorporated in brief with a thorough and elaborate synthesis of treatment procedures that have been found working and recommended in dealing with the disease.

Symptoms

Major signs and symptoms of the disease revolve around the memory of patients as their brain gets damaged with time. Although memory problems could also be attributed to other infections, which affect the brain, medical practitioners concur that most cases are Alzheimer-related.

A common condition which affects memory is amnestic mild cognitive impairment. People with MCI are likely to experience more memory complications as compared to their age mates who are normal (Callone, 2010). The main difference with those with Alzheimer’s disease is that MCI patients experience mild symptoms as compared to severe symptoms observed among Alzheimer’s disease patients.

Although not guaranteed, some researchers believe that old people with MCI are likely to develop Alzheimer’s disease. Apart from memory impairment, Alzheimer’s disease patients demonstrate low aspects of cognition, which is characterized by impaired reasoning and judgment, poor vision and word. As mentioned above, Alzheimer’s disease is progressive and shows varying symptoms depending on the development stage of the disease (Soukup, 1996).

During mild stage of Alzheimer’s disease, patients experience simple but dangerous problems like getting lost in a familiar neighborhood, inability to complete simple tasks even with plenty of time and inappropriate handling of money that may result into defaulting to pay bills. Some patients start repeating questions when asked and develop personality changes. Under normal circumstances, Alzheimer’s disease is diagnosed during this stage of development (National Institute on Aging, 2003).

In cases where Alzheimer’s disease is not controlled during its first stage, it generally advances to the moderate stage of development, which involves damage of some brain parts that are responsible for language moderation, conscious thoughts and reasoning among others.

At this stage, most patients experience severe loss of memory leading to a high level of confusion that makes them impossible to recognize their environment, family members and close friends (NHS, 2010). Ultimately, patients become unable to perform simple tasks which may involve a series of steps like dressing up, become unable to cope with new situations and learn anything new.

The last stage of Alzheimer’s disease development is considered dangerous since tangles, and plaques may have widely spread to most parts of the brain leading to severe shrinking of several brain tissues. At this stage, patients are described as dependents due to their inability to communicate and take care of themselves (Nordqvist, 2011).

During final levels of this stage, patients spent most of their time in bed helplessly as their body systems shut down slowly. Notably, these three stages are irreversible although intervention during the first stage can be helpful in reducing the severity of the symptoms manifested.

Causes of Alzheimer’s disease

According to Mayo Clinic Staff, Alzheimer’s disease has no single cause identified by medical experts throughout the world. It is believed to be caused by intertwined factors, which include environmental, lifestyle and genetic make-up, which progressively affect the normal body functioning (Mayo Clinic Staff, 2011).

Research further indicates that less than five percent of cases, which occur are gene-related. Importantly, some people show the symptoms of infection after the disease has developed to advanced levels that the severity of the symptoms cannot be regulated.

Although there are varying findings, Alzheimer’s disease people who are above the age of sixty years are always at a higher risk of developing the Alzheimer’s disease. In the United States, more than five million people live with Alzheimer’s disease today. The following segments describe some of the factors known to cause Alzheimer’s disease.

Age

Among all the factors, age is the greatest predisposing factor of Alzheimer’s disease. According to scientific research done by Alzheimer Society, Dementia is common in people who are above the age of sixty-five years with statistical analysis showing that one out of fourteen people who have attained this age is at risk of developing the disease(Alzheimer’s Society, 2011).

Genetic Inheritance

Although research is still underway, there have been cases where certain families show consistency and high risk of infection than others. Nevertheless, genetic factors rarely affect older people in spite of them having a higher risk of being infected by Alzheimer’s disease.

Those people who have close family members with the disease have a slightly higher chance of developing as compared to families, which lack traces of the disease (Alzheimer’s Society, 2011). With regard to environmental factors, no substantive research has been documented even though some experts have associated Alzheimer’s disease with high exposure to aluminum metal. Nevertheless, these claims have been discounted on several occasions, leaving room for further investigations.

Additionally, the majority of people who suffer from Down’s syndrome are highly susceptible due to the existing variations in their chromosomal make-up. The risk is considered higher among people who are above the age of fifty years.

Similarly, exposure to head injuries resulting from accidents and high pressure exerted during boxing and other related activities, which may cause injury of brain tissue leading to subsequent development of the disease. Lastly, cigarette smokers and people have developed high blood pressure are at a higher risk of developing the disease. Maintaining a holistic healthy life is highly recommended in lowering the risk of Alzheimer’s disease infection (Alzheimer’s Disease Research, 2011).

Tests and Diagnosis of Alzheimer’s disease

An important remark is that there are no specific tests, which have been recommended to be confirmatory. As a result, tests are usually determined by the doctor’s judgment based on the physical observations and other simple test, which may be carried out to give some form of clarity. Most doctors are able to identify patients with dementia and even go-ahead to evaluate whether the situation may have been caused by Alzheimer’s disease.

However, accurate diagnosis can only be established after the death of a patient through microscopic examination of brain tissues (National Institute of Aging, 2010). Such analysis usually reveals the characteristics of plaques and tangles that may have developed after the disease developed to advanced and severe stages. Moreover, there are several tests, which have been designed in order to establish a basis to differentiate other causes of memory loss from Alzheimer’s disease.

Physical examination

This involves the general analysis of the neurological health of a patient which among other things focuses on coordination, reflexes, balance, muscle tone, functionality of sense of touch and sight and locomotive ability. Laboratory tests are very important in eliminating other potential causes of observed memory impairment among patients like insufficient vitamins and thyroid disorders (Hill, 2011).

Additionally, mental tests are imperative in identifying the stability of a patient’s memory. This takes close to ten minutes before the neurologists can ascertain the exact condition of the memory of his or her patient. This test involves simple tasks like drawings, copying some design, writing and memory of some words uttered by the examining specialist.

Neuropsychological testing

Based on results obtained during initial stages of testing, doctors may recommend a broader assessment exercise that would lead to finer diagnostic results. These tests usually take longer hours and is considered helping in determining whether the disease is at its initial stages or that the patient could be suffering from another type of dementia. They also help in the identification of specific changes which occur as a result of different manifestations of dementia (Nazario, 2011).

Imaging

Brain imaging is rarely used in understanding the nature of brain abnormalities which could not necessarily be related to Alzheimer’s disease. These include tumors and strokes which have the ability to cause quantifiable cognitive variation in patients. Common imaging techniques used include Computerized tomography (CT), Magnetic resonance imaging (MRI) and Positron emission tomography (PET) (Nazario, 2011).

Although these techniques are used in testing Alzheimer’s disease, it is important to understand that they make use of radiations which have been found to have adverse effects on human beings. As a caution, doctors are not allowed to expose human brain to extreme radiations to avoid long-term damage of cells and emergence of other health complications.

Treatment

As mentioned above, Alzheimer’s disease is the most common type of dementia affecting millions of people around the world. With close fifteen million people suffering from the disease worldwide, there has been research efforts geared towards identifying methods of preventing the disease or reversing of progressive symptoms. However, these efforts have not bore substantive results (Alzheimer’s Association, 2010).

While this has been the case, there are drugs recommended for Alzheimer patients for lowering the severity of observed symptoms and prevention of other opportunistic infections, which may affect Alzheimer patients. The most important thing about management of Alzheimer’s disease is early diagnosis before it develops to unmanageable levels.

If management programs are initiated early enough, many neurologists argue that such patients may be able to manage their lives without necessarily depending on caregivers at home. Additionally, may live longer due to reduced effects of manifested symptoms. Of extreme significance is the need for doctors to observe specific symptoms and administer relevant drugs. Common symptoms to be observed and taken care of include but not limited to behavioral problems, aggression, depression and sleeplessness (Kantor, 2010).

Drugs

Even though no drugs have been discovered for treatment and prevention of Alzheimer’s disease, there are those that are administered to lower the severity of symptoms among patients. In many cases, the effect and overall benefit of these drugs may be quite small to go unnoticed by patients and family members. Before patients and caregivers decide to use recommended drugs, it is important for proper consultation to be done to know when to use the drugs (Delrieu et al., 2011).

In this respect, one is supposed to be aware of the side effects and some of the risks associated with it, having in mind that the expected change in functioning or behavior might be negligible. Patients also need to know the best time to use the drugs, and if there could be situations that would require the patient to discontinue drug administration. So far, there are two types of drugs, which have been approved for the management of Alzheimer’s disease. These are:

Cholinesterase inhibitors

Cholinesterase inhibitors

This class of drugs consists of four drugs, which are Razadyne, Cognex, Aricept and Exelon. Cholinesterase inhibitors are known for their ability to prevent the breakdown of acetylcholine, a chemical found in the human brain that is responsible for memory and learning. The drugs have also been found to slow down the usual progression of Alzheimer’s disease symptoms for a limited duration of time ranging up to twelve months (Delrieu et al., 2011).

In understanding these drugs, it is essential to know that Aricept is the only drug which has the approval of Food and Drug Administration for treating Alzheimer’s disease during its three stages of development discussed in the segments above. It is administered orally since it exists as tablets, which can be directly swallowed or dissolved in the mouth.

Additionally, Cognex is reported to have been the first Alzheimer’s drug to be recognized and recommended for use by FDA. However, it is the least used drug in managing Alzheimer’s disease as compared to the other members of this category of drugs (Delrieu et al., 2011).

Similarly, Exelon has been recommended for use mildly in moderating Alzheimer’s disease symptoms before they become severe and irreversible. Exelon exists is several forms; as liquid, skin patch and in capsule form. Lastly, Razadyne, formerly known as Reminyl is recognized and approved for its ability and effectiveness in Alzheimer’s disease management (Cummings, 2001).

It exists in three formulations, namely, liquid, immediate-release tablet and extended-release capsule. Like many other drugs used in treatment of diseases, Cholinesterase inhibitors have side effects, which have to be understood when a patient is using them.

These include vomiting, insomnia, weight loss, diarrhea, loss of appetite, fatigue and nausea. Likewise, the use of Cognex may result into liver damage. It is considered to be the most dangerous side effects described by doctors. In order to prevent liver damaging, it is highly advisable for the doctor in charge to carry out liver tests to determine its functioning and likelihood of being affected as a result of Cognex (Cummings, 2001).

Namenda

This drug has been approved to treat Alzheimer’s disease from moderate stage of development to the severe level. Unlike other drugs which have been approved for the treatment of the disease, Namenda has a unique mechanism in treating Alzheimer’s disease.

Its protective ability allows it to moderate the release and activity of certain brain chemicals referred to as glutamate (Growdon, 1992). This is quite important since glutamate regulates the learning and memory ability of human beings. It has been observed that Alzheimer’s disease patients usually release excess glutamate in their brain which consequently affects their cognitive ability.

In administering this drug, the brain would become capable of releasing normal amount of glutamate thus maintaining the ability of affected individuals to maintain their sense of memory and learning. Importantly, Namenda is the only drug which has proved to work this way and increases its efficiency when used with other drugs like Cognex, Aricept, Razadyne or Exelon. Common side effects associated with Namenda include headache, confusion, tiredness, constipation and dizziness (Kantor, 2010).

Supplements

There are several cases, which are been documented about people using vitamin E, B12 and B9, although no research has supported their efficiency in Alzheimer’s disease treatment. In other places, people believe that ginkgo biloba herb prevents the disease whereas scientific research has shown no correlation between the herb and Alzheimer’s disease. It, therefore, follows that drugs used as supplements in Alzheimer’s disease treatment should be recommended by a specialist since FDA does not approve over counter drugs.

Supportive environment

Patients with Alzheimer’s disease require supportive programs as part of the treatment plan. It is recommended that they be exposed to a safe environment that minimizes accidents due to their inability to support themselves and identify their surrounding correctly.

Simple things like proper arrangement of furniture are important in promoting their safety (Nazario, 2011). Others include fixing handrails for support during movement, proper shoes selection and reducing the number of mirrors in the house since mirror images may frighten patients.

Exercise and nutrition

Regular exercising is highly recommended for everybody, including Alzheimer’s disease patients. This helps to maintain healthy joints, muscles and improve their mood. It also prevents constipation and augments sound sleep. These patients need to be well identified while exercising for easy identification by the public and offer them assistance once needed.

Immobile patients can adopt stationary bikes and other approved machines (Mayo Clinic Staff, 2011). Regarding meals, Alzheimer’s patients need a balanced diet to maintain their deteriorating health. Reminding them to eat and giving them a hand in preparation and serving is healthy and encouraging.

Conclusion

From the above analysis of Alzheimer’s disease, clearly its prevention and treatment remain a major challenge for neurologists around the world. While efforts to discover drugs for preventive purposes are on, it is imperative for the public to understand the manifestation of the disease in order for them to seek medical attention or help affected individuals to access specialized treatment before the disease advances.

The use of FDA-approved drugs should be prescribed by a doctor to curb against negative side effects or wrong drug choice. Other healthy practices like excising and proper nutrition are equally essential in preventing the progression of symptoms (Mayo Clinic Staff, 2011).

References

Alzheimer’s Association. (2010). Alzheimer’s Disease. Alzheimer’s Association. Web.

Alzheimer’s Disease Research. (2011). Common Alzheimer’s Treatments. Alzheimer’s Disease Research. Web.

Alzheimer’s Society. (2011). What is Alzheimer’s disease?Alzheimer’s Society. Web.

Brill, M. (2005). Alzheimer’s disease. Singapore: Marshall Cavendish.

Callone, P. (2010). Alzheimer’s Disease: The Dignity Within: A Handbook for Caregivers, Family, and Friends. NYC: ReadHowYouWant.com.

Cohen, E. (1999). Alzheimer’s Disease. New York City, U.S.: McGraw-Hill Professional.

Cummings, J. (2001). Treatment of Alzheimer’s disease. Clinical Cornerstone, 3(4), 27-39.

Delrieu et al. (2011). Managing Cognitive Dysfunction through the Continuum of Alzheimer’s Disease. Article Review, (25)3, 213-220.

Growdon, J. (1992). Treatment for Alzheimer’s Disease? New England Journal of Medicine, 327, 1306-1308.

Harvard Health Publications. (2009). A Guide to Alzheimer’s Disease. New York City: Harvard Health Publications.

Hill, L. (2011). Drug treatments in Alzheimer’s. Royal College of Psychiatrists. Web.

Kantor, D. (2010). Alzheimer’s Disease. New York Times. Web.

Mayo Clinic Staff. (2011). Alzheimer’s disease. Mayo Clinic Staff. Web.

National Institute of Aging. (2010). Alzheimer’s Information. National Institute of Aging. Web.

National Institute on Aging. (2003). Alzheimer’s Disease: Unraveling the Mystery. NYC: Government Printing Office.

Nazario, B. (2011). A Treatment Overview of Alzheimer’s Disease. WebMD. Web.

NHS. (2010). Alzheimer’s Disease. NHS. Web.

Nordqvist, C. (2011). What Is Alzheimer’s Disease? What Causes Alzheimer’s Disease? Medical News Today. Web.

Soukup, J. (1996). Alzheimer’s disease: a guide to diagnosis, treatment, and management. Westport, Connecticut: Greenwood Publishing Group.

Turkington, C. & Mitchell, D. (2009). The Encyclopedia of Alzheimer’s Disease. New York City: InfoBase Publishing.

Abstract

Alzheimer’s disease is a psychological disorder that does not only affect the functioning of the brain, but also the nervous system leading to poor coordination of the body. The disease is incurable and progresses slowly through consecutive four stages of pre-dementia, early stage, middle stage, and late stage that ultimately leads to death.

A patient depicts major symptoms such as loss of cognitive ability, memory loss, and physical impairment due to inability to coordinate body functions. Advancing age and genes are dominant factors that can predispose individual to the disease.

Introduction

Alzheimer is a psychological disorder that affects normal functioning of the brain. It is a form of dementia that interferes with cognitive abilities and behavior of an individual. Dementia is a psychological disorder that is associated with other mental disorders but Alzheimer’s disease is an incurable and degenerative mental disorder that occurs mostly due to aging.

According to statistics, “about 4 million Americans, 90 percent of whom are age 65 and older, have Alzheimer’s disease and the prevalence of Alzheimer’s disease doubles every five years beyond age 65” (Hoffman, 2000, p.1). The statistics imply age is the major predisposing factor that leads to the Alzheimer’s disease although at some instances, there is an early onset attributed to genetic factors, but it is quite rare.

Alzheimer’s disease weakens the cognitive ability of the patient by destroying cells of the brain, unlike destruction that occurs in normal aging. Since the Alzheimer’s disease affects the brain, psychological characteristics of the disease include loss of memory, language interference, poor judgment, and change of personality. To understand psychological aspect of the Alzheimer’s disease, this essay explores literature review, development, symptoms, and causes of the disease in population.

Alzheimer’s disease

As aforementioned, Alzheimer’s disease is a form of dementia that occurs due to aging; a psychological disorder that affects brain cells leading to diminished cognitive abilities and changed behavior. Over the history, the disease mostly affected the old people with the ages above 65 years.

Hoffman argues that, “Alzheimer’s disease is an irreversible, progressive brain disorder related with the changes in nerve cells that result in the death of brain cells. It occurs gradually and is not a normal part of the gaining process” (2000, p. 2). Earlier before its discovery in 1906 by Alois Alzheimer, psychiatrists considered it as an aging disease because it only affected old people. Based on the time of onset, there are two types of Alzheimer’s disease, the early onset and the late onset.

Early onset of the disease affects individual who are below 60 years and appears to be more degenerative although very rare. The late onset of the disease affects individuals above 60 years and is the most common disease. The discovery of the early onset type of the disease confirmed that Alzheimer’s disease is not an aging disease.

Research studies have revealed that prevalence of the Alzheimer’s disease is increasing exponentially due to change in lifestyles and the incurable nature of the disease. Statistics show that approximately 4 million of the Americans who are above 65 years old are suffering from the disease, which forms about 90% of the old people.

In addition, since there are more old women than men, the statistics show that about two third of the old people who are suffering from the disease are women. Based on these findings, scientists have predicted that, the incidences of Alzheimer’s disease are going to increase exponential until a cure is available.

Kantor explains that, in recent past “scientists have made great progress in unraveling the mysteries of Alzheimer’s disease; however, much is still unknown. Unless prevention or a cure is found, the number of Americans with Alzheimer’s disease could reach 14.3 million 50 years from now” (2011, p.30).

Given the 14 million patients and the nature of healthcare that the patients need, it means that government is going to spend great deal of resources in building and expanding nursing homes in order to cater for the increasing needs of the patients.

Since the Alzheimer’s disease is incurable and degenerative, the patients need special care for they do not have sufficient cognitive abilities to perform normal duties. The patients need complete attention of the caregivers in terms of feeding, bathing, dressing and washing among other basic assistance.

“Compared to non-dementia caregivers, larger proportions of Alzheimer’s patient caregivers experience employment complications, have less time for their own leisure activities and other family members, and suffer from physical, mental, and emotional stress due to care giving” (Hoffman, 2000, p. 3). The disease does not only affect patients, but also care givers thus necessitating intensive research concerning prevention and cure of the disease.

Development of Alzheimer’s Disease

The development of the Alzheimer’s disease is a continuous process but there are three stages for the sake of understanding and classifying the extent of the disease. The four stages are pre-dementia stage, early stage, middle stage, and late stage, which consecutively follow the progression of the disease from its onset.

In pre dementia stage, one can easily confuse the Alzheimer’s disease with stress and aging process because signs and symptoms are not yet definitive for a psychiatrist to diagnose. Williamson argues that, during pre-dementia stage “nerve cell damage typically begins with cells involved in learning and memory and gradually spreads to cells that control other aspects of thinking, judgment and behavior, and eventually affects cells that control and coordinate movement” (2007, p.2).

At this stage, there are latent symptoms such as problem in language, slight change in behavior, and subtle change in movement. It is very hard for a psychiatrist to diagnose the disease at this stage unless with the use of diagnostic tools. In the early stage, patient’s cognitive ability continues to degenerate more as there is increased memory loss that is very evident. Moreover, there is increased language problem, poor reading and writing, impulses of aggression, instances of illusions, and irritability.

“Individuals at this stage have memory lapses, forgetting familiar words or names or the locations of keys, eyeglasses or other everyday objects, and these problems are not evident during a medical examination or apparent to friends, family or co-workers” (Berchtold, 1998, p. 5).

At this stage, the patients can feel the changes for they begin to realize that they have lost some ability to read, write, and even talk. Realizing that they have lost some abilities, the patients become dependent by asking for assistance in terms of reading, writing, and remembrance of important events. Psychiatrists can differentiate aging and the disease at this stage due to prevalence of the symptoms.

In the middle stage, the cognitive ability degenerates to the extent where the patient loses independence. Language problem become more evident at this stage as the patients have difficulties in fluency, reading, and writing.

Memory is also affected and the patients lose the ability to remember events and identity of even close relatives. At this stage, the patients also lose motor activity causing caregivers to move and guide them in their movements.

Williamson argues that, patients have “decreased capacity to perform complex tasks, such as marketing, planning dinner for guests, or paying bills and managing finances, reduced memory of personal history and become withdrawn socially” (2007, p.6). The gradual loss of memory and physical ability make the patient to become dependent on the caregivers in doing most of the activities.

In the late stage, the patient completely loses independence and begins to depend on caregivers on virtually all activities. The cognitive ability degenerates completely in that the patient cannot recall anything, speech reduces to mere utterances, and eventually reading and writing becomes impossible.

“At this stage, individuals may lose most awareness of recent experiences and events as well as of their surroundings and occasionally forget the name of their spouse or primary caregiver but generally can distinguish familiar from unfamiliar faces” (Williamson, 2007, p.7). The patients at this stage portray significant psychological and physical deficiency, as they become dependent on the caregivers until the day when they die.

Symptoms

Alzheimer’s disease has psychological and physical symptoms. Loss of memory, problem with language, poor judgment, change in moods and loss of cognitive abilities are some of the psychological symptoms associated with the disease. According to American Academy of Neurology (AAN), “memory loss that affects job skills is the main symptom of Alzheimer’s disease because frequent forgetfulness or unexplainable confusion at home or in the workplace may signal that something’s wrong” (2009, p.7).

Language impairment is also a psychological symptom since the patient loses ability to coordinate speech, thus complicating effective communication. Poor judgment is another symptom that shows cognitive impairment in a patient. Due to poor judgment, the patient cannot perform simple arithmetic calculations, misplaces valuable things, or even dress awkwardly. Moreover, the patient also experiences intermittent mood swings and deficiency cognitive abilities that are evident in the change of behavior.

Physical symptoms associated with the disease include inability to perform normal tasks, change in personality, failure to recognize people or environment. Normally, the disease affects the brains cells making the patient lose ability to coordinate movement. At the late stage of the disease, the patient completely loses memory and subsequently coordination of the body.

Eventually, the patient becomes entirely dependent on the caregivers in order to fulfill daily activities such as washing, bathing, eating, and walking. “People’s personalities may change somewhat as they age, but a person with Alzheimer’s can change dramatically, either suddenly or over a period of time, for instance someone who is generally easygoing may become angry, suspicious, or fearful” (AAN, 2007, p.8).

Change in behavior is very evident to the people who are close to the patients as they depict unusual behaviors such as dressing wrongly, becoming aggressive, withdrawing from friends and losing ability to perform daily activities. In addition, the patient cannot perceive people or the environment, for example failing to recognize friends, usual places, and losing direction.

Causes

Advancing age and genes are two main predisposing factors associated with the development of Alzheimer’s disease. Statistics show that the disease mostly affects older people of about the age 60 years and above. Michelle argues that, “advancing age is the most significant risk factor for Alzheimer’s disease since most people who develop the disease are over the age of 65, although the disease process is thought to begin years before cognitive and memory impairments are apparent” (2009, p.21). Therefore, old age is the most important predisposing factor of the Alzheimer’s disease because there are no incidences of the disease in young people.

Other research studies have also shown that occurrence of the Alzheimer’s disease in the population can be due to the genetic factors. The early onset of the disease in some instances is due to genetic effects while late onset may be due to aging. “The familial Alzheimer’s disease, which is passed on directly from generation to generation, accounts for only about 7 percent of the total incidence of Alzheimer’s disease” (Michelle, 2009, p.22).

Genes contribute significantly to the cases of early onset since late onset occurs due to sporadic nature of the disease. Despite the fact that Alzheimer’s disease is mostly sporadic in occurrence, studies have revealed other predisposing factors that contribute to the development of the disease in the population. These factors are unhealthy eating habits, stress, depression, smoking, brain injury, stroke, hypertension, diabetes, and inadequate exercise. These and other related factors affect production and functioning of neurotransmitters in the brain leading to impaired brain function and ultimately cause Alzheimer’s disease.

Conclusion

Alzheimer’s disease is a disorder of the brain characterized by loss of memory and cognitive abilities making the patient unable to perform usual duties of life. The disease commonly affects old people of age 65 years and above due to decreasing cognitive ability. In American, the disease has affected approximately 4 million old people with a high percentage of women, while the scientists are predicting exponential increase in the incidences because it is incurable.

The Alzheimer’s disease is a terminal illness that progresses slowly through four stages of pre-dementia, early stage, middle stage, and late stage, which eventually leads to death. The major symptoms of the disease are loss of memory and physical impairment of the patient. Most research studies have established that the cause of the disease is sporadic old age and genes in young age.

References

American Academy of Neurology. (2009). Alzheimer’s Disease. Alzheimer’s Association, 1-9.

Berchtold, C. (1998).Evolution in the Conceptualization of Dementia and Alzheimer’s Disease: The Journal of Mental Disorders, 1-33

Hoffman, M. (2000). Alzheimer’s Disease and Dementia. National Academy on an Aging Society, 1-17.

Kantor, D. (2011). Alzheimer’s Disease. National Institute of Health, 23-67.

Michelle, P. (2009). What Causes Alzheimer’s Disease. Alzheimer Society of Canada, 1-24

Williamson, J. (2007). Stages of Alzheimer’s Disease. Alzheimer’s Association, 1-43.

Introduction

Alzheimer’s disease is a form of dementia characterized by decreased cognitive and functional abilities. Mostly, it affects elderly people from the age of 50-65. Alzheimer’s progresses gradually and early symptoms are not easily identified.

Some of the early symptoms of the disease include memory impairment where the individual experiences difficulty remembering new information (Cappel et al., 2010). Moderate stage of the disease is characterized by confusion, functional impairment and behavioral changes.

The economic burden associated with Alzheimer’s disease is high. This includes both direct and indirect medical costs. Rapid disease progression is the main catalyst for escalated medical costs. One method that can be used to curb the escalation of the cost associated with the disease is early introduction of drug therapy.

Several drugs have licensed by FDA in the treatment and management of the disease. They include Memantine, Donepezil, Rivastigmine and Galantine (Cappel et al., 2010).

Although they do not cure the disease, these drugs are instrumental controlling the progression of the disease. The paper explores the economic burden associated with Alzheimer’s disease and importance of early introduction of drug therapy

Discussion

Economic Burden associated with Alzheimer’s disease

The economic burden associated with Alzheimer’s disease can be put into two major categories including clinical severity and residential status. Clinical severity explores the disease’s impact on the individual cognitive abilities and consequent behavioral changes.

The mini-mental state examination (MMSE) is used establish the severity of Alzheimer’s disease (Cappel et al., 2010). The test’s total score is 30 points where 21-26 score is considered mild Alzheimer’s, 10-20 is considered moderate Alzheimer’s and >10 score is considered severe Alzheimer’s.

Several studies in countries such as the UK and France have indicated that one point increase in MMSE results in cost increase.

Therefore, early introduction of drug therapy derails the progression of the disease and thus results in substantial cost savings. Cost savings are established on the basis of comparison of cost of drugs to the cost incurred in absence of drug therapy.

Alzheimer’s disease results in increased behavioral changes (Cappel et al., 2010).. Behavioral changes caused by dementia are measured using the Neuro-psychiatric inventory (NPI).

Most studies indicate that an increase one point results in increased costs associated with the disease. However, most studies focused on mild Alzheimer’s patients thus limited data on moderate and severe Alzheimer’s patients.

Residential status is associated with the transfer of Alzheimer’s patients to such places as nursing homes. This is the case for severe Alzheimer’s patients needing round- the- clock care (Cappel et al., 2010). Direct costs incurred as a result of placement in a nursing home include caregiver fees that are charged by the home.

In other cases, Alzheimer patients remain at home where family members are assigned duties to take care of them. In this case, the concept of opportunity cost applies where the family member has to forego a productive activity to take care of the Alzheimer’s patient.

Drug Therapy

Drug therapy can be analyzed using both clinical and pharmaeconomical outcomes. Memantine controls the production of glutamate. Increased levels of glutamate can cause neuronal dysfunction (Cappel et al., 2010).

Studies have shown that patients who switch from placebo to memantine showed reduced progression of the disease especially the effect on their cognitive abilities. Donepezil has been associated with decreased disease progression affecting such areas as cognitive and functioning abilities.

Continued administration of rivastigmine among patients with moderate Alzheimer’s resulted in improved MMSE scores. Galantamine effects have not been well explored but patients under the drug reported improved SIB scores (Cappel et al., 2010).

Pharmaeconomical outcomes are related to the either drug therapy in comparison to cost incurred by patients on placebo trial. Use of drugs increased the treatment costs incurred by the Alzheimer’s patients.

However, in comparison to costs associated with rapid progression such placement and caregiver cost, significant cost savings were identified. This underscores the importance of early intervention that results in cost savings.

Conclusion

The effects of Alzheimer’s disease can be controlled by early detection. This includes introduction of drug therapy that inhibits the disease’s progression.

Most studies are based on the effects of drug therapy mild Alzheimer’s patients. Therefore, there is need for more research on effect of drug therapy on moderate and severe Alzheimer’s disease patients.

Reference

Cappel, J., Hermann, N., Cornish, S., & Lanctot, K. (2010). The Pharmacoeconomics of Cognitive Enhancers in Moderate to Severe Alzheimer’s Disease. CNSDcugs, 24(ll), 909-927

Alzheimer’s disease (AD) is the leading cause of memory loss or dementia. Currently, its diagnosis uses clinical criteria and the ruling out of other causes.

The clinical characteristics of Alzheimer’s disease include progressive loss of memory and impaired cognition. The impact of AD on public health includes increased rates of informal care and the direct charges of communal care (Wimo et al., 2010).

Biomarkers in AD research are useful in the prompt diagnosis of AD. It has been reported that the neurodegenerative effects of AD are irreversible. However, the associated symptoms can be addressed before they worsen. Therefore, biomarkers help in the prediction of AD.

Plasma Ab would be considered a good candidate biomarker because obtaining blood samples for the test is less invasive and more cost-effective than getting CSF samples (Gouras, Olsson, & Hansson, 2015).

The main difference between plasma and CSF Abeta is that CSF Abeta is obtained from the cerebrospinal fluid while the plasma variant is the plasma amyloid that has crossed the blood-brain barrier to the blood through special receptors such as low-density lipoprotein (Butterfield, Swomley, & Sultana, 2013).

There are no other valid measures of amyloid plaque burden because amyloid plaques arise from the deposition of Abeta 40 and 42 in the brain. These proteins can only be found in the brain, blood, and CSF.

Previous studies have shown that the concentration of Ab42 in (CSF) is diminished in patients with slight reasoning deficiency and AD. Therefore, tests that quantify CSF Ab42 as well as phospho-tau are useful in the prompt diagnosis of AD (Toledo, Shaw, & Trojanowski, 2013).

The aim of this study is to find the precise relationship between plasma amyloid beta and Alzheimer’s disease.

Methods

The nested case-control study was appropriate for the study. This approach entails the identification of a specified number of the disease under investigation. For each case, a corresponding control (without the disease at the time of the study) is selected from the same cohort. This method is reported to be effective in investigations involving biologic precursors of disease, which is the focus of this study (Keogh & Cox, 2014). Additionally, it is cheaper than full cohort studies.

The subjects were classified into dementia and dementia-free based on cognitive function tests. The subjects included males and females aged 50 and above. The study reports three measures: plasma Abeta 40, Abeta42 levels and the ratio of Abeta 42:40 in AD cases and dementia-free cases.

Means were used to depict the concentrations of plasma Abeta levels. T-tests were used to determine the differences in plasma Abeta levels between the Ad cases and dementia-free groups.

Results

The plasma Abeta 42 levels were lower in AD cases than in the controls. Similarly, plasma Abeta 40 levels were lower in AD cases than in the dementia-free group. However, the differences in the plasma Abeta levels between the AD cases and controls were not statistically significant because the P-values were greater than 0.05. The findings are summarized in Table 1.

Table 1. Association of plasma Abeta with AD.

Similar findings were observed in subgroup analyses according to sex (men and women) and age (<60; ≥60).

Discussion

It was observed that the plasma Abeta 40 and 42 levels were higher in cases of AD than in the dementia-free subjects. Therefore, it can be concluded that plasma Abeta levels are useful indicators of AD.

The findings of this study are in line with the current literature that Abeta levels reduce in AD (Seppälä et al., 2010).

The strength of this study is that it involved the direct comparison of plasma Abeta levels in diseased and disease-free subjects thus helping to establish a relationship between the concentrations of this proteins in AD and dementia-free states. However, the findings were not statistically significant thus introducing an element of doubt to the reliability of plasma Abeta levels in predicting the occurrence of AD.

Future studies could determine ways of optimizing the test to increase its reliability.

References

Butterfield, D. A., Swomley, A. M., & Sultana, R. (2013). Amyloid β-peptide (1–42)-induced oxidative stress in Alzheimer disease: Importance in disease pathogenesis and progression. Antioxidants & Redox Signaling, 19(8), 823-835.

Gouras, G. K., Olsson, T. T., & Hansson, O. (2015). β-amyloid peptides and amyloid plaques in Alzheimer’s disease. Neurotherapeutics, 12(1), 3-11.

Seppälä, T. T., Herukka, S. K., Hänninen, T., Tervo, S., Hallikainen, M., Soininen, H., & Pirttilä, T. (2010). Plasma Aβ42 and Aβ40 as markers of cognitive change in follow-up: A prospective, longitudinal, population-based cohort study. Journal of Neurology, Neurosurgery & Psychiatry, 81(10), 1123-1127.

Toledo, J. B., Shaw, L. M., & Trojanowski, J. Q. (2013). Plasma amyloid beta measurements: A desired but elusive Alzheimer’s disease biomarker. Alzheimer’s Research & Therapy, 5(2), 1.

Wimo, A., Jönsson, L., Bond, J., Prince, M., Winblad, B., & International, A. D. (2013). The worldwide economic impact of dementia 2010. Alzheimer’s & Dementia, 9(1), 1-11.

Keogh, R. H. & Cox, D. R. (2014). Case-control studies. Cambridge, UK: Cambridge University Press.

Implications or Alzheimer’s Disease

Nursing

Since there is currently no cure for Alzheimer’s disease, the future of the nursing care for the people that have the identified disorder concerns mostly maintaining the patient’s quality of life. Therefore, designing the tools for improving the patient’s cognition functions, as well as fostering a safer environment for the target members of the population, should be viewed as the further course of nursing.

Pastoral Care

At present, there is a definite propensity in pastoral care to believe that memory loss and the deterioration of the cognitive abilities are not to be viewed as a sign of personal degradation. Thus, caregivers should focus on reconstructing the essential details of the patient’s life. Active use of personal pronouns, the emphasis on the unique characteristics of the patient, etc., will help retain the latter’ memory and improve the communication between the patients and their family members (Varcarolis & Halter, 2010a).

Social Services

The social services seem to be geared toward providing patients with Alzheimer’s disease with an opportunity to learn more about their condition and explore the treatment options that they have. Furthermore, social services are geared toward offering the family members the essential information about tending to the needs of people with Alzheimer’s disease.

Home Health Care

There is positive evidence that home care has a better effect on patients with Alzheimer’s than hospital care. Therefore, home care opportunities are becoming increasingly more numerous. New options for home health care have emerged, the current list containing companion, personal care, homemaker, and skilled care services (Ruz, 2016).

Community

The increase in the number of chances that people with Alzheimer’s have to integrate back into society successfully has had an effect on their relationships with the community. Among the essential effects, the communication process has become simpler and more efficient.

Antisocial Personality Disorder

By definition, the Antisocial Personality Disorder (APD) is rather difficult to address. Because of the comorbid disorders, as well as the fact that the patient is typically incapable of experiencing remorse (Varcarolis & Halter, 2010c), the treatment process may be hampered. In a case in point, the situation is aggravated by the fact that the patient has a drug problem. Therefore, using the traditional persuasion tactic in order to make the patient change his behavioral patterns does not seem like a sensible step to make.

Instead, a nurse must focus on psychotherapy. Thus, the motives for the patient to beg for money can be identified. The application of medical treatment is not quite reasonable at this point since there are no specific drugs for APD. Instead, a therapist may consider prescribing medicine for preventing the development of comorbid conditions, such as anxiety disorder or depression (Varcarolis & Halter, 2010b). For example, if the psychotherapy sessions show that the patient asks for money because of his fear for his physical, emotional, or economic wellbeing, active therapy sessions will have to be provided to address the fear issue.

Cognitive therapy can be used as the foundation for reconstructing the patent’s identity. Aimed at improving his intellectual and social skills, the treatment is bound to have a positive effect on him. The goal of the therapy, in this case, is to show the patient that his current behavioral patterns are the primary causes of his problems. Thus, the understanding of the necessity to alter the current habits will appear. As a result, the man will be able to accept the need to adopt new and more socially appropriate behavioral strategies.

References

Ruz, M. A. (2016). Patient’s caregiver satisfaction with home health care services provided by King Fahad Specialist Hospital – Dammam. Journal of American Science, 12(6), 8-14.

Varcarolis, E. M., & Halter, M. J. (2010a). Chapter 15. Schizophrenia. In Foundations of psychiatric mental health nursing (6th ed.) (pp. 306-343). St. Louis, MO: Saunders.

Varcarolis, E. M., & Halter, M. J. (2010b). Chapter 15. Schizophrenia. In Foundations of psychiatric mental health nursing (6th ed.) (pp. 344-368). St. Louis, MO: Saunders.

Varcarolis, E. M., & Halter, M. J. (2010c). Chapter 29. Psychological needs of the older adult. In Foundations of psychiatric mental health nursing (6th ed.) (pp. 653-676). St. Louis, MO: Saunders.

The phenomenon of Alzheimer’s disease (AD) was first explored and defined a bit more than a century ago. It is considered to be the most prevalent basis for dementia with an assessed incidence of more than 25 million individuals on the international scale (Barnes, 2012). What is more interesting, this number is projected to increase fourfold in the next four decades. Medicinal research shows that there presently is no efficient care that postpones the inception or decelerates the development of AD. Nevertheless, there were significant methodical developments in the different areas of biology, genetics, chemistry, and other sciences through the course of the prior two decades that were capable of altering the way we reflect on AD (Barnes, 2012). The scientists all over the world discuss some of the complexities of rendering these elementary biological and genetical findings into the medical treatment. The existing data proposes that if the illness is distinguished before the commencement of evident warning signs, it is probable that the treatments founded on the facts of fundamental pathogenesis will be of assistance in battling the Alzheimer’s disease (Barnes, 2012).

In the rummage around for the new DNA segments that would provide evidence of the cure for Alzheimer’s disease, definitive relation-based and individual-gene-based connotation studies have been displaced (Bettens, Sleegers, & Van Broeckhoven, 2013). Instead, a number of innovational methods of sequencing were incorporated into practice (such as exome and genome-wide) for mendelian types of AD, and genome-wide connotation revisions for non-mendelian types of AD. The discovery of new vulnerability genetic factor has unlocked the new extents for investigation of the fundamental disease prognosticators (Bettens et al., 2013). On top of distinguishing innovative risk aspects in large models, the revised sequencing methods can bring fresh perceptions with even an insignificant number of individuals suffering from AD. The change in emphasis towards rendering research and categorizing of specific patients makes each patient’s genetic material the essential component of genetic research (Bettens et al., 2013). The theoretical swing required to turn the patient into the central figure of the genetic studies will necessitate robust teamwork and contribution from medical experts in neurology.

Preclinical AD is dominant in mentally ordinary aged people and is connected to the impending perceptive deterioration and impermanence. Consequently, preclinical instances of AD could be the central clinical aspect in which the medical workers should be involved (McKhann et al., 2011). Recently, a group of researchers was given the task of reviewing the previously set norms for defining AD and dementia. The team of scientists wanted to guarantee that the reviewed conditions would be sufficiently flexible to be implemented into practice by both all-purpose healthcare workers without admission to neuropsychological examination, extended testing, and other important measurement procedures, and dedicated professionals taking part in research or medical experimental studies who ought to have these utensils accessible (McKhann et al., 2011).

These researchers offered the norms for all-inclusive dementia and Alzheimer’s disease dementia. They have also incorporated the universal background of feasible AD dementia from the 1984 conditions in their study. Using the past three decades of experience, the researchers have performed some modifications in the medical principles for the diagnosis. The researchers as well took the notion of probable AD dementia and restated it in a way more attentive to detail than before (McKhann et al., 2011). Biological identification evidence was also involved in the analytic designs for feasible and probable AD dementia for exploitation in research situations. The essential scientific measure for Alzheimer’s disease dementia will still be the keystone of the verdict in medical practice, but biological identification evidence is projected to improve the theoretical precision of the diagnosis. There is still research to be done in the area of confirming the biological identification diagnosis of Alzheimer’s disease (McKhann et al., 2011).

Since the discovery of Alzheimer’s disease, numerous research projects were conducted so as to recap the evidence concerning the key hypothetically adjustable risk influencers for AD – midlife corpulence, smoldering, despair, mental idleness or insignificant educational realization, diabetes, and corporal inoperativeness (Selkoe, 2012). Moreover, these studies predicted the influence of risk factor decrease on Alzheimer’s disease occurrence by calculating the populace characteristic risks (the percent of cases characteristic to a certain aspect) and the number of Alzheimer’s disease incidents that might be disallowed by a significant (from 10% to 25%) decrease in the ratio of risk influencers both in the United States and worldwide (Selkoe, 2012). Together, up to nearly 50% of Alzheimer’s disease cases internationally (18 million) and solely in the US (3.5 million) are hypothetically dependent on these aspects. More than two millions of Alzheimer’s disease cases could be prevented if the risk factors were carefully assessed and promptly evaluated (Selkoe, 2012).

Regardless of the rigorous test center and medical research over the past 30 years, an effectual treatment to suspend the commencement and development of Alzheimer’s disease is still not on the way. Current medical trial fiascos advocate that we must cure the disease earlier than in its minor to sensible phases, and serious advancement in authorizing presymptomatic biological indicators now makes subordinate deterrence trials probable (Stern, 2012). Medical experts have to find out more about the past of the disease so as to give at least a couple of incomplete treatment answers based on the comprehensive evaluation of the modern trial outcomes. This method will possibly settle the grounds for accomplishments, but only with a much bigger venture in all of the characteristics of Alzheimer investigation and with a watchful design of the upcoming studies and experiments (Stern, 2012).

There is no proper cure for Alzheimer’s disease but exists medicine that can assist in relieving numerous AD symptoms and hold back the development of the disorder in some individuals. Many other kinds of assisting methods are as well offered to help persons with Alzheimer’s live as self-sufficiently as possible. These challenges may be mitigated through transforming the patient’s home setting, so it is more laid-back to stroll through the house and recall the day-to-day household tasks (Vos et al., 2013). Emotional treatments such as mental stimulus therapy may similarly be presented to help sustain the patient’s remembrance, issue resolving capability, and verbal skills. Normally, individuals with Alzheimer’s disease live peacefully for almost seven to ten years after the AD symptoms begin to progress. Nevertheless, this can contrast significantly from individual to individual. Some persons with the illness will live more than, for instance, ten years, but others will not (Vos et al., 2013). Alzheimer’s disease is a life-restraining disease, even though many persons that were found to suffer from Alzheimer’s disease will pass away from another reason.

As Alzheimer’s disease is a reformist illness for the neurologists, it can be the reason for difficulties with swallowing. This can be the cause of aspiration (nutrition being breathed in into the lungs) which can be the root for recurrent upper body contaminations. It is as well prevalent among the individuals with Alzheimer’s disease to ultimately have trouble consuming food and have a reduced need to eat (Vos et al., 2013). There is a growing consciousness that persons with Alzheimer’s disease require a comforting care. This comprises support for relatives, in addition to the person with AD. As the precise basis of Alzheimer’s disease is not evident, there is no identified way to avert the disorder. Nevertheless, there are things that the person can do that may decrease the hazard or suspend the beginning of dementia, such as discontinuing smoking and completely refusing the consumption of alcohol, maintaining a vigorous, well-adjusted diet and sustaining a healthy body mass, staying in a good physical shape, and being rationally full of life (Vos et al., 2013). These actions also have additional health profits, such as cutting down the patient’s risk to be affected by a cardiac illness and refining their general psychological health.

Alzheimer’s disease is a critical issue due to the fact that more and more persons are exposed to this disorder. This distresses the general public wellbeing and sets the ground for further research on this crucial topic. Medical workers from all over the world should carefully assess the risks of AD and continue studying the phenomenon of this illness. Using the evidence from prior research, the experts should render the most certain predictors of Alzheimer’s disease and put the effort in elaborating the strategy that would prevent the illness or successfully hold it back for a decent period of time.

References

Barnes, D. (2012). Risk Factor Reduction and Alzheimer’s Disease Prevalence: Projected Effect and Practical Implications. Alzheimer’s & Dementia, 8(4), 819- 828. Web.

Bettens, K., Sleegers, K., & Van Broeckhoven, C. (2013). Genetic insights in Alzheimer’s Disease.The Lancet Neurology, 12(1), 92-104. Web.

McKhann, G., Knopman, D., Chertkow, H., Hyman, B., Jack, C., Kawas, C.,… Phelps, C. (2011). The Diagnosis of Dementia due to Alzheimer’s Disease: Recommendations from the National Institute on Aging-Alzheimer’s Association Workgroups on Diagnostic Guidelines for Alzheimer’s Disease.Alzheimer’s & Dementia, 7(3), 263-269. Web.

Selkoe, D. J. (2012). Preventing Alzheimer’s Disease.Science, 337(6101), 1488-1492. Web.

Stern, Y. (2012). Cognitive Reserve and Alzheimer Disease.The Lancet Neurology, 11(11), 1006-1012. Web.

Vos, S., Xiong, C., Visser, P., Jasielec, M., Hassenstab, J., Grant, E.,… Fagan, A. (2013). Preclinical Alzheimer’s Disease and Its Outcome: A Longitudinal Cohort Study.The Lancet Neurology, 12(10), 957-965. Web.

Introduction

Alzheimer’s disease, popularly known as AD, is an irremediable, progressive ailment of the brain that destroys brain cells responsible for executing brain roles such as memory and thinking. Alzheimer disease destroys some brain faculties making the person unable to perform even the simplest tasks. To begin with, the disease affects regions of the brain, which manage language, memory and thought.

Thus, women suffering from Alzheimer disease find it hard to memorize things that have occurred lately and in most cases, they cannot even remember the names of people conversant to them. As time goes by, the symptoms become ubiquitous and worse. The disease also affects men but not vicious as compared to women.

For instance, women like men suffering from Alzheimer disease cannot recognize family members, experience some speaking difficulties and they loose their ability to read and write. Additionally, they forget to do even simple things like combing hair and brushing their teeth.

With time, they become very nervous and belligerent, wandering far away from home never to return back as they cannot remember the way back home.

The symptoms of Alzheimer disease become prevalent the age of 60. This means that as one gets older, the risks becomes high. Notably, research shows that the disease leads to dementia- a disease common among older people- men and women. Dementia is a brain disease characterized by the loss of cognitive functioning.

For instance, persons suffering from dementia have remembering, thinking and reasoning intricacies, which end up affecting their daily activities. So far, statistics reveal that there are over 5.1 million people suffering from Alzheimer disease in United States alone and the disease affects more women than men (U.S National Institute of Health, 2010, p.1).

Brain Changes with Alzheimer’s disease

So far, medics are yet to identify the real cause of Alzheimer disease. Additionally, medics are busy doing research to identify how the process starts and whether brain damage occurs 10 to 20 years prior to the appearance of first symptoms. The brain changes are the same in both men and women suffering from Alzheimer’s disease.

Nevertheless, some medical practitioners believe that it all starts with the development of tangles in the brain especially in the entorhinal cortex and affects more women than men. Other regions of the brain may also develop plaques. Further development of the plaques and tangles within the brain regions hampers the normal functioning of the healthy neurons. Eventually, the neurons become less efficient and cannot communicate effectively with each other; consequently, they die leaving the person in big problems.

The tangles and the plaques continue to damage the entorhinal cortex and eventually spread into a nearby region, hippocampus. The hippocampus is the region of the brain responsible for memory. There is also a significant increase in the death of the neurons leading to the shrinking of the affected regions.

Signs and Symptoms

The society has mixed perceptions on the signs and symptoms of the disease. In most cases, they associate them with disability. Alzheimer’s disease develops slowly making it hard for medics to establish the whole process.

Several neuropsychological testing reveals the dominance of mild cognitive intricacies eight years before the real diagnosis. Some of the common early symptoms include memory loss, which affects the person’s ability to remember or even get new information.

In the early stage, persons suffering from Alzheimer’s disease experience memory loss, language difficulties, changed perceptions (agnosia), and difficulties in moving from one place to another, apraxia. At this stage, the disease does not impair all memory capacities. Even if it affects these memory capacities, the extent of damage is not uniform across all memories.

For example, research shows that the episodic memory responsible for remembering past happenings, the semantic memory responsible for recognizing learned facts, and the implicit memory of how the body works has lesser damages as compared to other memory capacities. This problem is more prevalent in men than in women.

Additionally, both men and women experience language problems like hesitancy of words and dwindling vocabulary hence, the penury of spoken and written language. Nevertheless, the person can still perform fine motor tasks for example, walking, eating, writing, and drawing (Forstl, H. & Kurz, 1999, pp. 288-290).

The second stage of symptoms is the moderate. Here, the early signs and symptoms starts to deteriorate and eventually hinders the independence of a person. In most cases, this effect is dominant in men. On the other hand, women also experience speech difficulties and become prevalent-paraphasias.

With time, they loose the ability to read and write. The memory loss problem also worsens and the person cannot even recognize family members. This stage exhibits behavioral and neuropsychiatric changes such as tetchiness, labile effect, outbursts, itinerancy, sundowning and aggression.

In the advanced stage, the both men and women cannot perform any task individually. There is complete loss of speech characterized by single words and phrases. Nevertheless, although such persons cannot communicate effectively, they understand and can answer using emotional gestures.

At this stage, they experience acute apathy, aggressiveness and exhaustion and they cannot perform any task including the simple ones minus assistance. Other symptoms include the deterioration of mobility and muscle mass to a stage where they confine to bed, unable to feed themselves. The table below shows the number of incidences affected after the age of 65 (Frank, 1994, pp. 417-423).

Causes

To date, scientist have not identified the real cause of Alzheimer’s disease, although it is clear that the disease starts with some complications and a chain of events occurring in the brain for a lengthy period of time. Genetic, lifestyle, and environmental factors are some of the possible causes of Alzheimer’s disease. Nevertheless, scientists have put across several hypotheses, which tend to explain the cause of AD.

For example, the cholinergic hypothesis depicts the reduced synthesis of neurotransmitter acetylcholine as the cause of Alzheimer’s disease. Nonetheless, many scientists do not agree with this hypothesis and always find faults in it. Another hypothesis, amyloid hypothesis, developed in 1991 explains that amyloid beta (Aβ) causes Alzheimer’s disease.

The hypothesis continues further to explain position of the gene in the amyloid beta precursor protein (APP) occurring in chromosome 21, a characteristic experienced by older persons. Since then, scientists have made numerous advances to the hypothesis explaining how amyloid plaques cause impairs the normal functioning of the neurons.

Another hypothesis, explains how the breakdown of myelin within the brain causes Alzheimer’s disease. Such breakdowns cause distractions in axonal transport hence, trouncing of neurons. The hypothesis also explains that the iron unconfined during the go kaput of myelin can cause brain damages (Polvikoski, Sulkava, Haltia, 1995, pp. 1242-1247).

Diagnosis of Alzheimer’s disease

The definitive diagnosis of Alzheimer’s disease is not an easy task. This is because it involves the assessment of the brain tissue and pathology examination in an autopsy. Nevertheless, due to the development of science and technology, medics are now in a position to determine whether persons suffering from memory problems have dementia or Alzheimer’s disease.

In order to diagnose Alzheimer’s disease, medical practitioners have to perform the following. Firstly, they examine the medical history of the person affected, which includes the ability to carry out different tasks, earlier medical quandaries, and alterations in personality and behavior. Secondly, doctors will then proceed to perform memory tests such as attention and problem solving.

They will also test the person’s ability to count and communicate effectively (language). Thirdly, they will then carry out medical tests from samples of urine, blood and the spinal fluid. The last test involves brain scanning. Using computerized tomography (CT) or another technique called magnetic resonance imaging (MRI); doctors can determine the extent of brain damage over time.

Perhaps this is the main reason why doctors prefer early diagnosis as they can be in a position to prescribe drugs, which control further development of the symptoms. Early diagnosis will also make many families prepare for the future in advance and develop support networks (Shiel & Marks, 2010, p. 1).

Society and AD

Depending on one’s background, the view on women with Alzheimer can vary greatly. Nevertheless, women are important people in society. Although many women are more likely to be affected, the mortality rate is higher in men than in women. In fact, severe dementia and delirium causes mortality in men. On the other hand, women suffering from dementia are having low insulin as compared to men meaning, the probability of women suffering from diabetes is higher than that of men.

Women and Alzheimer’s Disease

Research shows that women are at high risk of attack of Alzheimer’s disease. Currently, women contribute 66 percent of persons suffering from Alzheimer’s disease. United States government is going to spend over US$20 billion for over 78 million baby boomers, many of them suffering from this disease. Women suffer most because of their gender, not longevity.

Once women reach menopause, they experience estrogen deficiency. Medical research indicates that estrogen is imperative in protecting the mental functioning of the brain. It also controls the production of amyloid, which forms amyloid plaques dangerous to the brain.

Thus, as the level of estrogen plummet, the intrinsic fortification of women ceases; nonetheless, as for men, they change testosterone into estrogen even at old ages hence, ensuring them protection against the disease. In women, the brain’s vascular system is dependent on estrogen. Thus, once the production of estrogen stalls, there is no further preservation of the woman’s vascular system (Liesi, Scherr, McCann, Beckett, & Evans, 1999, pp. 132-136).

Various medical researches indicate that after menopause, the body of women fails to normalize its blood vessels just like in the past due to the absence of estrogen. This can cause further deterioration resulting from such abnormalities. However, with time, the body adapts to the new body condition and sets new modalities of maintaining the vascular system.

Blood vessels are like highways that ship oxygen and nutrients throughout the body. As women start their menopause period, certain vascular quandaries develop. Within vessels, some tiny vessels develop causing miscommunication. Doctors cannot use synthetic hormones to correct the situation as it can interfere with the normal functioning of the body.

Consequently, abnormal changes occur in the brain; nerves responsible for memory and capacity to learn damage, and brain cells die. This changes a person’s personality and behavior and in some occasions, the body can loose its ability to perform normal functions like walking, writing, and drawing (Lerner, 1999, pp. 1830-1834).

Treating the Psychiatric Symptoms

So far, there is no established cure for Alzheimer’s disease.Scientists have developed drugs that treat symptoms associated with Alzheimer’s disease. For example, in treating agitation, doctors recommend beta-blockers, anxiolytics, trazodone and antipsychotics. However, there is still pharmacological controversy on these drugs regarding their side effects such as stroke and sudden death.

For example, some drugs treat men effectively from depression but fails in women. Additionally, women suffering from Alzheimer’s disease, experiencing apathy, and concentrating problems should desist from using antidepressants as they may cause more harm.

Research shows that sedating atypical antidepressants, trazodone, is effective in controlling the dominant symptoms like agitation, hallucination and insomnia. Other modes of treatment include non-pharmacologic measures such as not taking fluids at night to reduce urination, pain treatment, exposure to sunlight and other activities that induce sleep.

Conclusion

It is true the disease affects both men and women. However, research shows that women constitute the highest percentage of those affected. Both men and women suffering from Alzheimer’s disease need maximum care, as they cannot perform normal activities due to brain damage.

Sometimes, families can have stress in caring for these patients, as they need total attention. Nevertheless, persons suspecting to have the disease should see the doctor for diagnosis and further treatment.

Reference List

Forstl, H. & Kurz, A. (1999). Clinical features of Alzheimer’s disease. European Archives of Psychiatry and Clinical Neuroscience, 249(6), 288–290.

Frank, E. (1994). Effect of Alzheimer’s disease on communication function. Journal of Science and Medical Association, 90 (9), 417–423.

Lerner, A. (1999). Women and Alzheimer’s Disease. The Journal of Clinical Endocrinology & Metabolism, 84(6), 1830-1834.

Liesi, E., Scherr, P., McCann, J., Beckett, L. & Evans, D. (1999). Is the Risk of Developing Alzheimer’s Disease Greater for Women than Men? American Journal of Epidemiology, 153(2), 132-136.

Polvikoski, T., Sulkava, R. & Haltia, M. (1995). Apolipoprotein E, dementia, and cortical deposition of beta-amyloid protein. New England Journal of Medicine, 333(19), 1242–1247.

Shiel, W. & Marks, J. (2010). Alzheimer’s Disease. Web.

U.S National Institute of Health. (2010). Alzheimer’s Disease Fact Sheet.

Alzheimer’s disease is a neurological condition that develops predominantly in people over 65 years old. According to the Alzheimer’s Association (2011), this condition is the sixth leading cause of lethal outcomes in the United States (p. 208). Alzheimer’s is also the main cause of dementia, which leads to cognitive problems, including memory loss and difficulties with day-to-day activities.

Nature and Causes

Named after the doctor Alois Alzheimer, Alzheimer’s disease is a condition that affects brain function. It is the most widespread cause of dementia. However, the disease may start developing unnoticed, and the symptoms might become visible at an advanced stage, i.e. difficulties with memory, reasoning abilities, and overall cognitive function. Alzheimer’s might even affect certain personality traits, as well as modify the behavioral patterns. Certain patients might experience troubles with routine tasks, as this condition may exert a negative influence on their habitual skills. The quality of life of patients suffering from Alzheimer’s disease is gravely affected.

The causes of the condition are of a complex nature. It was established that an array of factors might lead to Alzheimer’s disease. A combination of environmental, congenital, and lifestyle factors might contribute to the condition. According to the Mayo Clinic Staff (n.d.), nearly five percent of Alzheimer’s patients underwent certain genetic mutations that led to them developing the disease (par. 13). Although the causes of the condition are not fully established, researchers identify several risk factors.

These factors include age over 60, family history, Down syndrome, head trauma, and lifestyle choices. The latter include risk factors that are usually determined as contributing to the development of a heart condition, such as high blood pressure, high level of cholesterol, unbalanced diet, obesity, and a passive lifestyle lacking in exercise.

Signs and Symptoms

The most frequent symptoms of Alzheimer’s disease include problems with memory, reasoning, thinking processes, perception, and communication. At an early stage, the disease may manifest through memory lapses (Alzheimer’s Society, n.d., par. 6). A patient can experience difficulties recalling recent events or processing recently received information. These problems occur due to the damaged hippocampus that regulates the daily memory processes.

As the disease progresses, a patient might start forgetting where they put their things. It may also be difficult for them to find the right word when talking to somebody, or else they might find themselves lost while taking a familiar route. Certain dates that have special importance to the patient may be unexpectedly forgotten.

Difficulties concerning language, speech, perception, and communication can also prove to be vivid. Such problems include impaired visuospatial skills, speech articulation, language, difficulties with concentration or organization of daily tasks, or making long-term plans (Alzheimer’s Society, n.d., par. 10).

As the disease progresses, some patients may start behaving in an unusual way, including aggressive behavior, excessive irritability, or the loss of focus in the middle of a task. Increasing problems with memory and overall confusion are a considerable burden for Alzheimer’s patients. Multitasking can prove especially difficult, and even routine tasks may be challenging. Changes in sleep patterns, aimless wandering, withdrawal from the family members or social groups, apathy, and depression can manifest in people suffering from this condition.

Diagnostic Tests and Results

Diagnostic tests required to diagnose Alzheimer’s disease are multifaceted, as they include taking the necessary medical history, conducting a physical exam, neurological exam, mental status test, as well as performing brain imaging procedures (Alzheimer’s Association, n.d., par. 1). Laboratory tests are performed to determine the level of certain substances, chemicals, and minerals. These laboratory tests are supposed to help rule out certain conditions, such as liver and thyroid problems, vitamin deficiencies, and overall nutritional issues. The tests include a thyroid test, glucose and electrolyte levels test (sodium, potassium, creatinine, calcium), vitamin B12 test, testing liver function, HIV test, as well as a complete blood count test (Alzheimer’s disease – exams and tests, n.d., par. 5).

In people with Alzheimer’s disease, cerebral atrophy is often identified in parietal, frontal, and temporal areas (CND degenerative diseases, n.d., par. 5). A typical feature of Alzheimer’s test results is the presence of a high number of neuritic plaques in the cerebral cortex. In the periphery areas of these plaques microglia and reactive astrocytes may be discovered. However, the number of these plaques increases with age, which is why a correlation with the patient’s age must be made in order to reach a consistent diagnosis. Among other histopathology results, granulovacuolar degeneration is distinguished, as well as neurofibrillary tangles, and amyloid angiopathy (CND degenerative diseases, n.d., par. 5).

Nissl Staining

Nissl staining helps identify the signs of neuronal loss. Most often performed with cresyl violet, this test helps determine that the ribosomic RNA is negatively charged in the rough endoplasmic reticulum ribosomes (Serrano-Pozo, Frosch, Masliah, & Hyman, 2011, p. 10). The latter presents a dark blue color in the neurons’ perinuclear area. This histological staining technique helps identify certain changes in neuron structures that can help diagnose Alzheimer’s Disease, as well as other neurological conditions.

Prevention and Treatment

Alzheimer’s prevention measures are yet to be established. Since in some cases the condition appears to be inherited, changes in certain genes guarantee an eventual onset of the disease. However, by making specific choices regarding one’s lifestyle, it is possible to minimize the risks involved. Among the possible ways that can reduce the risk is staying fit, maintaining a healthy and balanced diet, and leading an active social life (Leonard, 2016, par. 1).

These measures can help protect the brain from neurological damage and sometimes even slow down the development of Alzheimer’s. Regarding diet, it is recommended to keep to a Mediterranean-style regime, as it also reduces the risk of cardiovascular disease and diabetes development (Alzheimer’s disease – causes, symptoms, treatment, prevention, n.d., par. 16). Such a diet excludes red meat and centers around fruit and vegetables, nuts, olive oil, fish, and various healthy fats (Leonard, 2016, par. 5).

Leonard emphasizes the importance of mental activities. The latter may include cognitive activities, such as puzzles, visiting museums, reading books and newspapers, learning a foreign language, or mastering a new skill. Social activities can also prove beneficial, such as traveling, spending time with others, or simply engaging in daily conversation that may contribute to one’s brain health. Moreover, smokers are demonstrated to be at a higher risk than non-smokers. Leonard (2016) also indicates the importance of lowering the level of homocysteine, which can be done by eating more food that is the source of folates, such as broccoli, spinach, cauliflower, and parsley (par. 11).

An efficient Alzheimer’s disease treatment is yet to be developed. However, the existing methods of treatment focus on managing the symptoms of the condition. There exist certain medications that help manage cognitive difficulties, including donepezil, galantamine, rivastigmine, and memantine (Current Alzheimer’s treatments, n.d., par. 2). These medications employ the memantine mechanism that is supposed to decrease the rate at which the neurotransmitters degenerate.

Conclusion

Alzheimer’s disease is a challenge nowadays, as there is no cure for this condition. Symptoms can be managed, and the mentioned medications may help slow down the neurological degeneration. An array of lifestyle choices can be made to ease the difficulties experienced by Alzheimer’s patients. However, an efficient treatment method is yet to be developed.

References

Alzheimer’s Association. (n.d.). Tests for Alzheimer’s disease and dementia. Web.

Alzheimer’s disease – causes, symptoms, treatment, prevention. (n.d.). Web.

Alzheimer’s Society. (n.d.). What is Alzheimer’s disease? Web.

Alzheimer’s Association. (2011). Alzheimer’s disease facts and figures. Alzheimer’s & dementia: the journal of the Alzheimer’s Association, 7(2), 208-220.

Alzheimer’s disease – exams and tests. (n.d.). Web.

CNS degenerative diseases. (n.d.). Web.

Current Alzheimer’s treatments. (n.d.). Web.

Leonard, W. (2016). Alzheimer’s disease prevention. Web.

Mayo Clinic Staff. (n.d.). Alzheimer’s disease. Web.

Serrano-Pozo, A., Frosch, M. P., Masliah, E., & Hyman, B. T. (2011). Neuropathological alterations in Alzheimer disease. Cold Spring Harbor Perspectives in Medicine, 1(1), 1-20.