Alzheimer’s disease A Research Paper for Science Introduction It occasionally happens to everyone. You can’t find your glasses. The grocery list is on the refrigerator, and you’re at the store. You forget the new neighbour’s first name. With over one hundred billion cells, fifteen thousand connections, and forty-five chemical messengers, it isn’t surprising that the brain periodically misfires. Often, these memory lapses are merely inconvenient. However, they can signal more serious medical conditions, including Alzheimer’s disease.
Recognizing normal changes, learning risk factors, and assessing signs and symptoms are critical for understanding your memory loss. If forgetfulness is impacting your everyday life, it is time to learn why. Body What is Alzheimer’s disease? Alzheimer’s disease (AD), also called Alzheimer disease, senile dementia of the Alzheimer type (SDAT), primary degenerative dementia of the Alzheimer’s type (PDDAT), or simply Alzheimer’s, is the most common form of dementia, a serious brain disorder that impacts daily living through memory loss and cognitive changes.
Alzheimer’s is a degenerative disease, progressing from mild forgetfulness to widespread neurological impairment and ultimately death. Chemical and structural changes in the brain gradually destroy the ability to create, remember, learn, reason, and relate to others. As critical cells die, drastic personality loss occurs and body systems fail. Who develops Alzheimer’s disease? The main risk factor for Alzheimer’s disease is increased age. As a population ages, the frequency of Alzheimer’s disease continues to increase. Ten percent of people over 65 years of age and 50% of those over 85 years of age have Alzheimer’s disease.
Unless new treatments are developed to decrease the likelihood of developing Alzheimer’s disease, the number of individuals with Alzheimer’s disease in the United States is expected to be 14 million by the year 2050. There are also genetic risk factors for Alzheimer’s disease. Most patients develop Alzheimer’s disease after age 70. However, 2%-5% of patients develop the disease in the fourth or fifth decade of life (40s or 50s). At least half of these early onset patients have inherited gene mutations associated with their Alzheimer’s disease.
Moreover, the children of a patient with early onset Alzheimer’s disease who has one of these gene mutations has a 50% risk of developing Alzheimer’s disease. There is also a genetic risk for late onset cases. A relatively common form of a gene located on chromosome 19 is associated with late onset Alzheimer’s disease. In the majority of Alzheimer’s disease cases, however, no specific genetic risks have yet been identified. Other risk factors for Alzheimer’s disease include high blood pressure (hypertension),coronary artery disease, diabetes, and possibly elevated blood cholesterol.
Individuals who have completed less than eight years of education also have an increased risk for Alzheimer’s disease. These factors increase the risk of Alzheimer’s disease, but by no means do they mean that Alzheimer’s disease is inevitable in persons with these factors. What are the symptoms of Alzheimer’s disease? The onset of Alzheimer’s disease is usually gradual, and it is slowly progressive. Memory problems that family members initially dismiss as “a normal part of aging” are in retrospect noted by the family to be the first stages of Alzheimer’s disease.
When memory and other problems with thinking start to consistently affect the usual level of functioning; families begin to suspect that something more than “normal aging” is going on. Problems of memory, particularly for recent events (short-term memory) are common early in the course of Alzheimer’s disease. For example, the individual may, on repeated occasions, forget to turn off an iron or fail to recall which of the morning’s medicines were taken. Mild personality changes, such as less spontaneity, apathy, and a tendency to withdraw from social interactions, may occur early in the illness.
As the disease progresses, problems in abstract thinking and in other intellectual functions develop. The person may begin to have trouble with figures when working on bills, with understanding what is being read, or with organizing the day’s work. Further disturbances in behavior and appearance may also be seen at this point, such as agitation, irritability, quarrelsomeness, and a diminishing ability to dress appropriately. Later in the course of the disorder, affected individuals may become confused or disoriented about what month or year it is, be unable to describe accurately where they live, or be unable to name a place being visited.
Eventually, patients may wander, be unable to engage in conversation, erratic in mood, uncooperative, and lose bladder and bowel control. In late stages of the disease, persons may become totally incapable of caring for themselves. Death can then follow, perhaps from pneumonia or some other problem that occurs in severely deteriorated states of health. Those who develop the disorder later in life more often die from other illnesses (such as heart disease) rather than as a consequence of Alzheimer’s disease Ten warning signs of Alzheimer’s disease
The Alzheimer’s Association has developed the following list of warning signs that include common symptoms of Alzheimer’s disease. Individuals who exhibit several of these symptoms should see a physician for a complete evaluation. 1. Memory loss 2. Difficulty performing familiar tasks 3. Problems with language 4. Disorientation to time and place 5. Poor or decreased judgment 6. Problems with abstract thinking 7. Misplacing things 8. Changes in mood or behavior 9. Changes in personality 10. Loss of initiative It is normal for certain kinds of memory, such as the ability to remember lists of words, to decline with normal aging.
In fact, normal individuals 50 years of age will recall only about 60% as many items on some kinds of memory tests as individuals 20 years of age. Furthermore, everyone forgets, and every 20 year old is well aware of multiple times he or she couldn’t think of an answer on a test that he or she once knew. Almost no 20 year old worries when he/she forgets something, that he/she has the ‘early stages of Alzheimer’s disease,’ whereas an individual 50 or 60 years of age with a few memory lapses may worry that they have the ‘early stages of Alzheimer’s disease. ‘ What are causes of Alzheimer’s disease?
The cause(s) of Alzheimer’s disease is (are) not known. The “amyloid cascade hypothesis” is the most widely discussed and researched hypothesis about the cause of Alzheimer’s disease. The strongest data supporting the amyloid cascade hypothesis comes from the study of early-onset inherited (genetic) Alzheimer’s disease. Mutations associated with Alzheimer’s disease have been found in about half of the patients with early-onset disease. In all of these patients, the mutation leads to excess production in the brain of a specific form of a small protein fragment called ABeta (A? . Many scientists believe that in the majority of sporadic (for example, non-inherited) cases of Alzheimer’s disease (these make up the vast majority of all cases of Alzheimer’s disease) there is too little removal of this A? protein rather than too much production. In any case, much of the research in finding ways to prevent or slow down Alzheimer’s disease has focused on ways to decrease the amount of A? in the brain. What are risk factors for Alzheimer’s disease? The biggest risk factor for Alzheimer’s disease is increased age.
The likelihood of developing Alzheimer’s disease doubles every 5. 5 years from 65 to 85 years of age. Whereas only 1%-2% of individuals 70 years of age have Alzheimer’s disease, in some studies around 40% of individuals 85 years of age have Alzheimer’s disease. Nonetheless, at least half of people who live past the 95 years of age do not have Alzheimer’s disease. Common forms of certain genes increase the risk of developing Alzheimer’s disease, but do not invariably cause Alzheimer’s disease. The best-studied “risk” gene is the one that encodes apolipoprotein E (apoE).
The apoE gene has three different forms (alleles) — apoE2, apoE3, and apoE4. The apoE4 form of the gene has been associated with increased risk of Alzheimer’s disease in most (but not all) populations studied. The frequency of the apoE4 version of the gene in the general population varies, but is always less than 30% and frequently 8%-15%. Persons with one copy of the E4 gene usually have about a two to three fold increased risk of developing Alzheimer’s disease. Persons with two copies of the E4 gene (usually around 1% of the population) have about a nine-fold increase in risk.
Nonetheless, even persons with two copies of the E4 gene don’t always get Alzheimer’s disease. At least one copy of the E4 gene is found in 40% of patients with sporadic or late-onset Alzheimer’s disease. This means that in majority of patients with Alzheimer’s disease, no genetic risk factor has yet been found. Most experts do not recommend that adult children of patients with Alzheimer’s disease should have genetic testing for the apoE4 gene since there is no treatment for Alzheimer’s disease.
When medical treatments that prevent or decrease the risk of developing Alzheimer’s disease become available, genetic testing may be recommended for adult children of patients with Alzheimer’s disease so that they may be treated. Many, but not all, studies have found that women have a higher risk for Alzheimer’s disease than men. It is certainly true that women live longer than men, but age alone does not seem to explain the increased frequency in women. The apparent increased frequency of Alzheimer’s disease in women has led to considerable research about the role of estrogen in Alzheimer’s disease.
Recent studies suggest that estrogen should not be prescribed to post-menopausal women for the purpose of decreasing the risk of Alzheimer’s disease. Nonetheless, the role of estrogen in Alzheimer’s disease remains an area of research focus. Some studies have found that Alzheimer’s disease occurs more often among people who suffered significant traumatic head injuries earlier in life, particularly among those with the apoE 4 gene. In addition, many, but not all studies, have demonstrated that persons with limited formal education – usually less than eight years – are at increased risk for Alzheimer’s disease.
It is not known whether this reflects a decreased “cognitive reserve” or other factors associated with a lower educational level. What are the stages of Alzheimer’s? Several methods based on the degeneration of the brain and nervous system are used to describe the symptoms of Alzheimer’s. Although these staging systems provide useful guidelines for understanding how the disease may develop, it is important to remember that each individual progresses differently. Cognitive, physical and functional phases often overlap, the time in each stage varies widely, and not all patients experience all symptoms.
If you receive a diagnosis of Alzheimer’s disease that includes a stage reference, it is important to understand which system is used: |3 Stages of Alzheimer’s disease | |Description |Duration |Characteristics | |Mild/Early |2-4yrs |Frequent recent memory loss, particularly of recent conversations and events.
Repeated questions, some | | | |problems expressing and understanding language. Writing and using objects become difficult. Depression | | | |and apathy can occur. Drastic personality changes may accompany functional decline. Need reminders for | | | |daily activities, and difficulties with sequencing impact driving early in this stage. | |Moderate/Middle |2-10 yrs |Can no longer cover up problems. Pervasive and persistent memory loss impacts life across settings. | | |Rambling speech, unusual reasoning, confusion about current events, time, and place. Potential to become| | | |lost in familiar settings, sleep disturbances, and mood or behavioral symptoms accelerate. Nearly 80% of| | | |patients exhibit emotional and behavioral problems which are aggravated by stress and change. Slowness, | | | |rigidity, tremors, and gait problems impact mobility and coordination.
Need structure, reminders, and | | | |assistance with activities of daily living. | |Severe/Late |1-3+ yrs |Confused about past and present. Loss of recognition of familiar people and places. Generally | | | |incapacitated with severe to total loss of verbal skills. Unable to care for self. Falls possible and | | | |immobility likely. Problems with swallowing, incontinence, and illness.
Extreme problems with mood, | | | |behavioral problems, hallucinations, and delirium. Patients need total support and care, and often die | | | |from infections or pneumonia. | How can we prevent it? At this time, there is no way to prevent Alzheimer’s disease. A panel of nationally known experts in the field convened by the National Institutes of Health (NIH) concluded that there is no solid scientific proof that lifestyle measures can prevent Alzheimer’s disease or cognitive decline.
However, staying healthy, exercising, eating a diet rich in omega-3 fatty acids and other healthful foods, and keeping your mind engaged have all been suggested as ways to possibly delay the onset of cognitive decline and the brain disorder known as Alzheimer’s. Click on the topics below to read about healthy lifestyle routines that may help your brain to function at its best. How can we cure it? There is currently no cure for Alzheimer’s, but scientific research is bringing us closer to a cure every day.
Outstanding progress has already been made in unraveling the mysteries of Alzheimer’s disease, including what causes it and what happens in the brain as the disease progresses. New understandings about these processes have already provided critical information about how doctors might prevent, delay, stop or even reverse the nerve cell damage that leads to the devastating symptoms of Alzheimer’s. All around the world, scientists and pharmaceutical companies are now racing to develop treatments that address the underlying disease processes, some of which (or a combination of which) might effectively solve the Alzheimer’s puzzle.
Scientific research is also providing valuable information about how drug and non-drug approaches to treatment can improve day-to-day functioning and maximize quality of life. Drug (pharmacological) treatments currently available are used to manage the cognitive symptoms of Alzheimer’s, such as changes in thinking, memory and perception. They can’t stop the disease, but they can slow the progression of symptoms in some people, at least for a while. While drug therapy is important and beneficial, especially in early stages, the management of Alzheimer’s has evolved to include non-pharmacological therapies as integral aspects of care.
These include various strategies aimed at managing problematic behaviors, including involvement in therapeutic activities, home or “environmental” modifications, and the use of appropriate communication techniques. Support and education for caregivers and family members is also crucial to the best care of people with Alzheimer’s. What treatment and management options are available for Alzheimer’s disease? The management of Alzheimer’s disease consists of medication based and non-medication based treatments.
Two different classes of pharmaceuticals are approved by the FDA for treating Alzheimer’s disease: cholinesterase inhibitors and partial glutamate antagonists. Neither class of drugs has been proven to slow the rate of progression of Alzheimer’s disease. Nonetheless, many clinical trials suggest that these medications are superior to placebos (sugar pills) in relieving some symptoms. General Safety Concerns People with Alzheimer’s disease become increasingly unable to take care of themselves. However, the disease progresses differently in each person.
As a caregiver, you face the ongoing challenge of adapting to each change in the person’s behavior and functioning. The following general principles may be helpful. 1. Think prevention. It is very difficult to predict what a person with Alzheimer’s might do. Just because something has not yet occurred does not mean it should not be cause for concern. Even with the best-laid plans, accidents can happen. Therefore, checking the safety of your home will help you take control of some of the potential problems that may create hazardous situations. 2. Adapt the environment.
It is more effective to change the environment than to change most behaviors. While some Alzheimer’s behaviors can be managed with special medications prescribed by a doctor, many cannot. You can make changes in an environment to decrease the hazards and stressors that accompany these behavioral and functional changes. 3. Minimize danger. By minimizing danger, you can maximize independence. A safe environment can be a less restrictive environment where the person with Alzheimer’s disease can experience increased security and more mobility. Conclusion
Although the human and societal cost of AD is staggering, there is hope that earlier and better diagnosis, increased knowledge of its natural history with support of the patient and family throughout the disease stages, effective symptomatic drugs, and potentially effective disease modification strategies will have a dramatic impact on the number of persons affected in the future, and the quality of life of persons currently affected. The fast pace of research and development in AD is unique in neurological history, and should lead to a better future for aging populations.
Ninety percent of what we know about Alzheimer’s has been discovered in the last 15 years. Some of the most remarkable progress has shed light on how Alzheimer’s affects the brain. The hope is this better understanding will lead to new treatments. Many potential approaches are currently under investigation worldwide. Sources http://en. wikipedia. org/wiki/Alzheimer’s_disease http://www. helpguide. org/elder/alzheimers_disease_symptoms_stages. htm http://www. medicinenet. com/alzheimers_disease_causes_stages_and_symptoms/page4. htm http://www. alzinfo. org/07/treatment-care/what-can-i-do-to-prevent-alzheimers