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The present study examines the case of Mr. Akkad who exhibits alarming symptoms. He is 76 years old and of Iranian origin, and his family reports unusual behavior on behalf of the patient. Mr. Akkad exhibits strange thoughts and behaviors that are not typical for him. Moreover, he has been less enthusiastic in regard to the family’s engagement in community’s religious activities. The onset of the symptoms is reported to have been within the past two years, but the situation has begun to deteriorate, prompting Mr. Akkad’s relatives to refer him to a medical institution for consultation. The reported condition also comprises difficulties with speech and selecting the optimal phrasing in day-to-day situations, often changing the line of conversation without an objective stimulus.
In terms of the personality, Mr. Akkad is cooperative and pleasant, actively engaging in the clinical discussion. He does not exhibit any anti-social behavior, remaining clearly interested in the interaction with other people. However, the memory testing procedure reveal certain confabulations with primary deficits in orientation, registration, attention, and calculation. Based on the 18 point out of 30 in the Mini-Mental State Exam, the possibility of moderate dementia is serious. At the same time, Mr. Akkad does not show any unusual motor movements or tics, remaining in euthymic mood. The patient reports no hallucinations, neither visual nor auditory, and the professional examination does not reveal any major signs of delusion or paranoia. Mr. Akkad remains aware of most of his surrounding, including the people. His place orientation is partial, but there are major time and event disorientations.
Diagnosis
Overall, the condition of Mr. Akkad may be alarming, as the onset of difficulties with speech and place-time orientation points toward the development of a major neurocognitive disorder. Such a condition is likely to have been caused by an early stage of Alzheimer’s disease. Crous-Bou et al. (2017) refer to it as “a healthcare burden of epidemic proportions for which there is currently no cure” (para. 1). More specifically, the development of Alzheimer’s disease (AD) is associated with the continuous aging process within the population, as the condition is prevalent among older residents. From a clinical perspective, AD is often associated with a long asymptomatic period that leads to mild and moderate stages of dementia (Crous-Bou et al., 2017). According to Rasmussen and Langerman (2019), Alzheimer’s remains the primary cause of dementia among older adults, becoming an inevitable and irreversible consequence of aging.
The case of Mr. Akkad corresponds with the aforementioned characteristics of AD. The patient exhibited certain abnormalities across two years before the family found the situation alarming. Being an older adult, Mr. Akkad gradually developed minor symptoms that did not become obvious until the onset of dementia and an AD-conditioned neurocognitive disorder. In this case, the asymptomatic stage of Alzheimer’s disease appears to have lasted for at least two years before the condition of the patient deteriorated. At the current point, Mr. Akkad is on the verge of irreversible mental transformations that mark an advanced stage of AD.
Treatment
Considering the magnitude of the situation, medical experts, scholars, and practitioners remain in the search for effective treatment procedures. As of now, contemporary medicine does not have a cure for Alzheimer’s disease, aggravating the impact of it on society. According to Maliszewska-Cyna et al. (2017), the damaging effect of AD is determined by the severe neuronal degradation, cognitive decline, and development of vascular pathology. The combined effect of these factors entails a gradual onset of dementia and delirium that impair the patients’ normal functioning. As a result, they become incapable of self-care, exhibiting major difficulties in all aspects by the end of life. Accordingly, the majority of existing interventions aim at mitigating the severe symptoms of AD, mainly through pharmacological treatments. As such, the objective of Alzheimer’s-related procedures is to preserve the main cognitive and social functions of an individual for the longest period possible.
The case of Mr. Akkad is not yet severe, as he remains in transition from the asymptomatic stage of the disease. In his situation, alleged AD has a limited impact on his day-to-day life, but the clinical experience suggests a possibility of the short-term deterioration. Thus, the correct treatment plan is to be executed within a similar timeframe to preserve the patient’s cognitive functioning to the maximum extent. In this regard, Kim et al. (2017) discuss the benefits of donepezil and it early use in AD treatment and prevention of complications. According to their research, this medication has a serious potential of a neuroprotective agent when administered early and continuously. It engages the protective mechanisms that are independent of cholinesterase inhibition, coping with AD’s symptoms for early stages without unnecessary complications. More specifically, the use of donepezil is not associated with glutamate toxicity or ischaemia (Kim et al., 2017). Thus, the use of five milligrams of donepezil-based medication (Aricept) at bedtime appears to be a viable solution for the case of Mr. Akkad.
References
Crous-Bou, M., Minguillon, C., Gramunt, N., & Molinuevo, J. L. (2017). Alzheimer’s disease prevention: From risk factors to early intervention.Alzheimer’s Research & Therapy, 9. Web.
Kim, S. H., Kandiah, N., Hsu, J. L., Suthisang, C., Udommongkol, C., & Dash, A. (2017). Beyond symptomatic effects: Potential of donepezil as a neuroprotective agent and disease modifier in Alzheimer’s disease.British Journal of Pharmacology, 174(23), 4224-4232. Web.
Maliszewska-Cyna, E., Lynch, M., Jordan Oore, J., Michael Nage, P., & Aubert, I. (2017). The benefits of exercise and metabolic interventions for the prevention and early treatment of Alzheimer’s disease. Current Alzheimer Research, 14(1), 47-60.
Rasmussen, J., & Langerman, H. (2019). Alzheimer’s disease – Why we need early diagnosis. Degenerative Neurological and Neuromuscular Disease, 9, 123-130. Web.
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