Category: Alzheimer’s Disease

Alzheimer’s disease (AD) is a mental disorder that originates from the degeneration of neurons in the brain. The diagnosis of AD is significant to Canada because about 30% of people with dementia remain undiagnosed, yet it has debilitating effects on patients, resulting in increased medical costs and augmented caregivers’ demand (Manuel et al., 2016). Pathophysiology mechanism shows that AD occurs due to the deficiency of neurotransmitters, genetic mutations, deposition of amyloid-beta proteins, and aggregation of tau proteins (Kaufman et al.., 2016; Du et al., 2018). In their study, Kraus et al. (2019) targeted aggregated tau proteins as molecular markers using Alzheimer’s disease real-time quaking-induced conversion (AD RT-QuIC). Research findings demonstrated that AD RT-QuIC is a sensitive diagnostic and prognostic method for detecting the levels of aggregated tau proteins in cerebrospinal fluid. NIH/National Institute of Allergy and Infectious Diseases (2018) reported the research findings in the news article, Science Daily, that AD RT-QuIC is an ultrasensitive test that detect corrupted tau proteins for early diagnosis and effective treatment. Critical analysis of the news article shows that it provides accurate reporting and presentation of the primary research.

The news article accurately reports the focus of the study in the diagnosis of AD. NIH/National Institute of Allergy and Infectious Diseases (2018), study designed an ultrasensitive test for AD by detecting a degraded tau protein in the brain tissues. Based on research findings, it is true that the designed test is accurate in detecting aggregated tau proteins. Krau et al. (2019) established that AD RT-QuIC is a very sensitive method because it can detect tau aggregates obtained from the brain tissues in the dilution ranges between 10^-7 and 10^-10 proportions. Comparative analysis shows that the news article accurately reported that AD RT-QuIC is a very sensitive method with the ability to detect low concentrations of tau aggregates in the brain tissues.

The news article also offers an accurate reporting of the significance of the study’s findings. The sensitivity of the designed method is not only important to the early diagnosis of AD but also the development of novel treatment strategies (NIH/National Institute of Allergy and Infectious Diseases, 2018). As AD associates with other neurodegenerative disorders, it is difficult to detect and differentiate its pathophysiology. Moreover, previous methods of diagnosis relied on the syndromic definition of signs and symptoms, which only appear at the late stages of AD. Following the design of this method, it is now possible to diagnose AD at early stages using tau aggregates as biomarkers and evaluate the progression of treatment interventions (Kraus et al., 2019). Early diagnosis enhances the effectiveness of treatment interventions, while the degree of the aggregation of tau proteins shows the effects of treatments. Hence, the news article accurately presents that the diagnostic method is important in the diagnosis and prognosis of AD among patients.

The analysis of the news article reveals that it made key statements that are in line with the pathophysiology of AD. One key statement is that tau protein clusters are some of the targeted biomarkers used in the diagnosis of AD (NIH/National Institute of Allergy and Infectious Diseases, 2018). This statement highlights that the accumulation of tau isoforms in the brain with four-repeats (4R) and three-repeats (3R) relates to the manifestation of AD in individuals (Kraus et al., 2019). Moreover, the assessment of literature indicates that tau aggregates comprise a significant biomarker for AD. According to the tau hypothesis, AD stems from the aggregation of tau proteins in the brain tissues, resulting in the impairment of neuronal functions and neurodegeneration (Du et al., 2018; Sharma & Singh, 2016). Another key statement is that AD RT-QuIC is an ultrasensitive method of detecting aggregated tau proteins. When compared to the detection of A-beta amyloid proteins, tau deposition is a sensitive and selective biomarker for AD (Brier et al., 2016). Thus, these key statements in the news article have a scientific basis, which supports their description of the pathophysiology of AD.

The presented findings in the news article would enhance the diagnosis of AD in the generation population. Since the news article describes the designed diagnostic method as ultrasensitive, people with mental disorders would consider using it in the diagnosis of AD. Moreover, patients with AD and researchers because would use this method in the prognostic evaluation of treatment interventions. A critical analysis shows that the news article does not report the selectivity aspect of the method in the diagnosis and prognosis of AD. Overall, the news article has a positive impact on the diagnosis and monitoring of AD among patients.

The analysis of the news article reveals that it provides an accurate reporting of the research findings of the study. The news article highlights the sensitivity of the designed diagnostic method and its benefits in the diagnosis and prognosis of AD. Key statements in the news article that are in line with the pathophysiology of AD relate to the aggregation of tau proteins and their sensitivity in predicting and differentiating AD from other mental disorders. Therefore, the presented findings have significant benefits because they would enhance the diagnosis and treatment of AD, as well as improve the design of new drugs.

References

Brier, M. R., et al. (2016). Tau and A-beta imaging, CSF measures, and cognition in Alzheimer’s disease. Science Translational Medicine, 8(338), 1-9. Web.

Du, X. et al. (2018). Alzheimer’s disease hypothesis and related therapies. Translational Neurodegeneration, 7(2), 1-7. Web.

Kaufman, S. K.et al. (2016). Tau prion strains dictate patterns of cell pathology, progression rate, and regional vulnerability in vivo. Neuron, 92(4), 796-812. Web.

Kraus, A. et al. (2019). Seeding selectivity and ultrasensitive detection of tau aggregate conformers of Alzheimer’s disease. Acta Neuropathologica, 137, 585-598. Web.

Manuel, D. G. et al. (2016). Alzheimer’s and other dementias in Canada, 2011 to 2031: a microsimulation Population Health Modeling (POHEM) study of projected prevalence, health burden, health services, and caregiving use. Population Health Metrics, 14(37), 1-10. Web.

NIH/National Institute of Allergy and Infectious Diseases. (2018). Test detects protein associated with Alzheimer’s and CTE: Findings could lead to early diagnosis, better treatment studies.Science Daily. Web.

Sharma, N., & Singh, A. N. (2016). Exploring biomarkers for Alzheimer’s disease. Journal of Clinical and Diagnostic Research, 10 (7), 1-6. Web.

Abstract

The majority of epidemiological researches regarding the incidence and rate of Alzheimer’s disease (AD) infection show that it occurs to a greater extent in adult women when judged against the men. Studies affirm that heart failure is a major risk aspect of Alzheimer’s disease. Moreover, women with AD tended to perform poorer than their male counterparts. More experiments and studies should be carried out to establish the most effective treatment of Alzheimer’s disease in adult women.

Patient Profile

Name: Martha Lopez

Date of Birth: 3/13/59

Age: 58

Sex: Female

Occupation: Head of Literature Department, Literature Professor

Marital Status: Married

Patient Demographics: The patient is a 58-year-old, married, female, of Mexican descent, who lives with her husband in Emeryville, California, in a three-bedroom house.

Familial History and Significant Relationships: The patient has been married for twenty-eight years. She has three children and five grandchildren. The patient’s mother recently died of complications from a heart attack in August 2016, which caused her father to move in with the patient. She describes her life as a mother as “gratifying” and “it kept me on my toes”.

Education and Employment History: The patient reported she is a college graduate and has a master’s degree in Victorian Literature. She described her academic life as “stressful” but “rewarding” and was never diagnosed with any learning disabilities as well as rarely struggling with grades. The patient is currently working full-time as a Literature professor at UC Berkeley, in a large lecture hall and serves as the head of the department for the university. She has been employed as a college professor for 20 years.

Presenting Issue: The patient was diagnosed with heart disease in early 2002; following her diagnosis, the patient has maintained good health. The patient follows-up with regular checkups and maintains a healthy lifestyle. Within the last year, her husband and colleagues have started noticing strange behavior and forgetfulness; beginning with missing a meeting that she conducts annually with the entire literature department. Concerns have arisen since, as she is now showing signs of being predisposed to early-onset Alzheimer’s disease. The patient’s husband describes what he has noticed about her as “abnormally forgetful” and “alarmingly frustrated with the little things”. The patient has consistently denied this, claiming it is a menopausal symptom. She has been experiencing problems with memory loss and regular confusion; sometimes accompanied by anger or mood swings.

Introduction Paragraph

Studies attribute gender differences in AD to the higher lifespan of females, in addition to lesser comorbidity than males (Viña & Lloret, 2010). It has been established that the sex hormones have a considerable impact on the brain and severe inadequacy in some adults may be a risk factor for AD. Elderly women may be more susceptible to suffering greater cognitive disorders all through the aging progression because of the hormonal shortfall. Disordered cognition in patients with heart failure results in considerably more and longer periods of hospitalization, as well as a higher mortality rate. Both heart failure and AD affect mainly adult women and augment the cost of care, which calls for the need to address the connection amid such conditions.

Background Section

Alzheimer’s disease is typified by a continued cognitive and operational decrease. The prevalence of AD also augments considerably with age, from about 0.4% every year at 65 to 69 years of age to approximately 7% at 85 to 89 years (Khundakar & Thomas, 2015). The level of adult women who have AD remains high be it in developing or developed nations. Depression, irritability, nervousness, and other changes in mood and diurnal rhythm are evident in AD diagnosis. Amid the crucial life occurrences linked with chronic stress and depression in adult women is widowhood. Stress-associated situations in such women encompass anxiety, sleeplessness, anger, distress, and reduced self-care.

Literature Review

Article 1

Benoit, M., Berrut, G., Doussaint, J., Bakchine, S., Bonin-Guillaume, S., Frémont, P., & Sellal, F. (2012). Apathy and depression in mild Alzheimer’s disease: A cross-sectional study using diagnostic criteria. Journal of Alzheimer’s Disease, 31(2), 325-334.

Depression and apathy denote the most recurrent symptoms in AD. The major depressive symptoms encompass loss of strength, fatigue, reduced positive impact, or joy in response to cheerful occurrences, and retardation. For apathy, loss of objective-oriented cognition, action, and sentiment is mainly evident. Depression and apathy overlap noticeably, and this may be elucidated by the existence of non-specific symptoms. The requirement for social backing is greater in cases where patients satisfy both diagnostic criteria.

Article 2

Cermakova, P., Eriksdotter, M., Lund, L. H., Winblad, B., Religa, P., & Religa, D. (2015). Heart failure and Alzheimer′ s disease. Journal of Internal Medicine, 277(4), 406-425.

With increased connection involving AD, heart failure, and the impact of aging across the globe, high consideration ought to be centered on the discipline of neurocardiology, an area of expertise that deals with issues of brain and heart. Enhanced comprehension of such concerns might benefit elderly patients through the establishment of effective evidence-based treatment.

Article 3

Sharma, K., & Gulati, M. (2013). Coronary artery disease in women: A 2013 update. Global Heart, 8(2), 105-112.

Coronary artery disease (also referred to as heart disease) is a major cause of death in women and their male counterparts across the globe. The impact of heart disease on women has not been sufficiently addressed attributable to higher occurrences in young men. This establishes that effective treatment of heart disease will greatly benefit both adult women and young men.

Article 4

Viña, J., & Lloret, A. (2010). Why women have more Alzheimer’s disease than men: Gender and mitochondrial toxicity of amyloid-β peptide. Journal of Alzheimer’s Disease, 20(2), 527-533.

The major risk aspects for the development of AD are gender and age where it has been found more frequent in adult women than men, a fact that cannot just be associated with the longer lifespan of females. It has been found that mitochondria from women are more safeguarded against amyloid-β toxicity, lead to less reactive oxygen varieties and discharge less apoptogenic indications when judged against men. To result in a successful finding, more experiments and medical trials are required to establish conditions where estrogenic compounds might be helpful to tackle or treat Alzheimer’s disease.

Article 5

Khundakar, A. A., & Thomas, A. J. (2015). Neuropathology of depression in Alzheimer’s disease: Current knowledge and the potential for new treatments. Journal of Alzheimer’s Disease, 44(1), 27-41.

The treatment for AD has focused on successful antidepressant drug treatment anchored in the monoamine theory of depression. This study creates affluence of pathological information assessing depression in AD and connects that to present ideas on treatment aimed at creating a discussion on possible therapeutic approaches.

Research Project

Discussion

Research Weaknesses/Limitations

The limitation of this study was based on the few pages required which means that just a few articles could be used. This could have affected the reliability of the study compared to a situation where a wider pool of studies was consulted.

Research Strengths

The fact that all the articles employed in the study were peer-reviewed enhanced its reliability and reputation. Moreover, such articles boosted the significance of the research.

Future Research

Future studies should conduct a wider search to ensure that the most important articles in this field are employed in an effort of promoting the implication of the research. This could entail writing more pages to ensure that the work done is comprehensive.

Personal Reflections

The impact of depression and heart failure in AD resulted in the health condition of my grandmother deteriorating greatly before resulting in her death later. Depression in late-life had initially caused deficits in her performance for cognitive functions. I believe that with improved treatment approaches, the cost of care will be greatly reduced and the quality of care for AD patients will improve considerably.

Conclusion

Heart failure and depression in adult women with AD augment the cost of care. There is a need to address such conditions through improved treatment approaches. AD specialists should carry out more experiments to arrive at the most successful treatment.

References

Benoit, M., Berrut, G., Doussaint, J., Bakchine, S., Bonin-Guillaume, S., Frémont, P., & Sellal, F. (2012). Apathy and depression in mild Alzheimer’s disease: A cross-sectional study using diagnostic criteria. Journal of Alzheimer’s Disease, 31(2), 325-334.

Cermakova, P., Eriksdotter, M., Lund, L. H., Winblad, B., Religa, P., & Religa, D. (2015). Heart failure and Alzheimer′ s disease. Journal of Internal Medicine, 277(4), 406-425.

Khundakar, A. A., & Thomas, A. J. (2015). Neuropathology of depression in Alzheimer’s disease: Current knowledge and the potential for new treatments. Journal of Alzheimer’s Disease, 44(1), 27-41.

Sharma, K., & Gulati, M. (2013). Coronary artery disease in women: A 2013 update. Global Heart, 8(2), 105-112.

Viña, J., & Lloret, A. (2010). Why women have more Alzheimer’s disease than men: Gender and mitochondrial toxicity of amyloid-β peptide. Journal of Alzheimer’s Disease, 20(2), 527-533.

Background and Clinical Question

Since the threat of acquiring specific disorders or diseases becomes higher with age to a pronounced degree, it is essential to consider causes, key stages, and treatment options for various health issues and complications in senior citizens. Alzheimer’s disease is perhaps the most notorious and common disorder in older adults (Santos et al., 2017). Thus, it is crucial to study the factors that affect the development and progress of AD, CVD being one of them. At present, the clinical question is stated in the following way: in elderly patients with AD, how do CVD-related prevention measures affect the success of the treatment compared to no CVD-associated measures?

Experience

The overall experience of searching for the required sources can be described as positive. With a set of clear and concise search terms, I managed to locate the required resources quite fast. Since I was comfortable with the research topic and the search process, in general, I did not need the assistance of a librarian. In the course of the search, I used databases such as Google Scholar and ResearchGate.

Review

The connection between CVD and AD might seem as not quite evident, yet there are indications that CVD increases the risks of AD progress and aggravation. In their study, Santos et al. (2017) specify that there is a tangible link between the AD and CVD. While the design of the study involves a review of the existing papers and a compilation of their key results, the information provided by the authors is nonetheless crucial to the understanding of the issue. The research design, which allowed embracing the latest discoveries concerning AD and CVD, can be seen as the key strength, while the lack of precision in research results is the main weakness.

When considering the effects that the instances of CVD have on patients with AD, one should explore the problem of depression and the general aggravation of patients’ mental condition. Due to the increasingly complex issues affecting patients’ quality of life, problems associated with their mental health may be the outcome (Peuler, 2018). Therefore, an in-depth analysis of the issue is required.

Significance

Determining the effects that the current approach to managing the needs of patients with Alzheimer’s is critical to the improvement of the quality of their lives. Therefore, determining the probability of AD patients developing CVD is essential to the efficacy of treatment. Although suppressing the effects of Alzheimer’s completely is impossible at present, reducing the negative impact of the disease as it progresses and assisting patients in retaining their cognitive functions for a significant period of time is a possibility. For these reasons, identifying the tools that will assist this vulnerable group in alleviating their current situation and assisting them in managing their condition is a critical objective.

References

Peuler, J. D. (2018). Resveratrol’s potential in the adjunctive management of cardiovascular disease, obesity, diabetes, Alzheimer disease, and cancer. Journal of the American Osteopathic Association, 118(9), 596-605. doi:10.7556/jaoa.2018.133

Santos, C. Y., Snyder, P. J., Wu, W. C., Zhang, M., Echeverria, A., & Alber, J. (2017). Pathophysiologic relationship between Alzheimer’s disease, cerebrovascular disease, and cardiovascular risk: A review and synthesis. Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring, 7, 69-87. doi:10.1016/j.dadm.2017.01.005

Getting older, many people face problems associated with memory and concentration. Such changes are often considered normal and are discussed in the framework of aging when they do not affect the level of function adversely. Nevertheless, many representatives of the elderly deal with memory loss that prevents them from living independently and happily. In the majority of cases, Alzheimer’s disease turns out to be the cause of this problem. It is a slowly progressive illness that affects human brain and leads to dementia. In this way, issues with memory are eventually accompanied by language and perception problems. Even though Alzheimer can be associated with genetic risks, it is mainly connected to aging. That is why increased age is a reason to start utilizing preventive measures. The symptoms of this disease can be of different severity while its causes remain unknown, which proves that additional attention should be paid to it.

Vulnerable Population and Causes

Alzheimer’s disease can be caused by different risk factors, but in the majority of cases, it is associated with aging. One in five people who are older than 65 years old suffers from this health issue while about 30% of people who are over 85 years old are affected by it (Galimberti & Scarpini, 2013). In order to protect these individuals from the possibility of facing negative consequences of Alzheimer’s disease, professionals developed various treatments. However, they do not seem to be rather effective because the number of affected older adults fails to minimalize.

Even though Alzheimer’s usually affects people over 70 years of age, it can also be found in those who are about 40-50 years old. In these cases, inherited gene mutations are considered (Farinde, 2012). Professionals usually pay attention to apolipoprotein E when they consider that a patient is likely to belong to this population. According to other studies, the levels of estrogen may affect the risk of having Alzheimer’s (Chhibber & Zhao, 2014). In this way, elderly women are considered to be at a higher risk of developing this disease. However, professionals still reveal their doubts considering the last two causes of Alzheimer’s, which means that aging is the only risk factor that can be definitely discussed.

Symptoms and Consequences

Alzheimer’s disease develops slowly, so those older adults who experience some of its symptoms have an opportunity to contact a healthcare professional in order to obtain required assistance. In particular, attention should be paid to the ability to perceive and memorize information (Boyle et al., 2012). If associated problems are observed, an older person can ask repetitive questions or start one and the same conversations several times. He/she can put things in different places and forget their location. In this way, one can not only miss some appointments but also get lost being next to his/her home. Reasoning and judgment can also be affected because of Alzheimer’s disease (Boyle et al., 2012). In this way, an older adult can hardly understand safety risks or make well-developed decisions. He/she cannot cope with multiple activities and manage personal finances. Visuospatial abilities can also be affected (Quental, Brucki, & Bueno, 2013). The elderly may not recognize familiar faces and items or use ordinary tools, such as clothes. Personality and behavior can also alter, which leads to mood changes and unacceptable actions.

An acute form of Alzheimer can be indicated if a person’s condition worsens daily, but generally, its progression is divided into several stages (Delrieu, Piau, Caillaud, Voisin, & Vellas, 2011). The first one occurs before any symptoms can be perceived. The second one starts with the mild impairment. The third one presupposes the beginning of dementia. Unfortunately, this disease is not usually diagnosed before the mild decline is observed because of the absence of a single test. As physicians need to focus on signs and symptoms to develop this diagnosis, they fail to find Alzheimer’s at the first stage. Nevertheless, the focus on medical history, neurological function, blood and urine tests, cognitive and memory tests, as well as MRI, make it easier to reveal if an aged person has Alzheimer’s (Delrieu et al., 2011).

Coping

The death of brain cells causes all those symptoms that are observed in patients with Alzheimer’s disease. Unfortunately, there is no cure for this process, but several therapeutic interventions can make the life of the elderly who are affected by this disease easier. For instance, drug therapy can be rather advantageous for the reduction of Alzheimer’s symptoms (Delrieu et al., 2013). Cholinesterase inhibitors can be used to increase the amount of chemical neurotransmitter that reduces because of this illness. Cognitive rehabilitation may be advantageous, but its effects are rather limited because the brain is affected anyway. Increased social interaction and engagement in enjoyable activities can enhance the quality of life. Psychiatric symptoms may be treated with standard medication. Nevertheless, the prognosis for the elderly with this healthcare issue is not positive because it cannot be cured.

Gaps in Literature

Unfortunately, information about Alzheimer’s that is currently available has numerous gaps because of the lack of research. It would be advantageous if the causes of this illness were revealed in detail, describing why some older adults start suffering from this disease while others manage to live normal lives. More information about prevention and the possibility of early diagnosis would be helpful, as it can reduce the number of affected older adults. Finally, the ways to minimalize adverse effects of Alzheimer’s and additional possibilities to enhance the quality of life should be discussed.

References

Boyle, P., Yu, L., Wilson, R., Gamble, K., Buchman, A., & Bennett, D. (2012). Poor decision making is a consequence of cognitive decline among older persons without Alzheimer’s disease or mild cognitive impairment. PLoS One, 7(8), e43647.

Chhibber, A., & Zhao, L. (2017). ERBeta and ApoE isoforms interact to regulate BDNF-5-HT2A signaling and synaptic function in the female brain. Alzheimer’s Research & Therapy, 9, 2-10.

Delrieu, J., Piau, A., Caillaud, C., Voisin, T., & Vellas, B. (2011). Managing cognitive dysfunction through the continuum of Alzheimer’s disease: Role of pharmacotherapy. CNS Drugs, 25(3), 213-226.

Farinde, A. (2012). Exploring Alzheimer’s disease (Alzheimer’s type dementia). The Pharma Innovation, 1(10), 33-46.

Galimberti, D., & Scarpini, E. (2013). Progress in Alzheimer’s disease research in the last year. Journal of Neurology, 260(7), 1936-1941.

Quental, N., Brucki, S., & Bueno, O. (2013). Visuospatial function in early Alzheimer’s disease—the use of the visual object and space perception (VOSP) battery. PLoS One, 8(7), e68398.

Prevalence

The estimated global prevalence of Alzheimer’s disease (AD) is 50 million and is projected to triple by 2050 due to growth in the older generation (Khoury, Patel, Gold, Hinds, & Grossberg, 2017). In the US, the number of people with Alzheimer’s dementias in 2018 stands at 5.5 million – 81% of them are aged over 75 years (Alzheimer’s Association, 2018). Age is a risk factor in AD onset; the older generation (>65 years) is the most affected. Its prevalence across the ages is 4%, 16%, 44%, and 36% for the <65, 65-74, 75-84, and 85+ years cohorts, respectively (Alzheimer’s Association, 2018).

Burdensome Disease

Alzheimer’s disease is associated with high morbidity and mortality, especially in older generations. According to Alzheimer’s Association (2018), AD is the fifth-ranking killer of persons in the >65 years age cohort in the US. Mortality often results from pneumonic complications in older patients. Further, affected individuals have to endure ill health for a long time before succumbing to AD-related complications. AD is ranked 12^th leading burdensome conditions in the US, up from 25^th in 1990 (Alzheimer’s Association, 2018). The lifetime cost of caring for an AD patient (including long-term care) is about $341,840 (Alzheimer’s Association, 2018).

Strategies for Preventing Alzheimer’s Disease

Evidence suggests that dietary modifications can delay cognitive deterioration. The Mediterranean diet comprising “fruits, vegetables, and fish” improves general mental functioning, memory, and language (Rakesh, Szabo, Alexopuolos, & Zannas, 2017, p. 126). This nutritional style is even more effective when combined with the Dietary Approach to Systolic Hypertension (DASH). Other nutrients that reduce the risk of AD are omega-3 fatty acids, folate, magnesium, and vitamin B 12 and vitamin D supplementation (Rakesh et al., 2017). Physical activity – aerobic exercise or fitness training – is also linked to improved cognitive function. Amelioration of psychological stress factors can improve cognitive function as well. Strategies such as exercise, sleep, and anti-inflammatory medication can reduce inflammatory responses that result in AD onset (Rakesh et al., 2017).

References

Alzheimer’s Association. (2018). 2018 Alzheimer’s disease facts and figures. Web.

Khoury, R., Patel, K., Gold, J., Hinds, S., & Grossberg, G. (2017). Recent progress in the pharmacotherapy of Alzheimer’s disease. Drugs & Aging, 34(11), 811-820. Web.

Rakesh, G., Szabo, S. T., Alexopoulos, G. S., & Zannas, A. S. (2017). Strategies for dementia prevention: Latest evidence and implications. Therapeutic Advances in Chronic Disease, 8(8), 121-136. Web.

Introduction

Alzheimer’s disease is defined as an unalterable, progressive brain disorder linked to changes in nerve cells which lead to the death of brain cells. Aging on the hand can be defined as the accumulation of different harmful changes in the tissues and cells that raises the possibility of disease and death. Dementia is mainly caused by Alzheimer’s disease and is mainly experienced in the brain. Alzheimer’s disease is typified by intra-neuronal fibrillary tangles, cell loss and plaques which are typical characteristics of the aging process. Alzheimer’s disease is diagnosed in adults of any age but common among persons aged above 65 years. Almost 77% of the people with Alzheimer’s disease are age above 75 years. (Rosenthal et al, 2001)

Ageing always result in changes in the cognitive abilities which consists of changes in the memory and other intellectual functions and the magnitude of the change varies widely. “At its early stages, Alzheimer’s disease is characterized by the inability to recall things observed recently” (Hayflick, 2000). As the disorder progresses, the symptoms also advances to include loss of memory for longer periods of time, changes in moods of the victims, confusion and the victim also tends to avoid people due the decline in their senses (Hayflick, 2000).

How has current research in Alzheimer’s disease advanced our understanding of the aging process?

Alzheimer’s disease which is a neuro-degenerative disorder is costing a lot to the society and as the number of persons aging increases, these costs also increases. The number of young people working is low and this result in less economic support to the increasing aging population. Alzheimer’s disease robs the community of wisdom and expertise as well as the deprive one of his/her sense of self (Tanzi, 2005). The disease is also a serious type of weakness which is characterized by the disorders in memory, continual and perceptional abilities and cognitive functioning. The high cost of neuro-degenerative illnesses amongst the middle-aged adults’ calls for immediate detection and treatment of the disorder as it is difficult to assess the effects of this disorder at later stages especially when one is very old. (Rosenthal et al, 2001)

The process of Alzheimer’s disease development takes three stages with early stages appearing amongst the young persons, while the more advanced symptoms appear amongst the old population. The formation neuro-fibrillary tangles which is a characteristics of Alzheimer’s disease is said to be dependent on the ageing process while dementia development is associated with the continuation of intra-neuronal changes (Hayflick, 2000).

Aging unlike disease occur in an individuals after a given period of time, it occurs in all the species after the age of reproduction and occurs also in animals removed from the wild by people even if it had never experienced ageing.

Research on Alzheimer’s disease has cleared the misunderstanding that was there between aging and age-related diseases and this notion had been an obstacle to funding of research related to the aging process as everybody believed that there is no one who can die from aging. Many people belief that old people die after suffering from a disease yet such deaths are caused by diseases which are brought about by old age. (Hayflick, 2000).

The findings, published in the April 12^th 2009, issue of the News Wise indicates that development of Alzheimer’s disease is mainly associated with age and that people aged above 65 years are the major victims of the disorder and the number is increasing after every five years. In developed countries, highest number of deaths is reported from the elderly people. Research on Alzheimer’s disease can help determine what causes death in the absence of diseases. From the research, it was found that such deaths resulted from extreme loss of physiological capacity resulting from increasing disfunctioning of essential organs in the body (News Wise, 2009).

Conclusion

The study of age-related disorders and manipulation of biological development at early stages of life has dominated the field of aging research. This has been attributed by the research done on Alzheimer’s disease which is linked to aging. Funding of research related to aging has now improved as statics show that the population of the aged has increased tremendously. The research has also provided ways of dealing with age related disorders apart from Alzheimer’s disease The re research has helped in dealing with other disorders related to old age and this has increased the population of the aged (Hayflick, 2000).

References

Hayflick, L., (2000).Longevity Determination and Aging, Nature. Cambridge: Cambridge University Press. 408, 37-39.

News Wise. (2009).Delaying The Aging Process Protects against Alzheimer’s. 5th St. SW, Suite 100, Charlottesville VA 22903. Web.

Rosenthal, R., Zenilman, M. and Katlic, M. (2001).Principles and Practices of Geriatric Surgery. New York, NY, Springer-Verlag.

Tanzi, R. and Bertram, L. (2005).Twenty Years of the Alzheimer’s disease. Amyloid Hypothesis:A Genetic Perspective. Harvard Medical School. 120(4):545–555.

Attention Getter

Alzheimer’s disease is one of the leading causes of death in the United States, accounting for more than 70% of dementia cases in the country, and it currently affects about 500,000 people in the United Kingdom. Most people suffering from Alzheimer’s disease are above 65 years old, and around 6% of patients experienced the early onset of the disease between the age of 40-60 years (Cummings, Isaacson, Schmitt, & Velting, 2015).

Thesis Statement

Despite the fact that there is no effective treatment for Alzheimer’s disease, scientists discovered that dancing could help reduce the severity of the disorder as this activity involves simultaneous brain functioning, which helps to affect damaged nerve cells in the brain and predict the cognitive decline.

Introduction

Alzheimer’s disease is one of the dementia types that affect older people’s memory, thinking, communication, and behavior. Possible causes of this disorder are the death of brain cells. Symptoms progress slowly, they become chronic, and at the last stages, people’s cognitive function becomes greatly affected, preventing them from carrying out daily routines (Byrd, 2014). Although there is no complete cure for the disease, social dancing is viewed as a therapy for activating the cerebral cortex and hypothalamus, enabling their cells to regenerate.

What Is Alzheimer’s Disease?

• Alzheimer’s disease is a specific neurodegenerative disorder that is known for causing dementia, and it results in memory loss and problems in thinking, communication, and problem-solving (Wolfe, 2016).
• The disease specifically leads to the inadequacy of essential chemicals, which are responsible for transmitting signals in the brain, performing their functions, and connect nerve cells (Klimova & Kuca, 2015).
• Most people who have Alzheimer’s disease are over the age of 65, although younger people can also suffer from the disease (Cummings et al., 2015). This disorder is progressive, which means the failure of cognitive performance develops gradually, and more symptoms develop as the brain damage increases.

What is the Cause of Alzheimer’s Disease?

• Alzheimer’s disease results from the accumulation of proteins in the brain, forming some plaques that cause synaptic and neuronal impairments or the breakage of links between nerve cells (Klimova & Kuca, 2015).
• The actual cause of Alzheimer’s disorder is not found, but scientists agree that the disease affects brain performance and psycho-behavioral function.
• People with Alzheimer’s disease live about five years after diagnosing the disorder, but physical exercising and social dancing can contribute to improving the state (Wolfe, 2016).

Is Dancing a Cure?

• Currently, Alzheimer’s disease cannot be treated completely, but research projects to develop effective interventions are organized in different countries.
• Dancing is a physiotherapy treatment that facilitates the neuroplasticity of the brain. The reason is that dancing requires quick decision-making that leads to the development of new neural pathways (Klimova & Kuca, 2015).
• Similar to physical exercising, dancing trains the body and brain. However, what is more important is that dancing stimulates different brain functions, including thinking, kinesthetic function, social function, and emotions (Poirier & Gauthier, 2014).

Summary

Alzheimer’s disease usually affects people who are aged 40-60 years old. Memory loss, difficulties with thinking, decision making, and problem-solving are among its typical symptoms. The brain disorder starts slowly but progresses to cause cognitive decline. No effective cure exists for the disease, but dancing is viewed as a physical activity that can relieve its symptoms.

Memorable Statement

In spite of the fact that no treatments are discussed as effective enough to address Alzheimer’s disease, dancing is an easy way to slow down its progress, make patients happier, and contribute to their social interactions.

References

Byrd, L. (2014). Alzheimer’s disease: Prevention strategies and ways to slow progression. New York, NY: Pesi Incorporated

Cummings, J. L., Isaacson, R. S., Schmitt, F. A., & Velting, D. M. (2015). A practical algorithm for managing Alzheimer’s disease: What, when, and why? Annals of Clinical and Translational Neurology, 2(3), 307-323.

Klimova, B., & Kuca, K. (2015). Alzheimer’s disease: Potential preventive, non-invasive, intervention strategies in lowering the risk of cognitive decline–A review study. Journal of Applied Biomedicine, 13(4), 257-261.

Poirier, J., & Gauthier, S. (2014). Alzheimer’s disease: The complete introduction. Toronto, Canada: Dundurn.

Wolfe, M. S. (Ed.). (2016). Developing therapeutics for Alzheimer’s disease: Progress and challenges. New York, NY: Academic Press.

Caregivers for Alzheimer’s disease are family, people, and friends. Paid worker’s assistance is also necessary to ensure that Alzheimer’s patients do not interfere with the busy school and work schedules of the family members. Determination of whether Alzheimer’s patients need to be at home is very necessary for evaluating the kind of care and attention that they receive from the family people. Most Alzheimer’s patients get their attention from informal caregivers who can be both men and women (LDBiondo –wood and Harber, 2006).

Alzheimer’s disease affects the brain and all the nerves in the body. The disease develops gradually and is said to be a disease of the old because it relates to the inability to remember. Failure to think and carry out consciousness, the mental process is not possible, and these are the main symptoms of Alzheimer’s disease. Inability to perform tasks, behavior changes, and rigidity at the social level can also be associated with Alzheimer’s disease (AD). Dementia results from AD, and the victim may die. Alzheimer’s victims have poor memory and other mental inabilities, which cause confusing behavior. Living with such people at the basic social unit, the family, may not be easy. Family caregiving advice and tips are necessary to deal with the effects of Alzheimer’s disease.

Family members diagnosed with Alzheimer’s disease live for less than ten more years and not more than twenty years. Their siblings, parents, or relatives consider them to be waiting for death. Alzheimer’s victims develop a negative attitude in life and may be focused on their conversations. They may feel rejected, and this results in self-isolation. The victim’s next of kin may not want to take advice from others, and this worsens the victim’s behavior. The unusual and confusing behavior makes the patients not be received well by other members of the family. Misunderstanding arising from an inability to remember makes communication to be impossible. Alzheimer’s patients do not have the self-confidence to express them, which causes neglect and dejection by the family members (LDBiondo –wood and Harber, 2006).

In the early stage of Alzheimer’s, individuals are not able to manage their funds properly. Unwise use of money may be costly in the long term. Victims with dependants will not have an easy time. Dependants need the Alzheimer victim’s resources for their daily basic needs, school fees, and investments or saving. The victim may not plan for his or her money wisely, given that he/she just about to pass away. Quarrels, disagreements, and disappointments will be the order of the day at the households level.

Alzheimer’s victims do not want to be part of social institutions. The victims lack interest or energy and are unwilling to take action. Family members may not give a nice reception to the rest of the siblings, parents, and relatives—lack of cooperation at the family level results in isolation. Alzheimer’s patient’s apathy is the main impact of the disease at the family level.

Repetition of questions, statements, and answers by Alzheimer’s victims is a barrier to effective communication with other family members. Lack of adequate and sufficient passing of information is unusual behavior, and other family members need caregiving knowledge, skills, and techniques to address the issue. Time may be limited for them to seek relevant caregiving tips, and the victims may not understand why (Shawn C, 2006).

Failure to recognize family members and friends by Alzheimer’s victims causes trouble. Family members are stressed and depressed by watching their loved members have a health deterioration caused by Alzheimer’s. Provision of a comfortable environment is not easy due to busy work and school schedules. Learning about AD by other family members may take time, causing a delay in good caregiving. Emotional, financial, and legal support may not be available due to the misunderstanding of the condition by caregivers.

Alzheimer’s in the middle stage destroys the capability to be focused and have long-term objectives, which results in different patterns of thought among family members. Respite care for the victims may be neglected due to the focus on giving attention to young members of the family.

In the end-stage, family members may not give adequate placement facilities due to the expensive nature of the condition. The brain is a very useful organ, and any disturbances caused will ruin a victim’s world, which starts at the family level (Carter, 2007).

References

1. 1. LDBiondo –wood and Harber (2006) Nursing research Methods and Critical appraisal for Evidence based 6^th edition P.g 30-46 Willey. New York
   2. Carter (2007) Family Care giver alliance. Web.
   3. Shawn C (2006) Long-term Care Placement of Dementia Patients and care giver. Health and well being pp. 1-2. Willey. New York

The Alzheimer’s disease article I examined was titled Alzheimer’s disease (AD) – Like pathology in Aged Monkeys after Infantile Exposure to Environmental Metal Lead (Pb): Evidence for a Developmental Origin and Environmental Link for AD. The authors of this article are affiliates of various universities including University of Rhode Island, Kingston; university of Montana, Missoula; National Institutes of Health, North Carolina; Mine department of Health and Human Services, Augusta; and Indiana University School of Medicine, Indianapolis. This study shows that environmental hazards, in this case lead, increase the risk of developing Alzheimer’s disease and that the development period is crucial for determining future vulnerability to neurodegeneration and Alzheimer’s disease. The last figure in this article, figure 6 illustrates a model of the adverse effects of lead on SP1- mediated expression of APP. Part A shows a normal DNA function; part B shows the partial effects which are insufficient to alter gene activity; and part C demonstrates normal changes of development, maturity and aging which lead to stimulation of SP1 regulatory alterations and the subsequent effects on the gene activity.

This guideline is called Guideline for Alzheimer’s disease management. This guideline was derived from California Workgroup for Alzheimer’s disease Management September 2008. The guideline seeks to facilitate a comprehensive care delivery for patients suffering from Alzheimer’s disease and their caretakers, by Primary Care Practitioners (PCPs). Moreover, the guideline is focused on Alzheimer’s disease patients. The guideline takes into consideration six major outcomes including mortality, cognitive level, functional level, incidence of abuse and neglect, adoption capacity of families and care providers, and the rate of disease progression.

The clinical trial for Alzheimer’s disease was called Alzheimer’s disease Anti-inflammatory Prevention Trial (ADAPT). This study was sponsored by the National Institute on Aging (NIA) in collaboration with the Department of Veterans Affairs of the University of Washington and john Hopkins University. The trial had been completed by the time this clinical trial was updated, which was on 20 September, 2007. This trial was base on Alzheimer’s disease in which interventions drugs like Naproxen Sodium and Celocoxib were employed in the study. This trial was a Phase III study. The participants eligible for this study were individuals who were at high risk of developing the disease, persons who are of any gender and above age 70. Another qualification includes a healthy individual with family history of the condition or family member has or developed severe age related memory loss, Alzheimer’s disease, senility, or dementia. Also, the participant must be fluent in written or spoken English. Also, should be willing to restrict use of vitamin E, non-aspirin NSAIDs, corticosteroids, analgesics, Histamine antagonists, or anti-inflammatory. Again, should be accepting to meet full participation of the study, and should provide informed consent of the trial. Moreover, the subject should not have a history of peptic ulcer; disease of the kidney or liver; history of allergy to aspirin, ibuprofen, naproxen, celecoxib or other NSAIDs; should not be on anticoagulants; not be a victim of dementia; or have alcohol dependence. The trial was conducted in various institutions including Sun Health Research Institute, Roskamp Institute Memory Clinic, Johns Hopkins University, Boston University School of Medicine, university of Rochester, and veterans’ affairs Puget Sound health care system, university of Washington. In these six locations the trial will aim to recruit a maximum of 700 participants. This trial was based on the sufficient evidence of the role of inflammation in the neurodegenerative process of Alzheimer’s disease (AD0. Because of the hypothesis that Non Steroidal Anti-inflammatory Drugs can reduce onset of AD, the ability of celecoxib and Naproxen to reduce the onset of AD were assessed in this clinical trial. From the guideline I discern that Alzheimer’s is a terminal disease and increases the risk for other adverse conditions such as functional and cognitive impairment. Thus patients with Alzheimer’s disease are eligible for palliative care.

Introduction

Environment can have many effects on a person living with an illness. Alzheimer ailment is a permanent and progressive brain disease that tampers with the memory and thinking ability. It affects people of all education, cultural and financial environments. It is the major basis of dementia in grown-ups. Dementia is memory loss and intellect interfering with everyday activities and existence (Weiner & Lipton 2003). Researches have maintained that is not a disease but rather, signs coming collectively with some ailments and situations. Other signs include agitation and depression (Weiner & Lipton 2003). Dan has been living with the illness for several years now. Following an interview, it is discovered that he becomes agitated at the noise coming from. This interview will help establishing the effects of environment on Dan who is living with Alzheimer disease.

Background history

In the 18^th Century, the word dementia was being used in hospitals. It referred to psychological inability regardless of period, reversibility and pathological backgrounds. Dementia was later identified as cognitive paradigm in the 19^th century. In the 1980s, delusions and hallucinations were added as signs of the disease (Weiner & Lipton, 2003). In 1906, a collection of brain cell abnormalities were identified as a disease by Doctor Alois Alzheimer. This was after one of his patients had died due to memory complications. There have been many breakthroughs in AD research after more than 100 years since the discovery. Researches in the 1960’s show a link between cognitive reduction and the number of ailments in the brain. This is when Alzheimer was identified as a disease. Drugs to cure cognitive symptoms of Alzheimer were approved after more research was done on Alzheimer disease genes (Weiner & Lipton 2003).

Dan’s occupational history

Examining Dan’s case, from the interview, it is established that he has worked with different companies in the UK. He worked for long hours and up to an overtime of 100 hours in a month. Day offs were minimal and his job was very demanding. Workers were humiliated in front of others whenever their productivity failed to meet the expectations of the boss. Some workers even collapsed and died in their work place. Facing these conditions meant the workers had to be very strong-hearted, since there was no occupational therapy. These jobs required enough motivation and therapy if Dan was to measure up. Dan has also disclosed that he takes pleasure in driving alone. He rarely undertakes any exercises and he does not participate in any sports activity.

Theoretical perspective

Occupational Therapy Practice Framework can be developed to make interventions in Dan’s conditions. This involves use of therapy in promoting the heath and participation of Dan in different activities. It emphasizes the interaction between a person, occupation and the environment where one resides, works and plays. In regard to Person-Environment Occupational Model, environment should be considered not from the interactive view but on transactive approach (Zgola, 1998). A transactive approach presupposes interdependence of an individual and the surrounding. Ones activities are influenced and are inseparable from background influences. A person’s situation changes as the environment changes. To help study the relations between individuals and the surrounding, a few taxonomies have been generated.

Environmental factors can be physical and also psychological. The psychological factors comprise social factors, for instance family approaches and government. Environment issues are categorized by the occupational therapy guidelines as cultural, economic and social factors (Zgola, 1998). Occupational therapy on environment revolves ensuring a patient is kept in an environment with minimal stress. Each environmental issue has its own different effects on a patient suffering from Alzheimer. Some changes should be made on the environment where patient living with Alzheimer lives (Moore & Marans, 1997). Examples of these transformations include; Painting with light and solid colors to avoid confusion, enhancing enough lighting in all areas of the house, getting rid of all cover mirrors, avoiding aggressive or upsetting TV programs. In addition, spoilt food should be disposed off, unused rooms closed, and keys kept away to avoid the patients from locking themselves in the house.

Slippery floors in the bathroom, toilet, and sitting room and in the kitchen should be avoided. Electrical appliances should be cleared from the floor while the water heaters should be set at recommended temperatures. In the bedroom, monitoring devices should be installed to notify when the patient is out of bed. In the kitchen, knives, blades, scissors and drugs should be locked up in drawers. Loud music and noise should be avoided within the environment (Moore & Marans 1997). Regarding to Dan, the environment has many impacts on his condition. Any loud noise that comes near him agitates him immensely. Running away, biting and banging his head on walls. These interventions will theretofore help avoid such occurrences.

Changes made on the Environment to enhance occupational engagement

The environment changes play a big role in ensuring that a patient with Alzheimer disease does not experience difficulties living around his home. Any difficulties can expose Dan to disease recurrence. Patients should be guided depending on the occupational exercises that interest them. Patients should be advised to make changes in the environment where they live.

Social Environment

• Advice them to hire drivers or to never drive when they are alone
• Take them for special outings
• Look for someone who will always take care of them.

Physical Environment

• Avoid wearing skid shoes or sneakers.
• Minimize windows opened to avoid seeing shadows and reflections.
• Change the lighting system in his house
• Paint the walls in light colors.
• Avoid noisy environment. For example listening to loud music and watching movies at the same time

Conclusion

Managing and supervising Alzheimer disease is challenging. Environmental changes are indeed recommendable, rather than medication. In some instances, medication cause more harm than benefit. Changing the environment to favor a patient with Alzheimer illness reduces physical and mental harm, for instance in the case of falls, shadows, hallucinations and agitation. Alzheimer patients, such as Dan should therefore be offered environmental and social interventions to help them cope with the disease.

References

Moore,G.T. & Marans, R.W. (1997) Advances in Environment, Behavior, and Design: Vol. 4: Toward the Integration of Theory, Methods, Research, and Utilization NY: Springer.

Weiner,M.F. & Lipton, A.M.(2003). The dementias: Diagnosis, Treatment, And Research. CA: American Psychiatric Pub.

Zgola,J. (1998). Alzheimer’s disease and the home: Issues in environmental design. Vol.5(3) 15-22.