DUY TRAN
Alzheimer’s Disease
Introduction
In the current world many people are being diagnosed with Alzheimer’s disease every
day. Alzheimer’s disease is the major cause of dementia which many people around the globe are
suffering. Statistically, the current number of Alzheimer’s disease victim in European countries
is estimated to be more than 2 million. Dementia is a disease come as result of death of nerve cell
and completely fail to function normally. The major signs of dementia are decline of memory,
confusion and another related mental malfunction. Alzheimer’s disease counts for about 60 to
80% of dementia cases. Alzheimer disease is an irreversible, progressive, neuro-degenerative
disease of the brain that alters the normal brain function of human being. Alzheimer Disease
often affects the old people whose age range run from 65 years and above. Alzheimer Disease
actively and continually destroy the human brain resulting to the memory loss, low thinking
capacity, difficult to speak and decline of learning ability. Furthermore, age is the major factor
for the increase and growth of Alzheimer Disease. With the significance increase in population
of elderly people, Alzheimer Disease clearly remains a major health challenge. Statistically, it is
approximated that 5-10% population of people aged 65 years and over and 40% of the
population greater than 85 years of age are likely to be affected by AD.
Historical Relevance
Alzheimer’s disease was named after Dr. Alois Alzheimer. In 1906, Dr. Alzheimer had a
patient who exhibited memory loss, language difficulty, and unusual behavior. The autopsy
revealed abnormal clumps and tangles in her brain. Today, those clumps and tangles are still
considered indicators of Alzheimer’s disease. In 1910, Alzheimer was officially recognized as a
disease by Emil Kraepelin, a German psychiatrist. Fifty-eight years later, in 1968, a
cognitive measurement scale was developed to determine how advanced the disease is and to
quantify an individual’s loss of abilities. In 1976, Alzheimer’s is recognized as the most common
form of dementia.
Some societies or cultures have suffered from this disorder more than others. According
to Clark et al (2005) assert, there were perception that Black American and other non-white
minorities may have an earlier occurrence of Alzheimer’s disease compared with their non-white
counterparts. In addition, according to the Alzheimer’s Association, Hispanic in America who
are 75 years and older have high chances of getting the Alzheimer’s Disease.
Many factors influence a person’s risk to have Alzheimer ’s disease. For example,
genetic predisposition, early life events, culture, lifestyle, beliefs about treatment and aging.
Moreover, people with fewer years of formal education are at a higher risk for Alzheimer’s and
dementias than those who are well-educated. In fact, a study shows that people who speak more
than one language are less likely to be diagnosed with Alzheimer’s disease when they get older.
Alzheimer’s Deaths- Alzheimer’s is a sixth leading cause of death. It is the fifth leading cause
among adults age over 65.
Epidemiology
Alzheimer disease is evident both in the developing as well as developed countries. Additionally,
it is most prevalent among the elderly individuals. From the research, it is evident that about 24
million individuals have developed dementia with a high percentage being affected by
Alzheimer's disease. Besides. The vascular risk factors and psychosocial factors are responsible
for the process referred to as pathogenetic. The most significant risk factors associated with
Alzheimer is age, family history, and heredity.
Etiology
Alzheimer disease is heredity disease as the genetic composition determines whether an
individual will acquire the disease. Additionally, age is a risk factor for Alzheimer as it increases
the risk of Alzheimer. Age is the most contributing factor to the disorder. It is most prevalent in
individuals who are 65 and above. According to the researchers, it is evident that one in about
nine individuals within the age bracket have the disorder. There are two groups of genes that are
responsible for Alzheimer’s disease. Such as deterministic genes and risk genes. Primarily, risk
genes are associated with increasing the probability of acquiring the disease. According to the
study conducted, it is apparent that there are genes responsible for increasing the risk of
developing the disease. Those genes include the following, E-e4, APOE-e4 or apolipoprotein.
They were initially found and are affiliated with great impacts. There are also know forms of
APOE gene which are APOE-e2 and APOE-e3. The genes are passed from the parents. As such,
when they are inherited, they lead to an increased risk of developing the disease. On the other
hand, two copies usually cause a higher risk of developing the disease. Conversely, deterministic
genes have a direct impact such that it is guaranteed that if one gets into contact with the genes,
itis a must one will develop the disease. There are various proteins responsible for causing the
disorder. Such as amyloid precursor protein, presenilin-1 and presenilin 2.
Therefore, autosomal dominant Alzheimer disease is the condition in which the Alzheimer’s
disorder is caused by the deterministic variations. The condition is also referred to as familial
Alzheimer’s disease. In most cases, the is prevalent at the age between 40s and 50s.
Pathology and Pathophysiology
Pathology.
The normal brain of an adult human being contains more than a hundred million nerve
cells. These brain nerve cells interconnect with each other to ensure the normal functioning of
the entire human brain. Additionally, the nerve cells usually act as the storage for the human
thoughts, memory and feelings. Similarly, the signals that move via the nerve cells are
responsible for feelings, thoughts and memory. Alzheimer disease destroys both the signal
movement in the nerve cell and the workability of the neurotransmitters. The death of the nerve
cells in AD is caused by the deposition of amyloid plaques and creation of neurofibrillary
tangles.
The human brain contains a clipping enzyme that facilitate the formation of beta amyloid
which is a peptide protein. The formation of the beta amyloid is around the normal neuron
membrane protein referred to as amyloid precursor protein (APP). Amyloid Precursor protein is
a natural neuroprotective protein. Consequently, the collection of amyloid beta protein into the
wall of blood vessels and on the surface of the neurons, lead to death of amyloid beta protein.
Similarly, the creation of beta amyloid collections comes as a result of two processes which
actively destroy the neurons. These two processes are inflammation and neurofibrillary tangles.
In the inflammatory process, there are two cells which are astrocytes and microglia cells.
Consequently, astrocytes in the Alzheimer disease, increase in number and then activated to
generate prostaglandin/arachidonic acid mediated inflammation. Additionally, the microglial
cells generate free radicals after its activation. When both astrocytes and microglial cells come
together, they always facilitate the death of neuron cells. Both nutrition and cell-relegation
substances are transmitted through the microtubules found in the neurons. Apparently, the Tau
protein is used to maintain the structural integrity of the microtubules. In Alzheimer Disease, Tau
protein undergoes hyper-phosphorylation and shrinks in size to stick to microtubules, and instead
stick to each other by wrapping themselves into knots referred to as the Neurofibrillary Tangles
(NFTs). Unfortunately, when Neuro fallibility come across the neuron, they fill them and, in the
process, destroy the neuron. Additionally, others change that are observed in the brain affected
by Alzheimer disease are neuronal degeneration of nucleus basalis of Meynert and decreased
levels of acetylcholine.
Pathophysiology
The injury and death of neurons or nerve cells are highly related to the pathophysiology
of Alzheimer Disease, more so around the memory and learning brains. Patients affected with
AD, show two specific microscopic changes-senile plaques (abnormal deposits of a protein
called beta amyloid) and neurofibrillary tangles (abnormal spiral filaments in neurons). Through
some unknown mechanism, senile plaques and neurofibrillary tangles prompt the injury and
death of neurons, and this subsequently produces the intellectual and behavioral symptomatic
changes evident in Alzheimer Disease.
Symptoms
Alzheimer disease starts with low pace continue to develop gradually. Ideally, the signs
and symptoms of Alzheimer disease usually vary from one person to other. At the earlier stages,
the first symptom of Alzheimer disease is forgetfulness. The patient often forgets the daily,
usual, basic and simple things of life. The Alzheimer disease symptoms exceed as the nerve cells
progressively get destroyed. Alzheimer disease is categorized into three steps according to the
severity of the symptoms.
1. Early or Mild stage: At this stage, the patient starts to forget simple and daily tasks. The
patient start to develop short term memory, cognitive impairment, slight personality and
the person start to strain when learning simple tasks.
2. Middle or Moderate stage: The level of memory level increase, cognitive impairment
increase compared to the early stage, the patient develop uncontrollable emotions and get
irritated easily. Also, the patient develops some abnormal behaviors and poor thinking
ability.
3. Late or Severe Stage: The victim the individual becomes muddled, forget and even fail to
identify close family members. Also, the patient fails to control urinary bladder. Due to
these intense conditions the victim requires constant and regular care.
Treatments
Apparently, the cure for the disorder is yet to be found. It is impossible to reverse the
death of brain cells. Nevertheless, there are therapeutic measures that make the lives of people
suffering from the disease comfortable. The following are significant measures to be taken. First,
management of any conditions happening as a result of Alzheimer’s effectively. Secondly,
activities and day-care programs should be in place. Thirdly, an involvement of support groups
and services.
However, the moment the signs begins to show up, one is put under various medications
that ease stop the disease. Such symptoms include the following; loss of memory, difficulties in
learning, problems with judgment, as well as daily life. However, treatment is not yet found to
reverse or stop the mentioned signs. Ideally, the available medicines work by controlling the
severity of the disorder. They are also associated with assisting the brain to work better for long
such, treatment is chosen considering the various items. First, the age, the overall health as well
as medical history. Secondly, the severity of the disease is also considered. Thirdly, the effect the
therapy will have on an individual. Finally, personal or family preferences. A chemical known
acetylcholine is prevented by certain drugs from breaking down. The chemical is significant for
memory and learning. They work by slowing down the symptoms. The drugs responsible for the
easing the symptoms include the following; donepezil, galantamine, and rivastigmine.
Additionally, other therapies are also required, such therapies are aimed at supporting the patient
as he or she is not able to live any longer independently. For instance, with the assistance of the
occupational therapist, one can recognize difficulties as well as unstable operations of everyday
life and be able to come up with measures to manage the problems. Additionally, psychological
treatments like cognitive stimulation are also required to aid in improving the memory, problem-
solving skills as well as enhancing language skill. Furthermore, cognitive behavioral treatment,
art treatment as well as music therapy may be provided are the other psychological therapies.
Such therapies aid in managing certain conditions such as depression, anxiety, hallucinations,
agitations, and delusions. There are some efforts implemented aimed at eradicating the disease.
First, the president Obama designed a plan which was a first national plan aimed at eradicating
the disease. The plan was to be effective through prevention of Alzheimer’s by
2025.consequently, the organization responsible which is National Institutes of health has been
funded to facilitate the study. Additionally, researchers have been encouraged to put more efforts
in eradicating the disease. Further, there is also a drug that is being tested by Peter that is aimed
at destroying the protein in people suffering from Alzheimer's known as amyloid.
Relevance to human Society
There are social impacts associated with Alzheimer's. It affects the personal life as well
as the community. For instance, it affects the lives of spouses, partners, families, and friends.
The disorder is also affiliated with behavioral and psychological signs of dementia. As a result,
there are severe and health consequences to the family carers. There is a reduction in the
workhouse as well as loss of employment. Also, it may result in loss of the relationship. It affects
time with friends and families and social activities.
There is a stigma associated with Alzheimer’s disease. For instance, an estimate of 25%
of dementia patients hides their diagnosis. Also, around 40% are reported to have withdrawn
from the normal activities. Additionally, people with Alzheimer's do not receive the proper
priority in terms of policy and resource allocation. Also, it is associated with numerous public
images as well as stereotypes, therefore, leading to lack of involvement in their social activities.
People with dementia face social isolation as the friends withdraw as well as other significant
people in their lives.
Misconceptions
Primarily, the perception that Alzheimer's are a normal part of aging is one of the
misconceptions. This is central to what is the reality. As such the disease is a result of countless
risk factors. Additionally, there exists a misconception that once a person suffers from the
disorder, he or she becomes aggressive and violent. The reality is the condition occurs in some
patients who suffer from fear and confusion. Further, there is a perception that patients suffering
from Alzheimer's
Are unable to enjoy functions or activities. However, if the patient is offered proper
assistance, patients with the diseases are able to live a normal life. There is urgent need to fight
against the stigma associated with Alzheimer's. The various reasons include the following. First,
it may prevent people from seeking the early medications. Additionally, it can make people with
the symptoms not to seek the required medications. Besides, it may be difficult for support
groups to be formed. More so, it can prevent people not to visit clinics for trials.
There are various efforts aimed at preventing the disorder. First, they include, being
direct and open. Further, people should be made aware of the need for better treatment as well as
cure. Politicians should be actively involved in liaising with them for funding the treatment of
the disorder as well as research. Participation in the fundraising activities aimed at funding the
research of the disorder.
There are various famous people suffering from the disease. Primarily, Glen Campbell is
one of the famous individual sufferings from the disorder. The icon became aware of the disease
at the age of 75 in 2011. Glen is famous for county music. Secondly, Ronald Reagan is the other
famous individual. He is the 40th president of the United States and was affected with
Alzheimer’s and eventually succumbed to the disorder at the age of 83. Another one of the
celebrities who suffered from Alzheimer’s is Charles Bronson who is best known for films such
as the great escape among many other great action movies. He was diagnosed with the disorder
in his late years hence lead to his death in 2003. There is various key legislation aimed at
advocating for Alzheimer's. First, the Expansion of the Diagnosis and care planning with the
Hope for Alzheimer's Act. As such, the act is aimed at advocating for proper medical attention
and results for individuals suffering from the disease. The other act aimed at advocacy for the
disorder is the Palliative and Hospice Education and Training. Therefore, the focus of the Act is
to improve palliative care as well as Hospice training for the healthcare experts. Additionally, it
aims at launching campaigns aimed at raising awareness to the patients suffering from the
disorder as well as the families affected.
Conclusion
Conclusively, Alzheimer disease is the major cause of dementia in people above the age of 65
years. Statistically, the number of affected people is expected to rise significantly in future and
this will offer huge financial burden to health care systems. In actual sense, there is a serious
requirement for effective and efficient medicines to fight the menace. Right now, the only
treatment accessible for AD is symptomatic treatment. Thorough and serious research need to be
carried in finding effective medicine that will help to fight this disease once and for all.
Additionally, hospitals should be equipped with modern equipment to help early diagnosis of the
Alzheimer disease. Management of AD is complex, and clinicians and caregivers are confronted
with numerous challenges in managing the AD. Some of these include employing unique social
and environmental interventions; knowledge and use of increasingly sophisticated medications,
and providing individualized therapy to patients, working with care takers or varying systems
providing care. Continuing efforts are still required. This includes developing medicines that
would slow progression, halt, or prevent AD from occurring. Additionally, challenges for clinical
services include early diagnosis, and intervening early with the most appropriate and effective
medicine. Furthermore, validated therapeutic targets need to be identified, and better animal
research models are needed which reflect the disease. Biotech and major industry also need to
recognize the potential market opportunities for AD and despite the high risk, the rewards for
effective medicines that could delay or halt the disease are huge. The high risks associated with
research and development and the lack of makers for disease progression need to be overcome so
that industry may confidently make further advances in this field and to implement phase II and
larger phase III trials for novel therapeutic agents.
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