Alzheimer's Disease - Research Paper Example

Alzheimer’s Disease Alzheimers disease (AD) is a neurodegenerative disorder. In approximately 5.2 million people were found to have developed Alzheimers disease in the US and a large proportion of them were of age 65 and above. Once a person is affected with Alzheimers disease, the tissues in brains will have fewer nerve cells and connections. Memory loss, obsessive behavior, insomnia, incontinence, hallucinations are some of the common symptoms found in the person affected with Alzheimers disease. As per the current guidelines, biomarker test is conducted to diagnose the disease in which levels of certain proteins in cerebrospinal fluid ascertains the presence of this disease. The person who inherits genetic mutations is most likely to develop Alzheimers disease before age 65 and in worst case the person may develop Alzheimers disease as early as age 30. Genetics and advancing age contribute significantly to developing Alzheimers disease in an individual. Medications can reduce the symptoms but cannot alter the disease. Progressive loss of brain cells is known as Alzheimers disease (AD). Though the precise cause of Alzheimers disease is not known but a family history, severe head injuries, life style and increasing age could be one of the causes of getting this disease. Being a progressive disease it may get worse with age. The paper attempts to explore several aspects that surround Alzheimers disease that include its progression, symptoms, treatment regime. History As such, the history of Alzheimers disease or its identification goes back to as far as over hundred years but the larger understanding about it such as its causes, symptoms, risk factors and treatment process has been developed in the last 30 years. Though the medical science has revealed much about Alzheimers disease in last few decades, it cannot describe precisely the real causes about its happening; however, it is certain that when neurons in brains die, the person is said to have the onset of Alzheimers disease (Alzheimers & Dementia, 2013). Prevalence of Alzheimers disease Almost 5.2 million people in the US are estimated to having Alzheimers disease in 2013. Out of this, almost 5 million persons are of age above 65. In other words, 4% of Alzheimers disease population belongs to age less than 65 and 82% are of age 75 and above. The population with Alzheimers disease will increase each coming year due to increase in ageing population of the US above age 65 (Thies & Bleiler, 2012). Symptoms Alzheimers disease is a neurodegenerative disease – due to progressive brain cells death over a period of time resulting into smaller brain size. Once a person is affected with Alzheimers disease, the tissues in brains will have fewer nerve cells and connections. Plaques form between the dying cells in the brain due to build up of a beta-amyloid protein (Querfurth & LaFerla, 2010). On its early symptoms, the disease begins with minor memory problems and some difficulty in choosing the right words while speaking. The Alzheimer’s disease on its progression passes through three stages – mild, moderate and severe. In mild form, it is characterized by forgetfulness, mood swings, and speech issues. On its further progression – taking a moderate form, the symptoms include hallucinations, disturbed sleep, incontinence, obsessive behavior, and difficulty in remembering recent things. When the disease reaches its severe form the patient becomes disoriented with hallucination and delusions getting worse at night. The person loses short-term and long-term memory and finds difficulty in swallowing. Even changing position could be difficult and needs assistance for movements from place to place. With progress of the disease, the affected persons cognitive and functional abilities are affected (Alzheimers & Dementia, 2013). Diagnosis Usually, primary care physician happens to diagnose Alzheimers disease based on the family and medical history of the patient that include behavioral, cognitive and psychiatric changes. The doctor conducts physical and neurological examinations along with cognitive tests. If needed, the physician may order to perform magnetic resonance imaging (MRI) on the patient as it helps identify brain changes (Alzheimers & Dementia, 2013). The Alzheimers Association and the National Institute on Aging (NIA) now recommend new guidelines to diagnose Alzheimers disease. This updates old diagnostic criteria laid down in 1984 by the National Institute of Neurological Disorders and Stroke and the Alzheimers Association. The old diagnostic criteria or guidelines emphasize on a doctors clinical judgment based on the reports from family members, friends, cognitive tests and general assessment. The new criteria make some significant changes; the first one is to identify three stages of Alzheimers disease and the second one is incorporating biomarker tests. Biomarker test will identify the risk of developing a disease. Levels of certain proteins in cerebrospinal fluid can indicate whether the person is affected with Alzheimers disease. According to the new criteria, Alzheimers disease begins before the symptoms are developed and the person detected with early brain changes would be described to have preclinical Alzheimers disease. In the preclinical Alzheimers disease stage, changes in the brain can be seen along with presence of biomarkers. Alzheimers disease-related brain changes may happen 20 years before actual symptoms are noticed (Alzheimers & Dementia, 2013). Experts now believe that multiple factors are responsible to develop Alzheimers disease rather than a single cause (Querfurth & LaFerla, 2010). Starting with initial brain changes and then noticing the symptoms that ascertain Alzheimers disease in a person is a time continuum of Alzheimers disease. At the beginning of the continuum, the person performs normally despite some brain changes; however, after some time the person shows noticeable decline in cognitive function. Physicians call this point in the continuum as MCI. At the end of continuum, cognitive decline is more visible and physicians, as per 1984 criteria, would diagnose the person suffering from Alzheimers disease. According to 2011 criteria, the entire continuum constitutes Alzheimers disease. It is a matter of research to find out why some persons with brain changes at the earlier points of continuum do not develop the observable symptoms at some later points of the continuum. Perhaps, this is due to complexity of the brain (Alzheimers & Dementia, 2013). Causes and Risk Factors Genetic mutation is the only known cause of Alzheimers disease. A less than 1% Alzheimers disease cases are attributed to three known genetic mutations. The person who inherits genetic mutations is most likely to develop Alzheimers disease before age 65 and in worst case such person may develop Alzheimers disease at an early age of 30. Lye & Shores (2000) suggest that traumatic brain injury can play a role in developing Alzheimers disease at the later stage. Advancing age is the greatest risk factor and the persons with at least one first-degree relative with Alzheimers disease would always prone to higher risk of developing Alzheimers disease. Thus, genetics and advancing age contribute to developing this disease significantly (Querfurth & LaFerla, 2010). Treatment of Alzheimers Disease A comprehensive treatment plan for Alzheimer’s disease also includes a care plan depending upon the functional capacity of the person affected. As such, drugs do not modify disease; it helps to reduce symptoms and improve quality of life. On medications, two kinds of drugs are used for treatment of Alzheimers disease. In first kinds, the drugs called cholinesterase inhibitors such as donepezil, galantamine and rivastigmine are used that helps increase the levels of a cell-to-cell communication. However, these drugs do have some of the side effects such as nausea, diarrhea, insomnia. In second kinds, the drugs called memantine is employed to enhance communication among brain cell network slowing progression of symptoms in the cases of moderate to severe Alzheimers disease. Memantine drug is also sometimes prescribed in combination with a cholinesterase inhibitor (Alzheimers disease, 2014). Education plays a pivotal role in controlling incidents of Alzheimers disease. The lesser the education, the higher is the risk of Alzheimers disease in an individual. Researchers state that more years of education generates a good cognitive reserve that helps to compensate for changes in brains. More years of education increases the connectivity between neurons in the brain as alternate route mechanism tends to facilitate communication between neurons to complete a cognitive task (Stern et al, 1994). Thus, it is amply clear that Alzheimers disease is a neurodegenerative disease and drugs cannot change the condition of Alzheimers disease except that medications can help reduce symptoms and enhance the quality of life. Since it progresses with age it is likely to be a major issue in the years ahead due to increased life of people in the US. References Alzheimers & Dementia (2013). The Journal of the Alzheimers Association. 9 (2). 208-245. [Also Available at] http://www.alzheimersanddementia.org/article/S1552-5260%2813%2900076-9/fulltext#sec2 Alzheimers disease (2014). Treatment and Drugs. Retrieved March 25, 2014 from http://www.mayoclinic.org/diseases-conditions/alzheimers-disease/basics/treatment/con 20023871 Lye, T. C., Shores, E. A. (2000). Traumatic brain injury as a risk factor for Alzheimer’s disease: a review. Neuropsychology Review. 10(2). 115–129. Querfurth, H.W., LaFerla F.M. (2010). Alzheimers disease. The New England Journal of Medicine. 362 (4). 329-344. Stern, Y., Gurland, B., Tatemichi, T. K., Tang, MX., Wilder, D., Mayeux, R., (1994). Influence of education and occupation on the incidence of Alzheimer’s disease. The Journal of the Alzheimers Association. 271. 1004–1010 Thies, W., Bleiler, L. (2012). Alzheimers Disease Facts and Figures. Elsevier. 8(2).131-168. Read More