Alzheimer’s disease is the most common cause of dementia in elderly individuals. Currently, 4.5 million people in the United States approximately have Alzheimer’s disease. (Burns) Alzheimer’s disease presents the victim with a sharp decline in memory, language, visuospatial perception, executive functioning and decision-making. Because this disease is so harsh on people’s personality, behavioral and psychiatric symptoms are frequently present in Alzheimer’s disease. The impact Alzheimer’s disease has on health care is significant and estimated to cost $100 billion dollars per year and predicted to rise as it is a demand to find new medication and the number of Alzheimer’s disease individual rise. (Burns) There is medication available, however there is currently no cure, the medications that are given have symptoms that do not alter the negative progression of the disease.
Alzheimer’s disease is defined as progressive, degenerative disorder that attacks the brain’s nerve cells and neurons resulting in a loss of memory, thinking, language skills, and behavioral changes. (Burns) Alzheimer’s disease is characterized by cognitive dysfunction, psychiatric symptoms, behavioral disturbances, and difficulty performing daily activities. Alzheimer’s disease is currently the 6th leading cause of death in the United States and presently 4.5 million Americans are living with it. Alzheimer’s disease is the leading cause of dementia in elder individuals. (Burns) Even though there is no cure for Alzheimer’s disease, the health care costs are extremely high, being just over 100 billion dollars per year. The hopefulness of the development of a cure or new therapies becomes more desperate every year for new advances in the future. (Burns)
The symptoms of Alzheimer’s disease in every individual vary; the disease can be extremely severe and other times slightly mild. Because Alzheimer’s disease is progressive it advances as time goes on, it starts off as the individual becomes forgetful and looses a small amount of memory and continues to severe dementia and loosing memory completely. The cognitive dysfunction of a person with Alzheimer’s disease includes memory loss, language difficulties, and executive dysfunction, which consists of a loss of higher level planning and intellectual coordination skills. (Burns) The psychiatric symptoms and behavioral disturbances can be anything from depression and agitation to hallucinations. The psychiatric symptoms of Alzheimer’s disease can also be collectively termed as non-cognitive symptoms. (Burns)
The general symptoms of memory loss is always the first symptom of a majority of the cases of Alzheimer’s disease. The gradual onset of memory loss has the same symptoms as normal aging, because ageing shows symptoms of some dementia as well, this can understandably become confusing to diagnose, and however Alzheimer’s disease is not a normal part of aging. (Burns) The onset of Alzheimer’s disease is sly and emerges with a mild loss of memory and continues on with difficulty in finding the right word to go along with sentences. A diagnoses occurs only when the symptoms interfere significantly with everyday life such as social and work functions.
Personal and emotional changes within the individual are very common for people who have Alzheimer’s disease. Major depressive disorder occurs in 20-35% of cases, while anxiety reaches 15-25% of people who have been diagnosed with Alzheimer’s disease. (Burns) Every 67 seconds someone in the United States develops Alzheimer’s disease. Women seem to get his the hardest with this disease. In a women’s 60’s, the estimated risk for developing Alzheimer’s is 1 in 6 and two thirds of Americans with Alzheimer’s disease are women. (Burns) Not only are women more likely to have Alzheimer’s, women are also more likely to be caregivers of those with Alzheimer’s disease.
Alzheimer’s disease leads to nerve cell death and tissue loss throughout the brain. Over time, the brain shrinks dramatically because of this, affecting nearly all of its functions, especially the memory. The cortex of the brain shrivels up and damages areas involved in thinking, planning, and remembering. (Fackelmann) Shrinkage is especially threatening in the hippocampus, which is the area that forms new memories. The ventricles, which are the fluid-filled spaces within the brain, grow larger to fill in the places that have shriveled up.
The tissue within an Alzheimer’s patient has fewer nerve cells and synapses than a healthy brain. Nerve cells and synapses are what carry messages throughout the brain they are crucial to the biological computations that make up perception and thought. The dead nerve cells contain tangles, which are made up of twisted strands of another protein. The small clumps can clock the synapse and can activate the immune system to trigger inflammation. (Fackelmann)
The plaques and tangles spread throughout the cortex in a predictable pattern as Alzheimer’s disease progresses. The rate of the progression of the tangles and plaques within the brain varies significantly. (Fackelmann) People with Alzheimer’s disease live an average of 8 years, but some individuals can survive up to 20 years. In a severely advanced Alzheimer’s disease most of the cortex is severely damaged. (Fackelmann) This is where the brain had shrunk dramatically because of widespread cell death. In this stage, individuals lose their ability to communicate, recognize their family and loved ones, and to care for themselves in their daily activities.
The cause of Alzheimer’s disease is unknown, however researchers have linked several risk factors with Alzheimer’s disease such as an increasing age, family history, head injury (anti-inflammatory drugs have been associated as a reduction of risk), depression, hypertension, high cholesterol, low physical and cognitive activity, diabetes, diseases that cause mutations of chromosomes 1, 14, and 21, ApoE genotype, and individuals diagnosed with down syndrome eventually develops the neurological symptoms of Alzheimer’s disease. (Fackelmann)
The genetic contribution to Alzheimer’s disease is a risk. The risk for the first degree of relatives of people with the disease is estimated at 10-40% higher than unrelated people. (Whalley) The fact that monozygotic twins (twins who share 100% of their genetic material) have a higher concordance rate than dizygotic twins indicates that there is a significant genetic component to Alzheimer’s disease. (Whalley) Because of the risks stated above, researches suggest that environmental factors are also a contribution to the diagnoses of Alzheimer’s disease. Environmental factors is confirmed by the fact that the strongest association is not true across all races; 50% of white patients with Alzheimer’s disease do not carry an e4 allele (ApoE genotype), which is a significant risk in getting Alzheimer’s disease. (Whalley)
The cure for Alzheimer’s disease is uncertain and is mainly focused on therapeutic treatments that help some dementia and other symptoms associated with it. For clinical reasons, non-drug interventions should be used initially, especially if the symptoms are not causing stress or placing the individual at risk to themselves or to others. If non-drug remedial interventions have no effect, cholinesterase inhibitors are the conventional drug treatment of choice for Alzheimer’s disease. Cholinesterase inhibitors have a moderate beneficial symptoms associated with the drug.
The drug modifies symptoms in the minority of people with Alzheimer’s disease because it is nicely tolerated in the majority of individuals. Memantine is a drug that is a glutamatergic antagonist that trials have found effective in individuals that have severe dementia, however it is restricted to those in clinical trials. Cholinesterare inhibitors and memantine are known to produce little identifiable improvements in the activities of daily life. Non-drug approaches are not effective in helping memory loss, even though there are therapeutic techniques that help retain memory and can offer support for people with mild dementia.
Burns, A. Alzheimer’s Disease. British Medical Journal, 338, 467-471. Retrieved June 2, 2014 Fackelmann, K. Forcasting Alzheimer’s Disease. Science News, 149, 312-313. Retrieved June 2, 2014 Whalley, L. Genetics of Alzheimer’s Disease. British Medical Journal (clinical research edition), 1556. Retrieved June 2, 2014