Alzheimers Disease Alzheimers Disease is a progressive, degenerative disease that attacks the brain and results in impaired memory, thinking and behavior (Internet). It is a degenerative disease affecting nerve cells of the frontal and temporal lobes of the cerebrum of the brain. The disease is the major cause of presenile dementia (i.e., the loss of mental faculties not associated with advanced age) and is thought to be the largest single cause of senile dementia as well (Britannica, 306). It causes the connections between cells to become ineffective and the cells themselves to shutdown and eventually die (Davies, 1). Alzheimers is a progressive, irreversible, fatal neurologic disorder that affects an estimated 4 million American adults.
It is estimated by 2040,approximately 14 million Americans will be diagnosed with Alzheimers Disease. Approximately 9% of the population older than 55 years and 20% of those older than 85 years have Alzheimers Disease. The duration of AD averages 2 to 10 years but can be up to 20 years. By 1992, Alzheimers Disease was the fourth leading cause of death among adults (more than 100,000 American deaths per year). It is projected that the number of people with Alzheimers Disease will triple in the next 50 years. This epidemic of dementia is not confined to sex, race, social, or economic class.
The public knows this disorder as “senility”, although the term Alzheimers is becoming more common (Rosdahl, 1356). According to a quote from Hasselbring ” Alzheimers disease.” Medical Self-Care 53- 57,January-February, 1986, a 61-year-old woman in early stages of Alzheimers disease stated, “My mind goes to an empty and horrible place. When I come back, Im in a room full of strangers. I fell so lost and afraid.” Many Alzheimers patients echo these sentiments. The disease is frightening and disabling (1356). Alois Alzheimer, a German neuropathologist, originally described the disease in 1906. In the autopsy of a 55-year-old patient who had died with severe dementia, Alzheimer noted the presence in the brain of two abnormalities (Britannica, 306). Recent studies have shown that in the autopsies of the brain of people who have died from Alzheimers, there is much higher concentration of aluminum than is normal (Weiner, 17).
Accounting for about half of all dementia cases, Alzheimers is more common in certain groups. Women are at higher risk, so are those who have a first-degree relation with the disease, or a history of head trauma (RN magazine, 26). Unfortunately, many people fail to recognize that these symptoms indicate something is wrong. They may mistakenly assume that such behavior is a normal part of the aging process; it isnt. Or, symptoms may develop gradually and go unnoticed for a long time. Sometimes people refuse to act even when they know something is wrong.
Its important to see a physician when you recognize these symptoms. Only a physician can properly diagnose the persons condition, and sometimes are reversible. Even if the diagnosis is Alzheimers disease, help is available to learn how to care for a person with dementia and where to find assistance. Ten warning signs to watch for are: (1) memory loss, (2) difficulty performing familiar tasks, (3) problems with language, (4) disorientation of time and place, (5) poor or decreased judgement, (6) problems with abstract thinking, (7) misplacing things, (8) changes in mood or behavior, (9) changes in personality, (10) loss of initiative (Internet). Typical problems that should alert us that a person needs some kind of help are repeated car accidents, getting lost, losing things and not recalling the previous day (Davidson, 13). Symptoms of the illness represent deficits in many areas of how a person remembers and thinks.
For instance, problems with memory may be manifested as forgetting names, dates, places, whether a bill has been paid for, or something said over and over. Intellectual abilities are lost eventually. Reasoning with the affected person is no longer a successful way to understand and deal with his problems. Judgement about common everyday situations is drastically diminished. The individuals capacity to express himself verbally gradually shrinks. Neither is he able to comprehend what others say to him.
As the disease progresses, he may gradually lose the ability to speak. Psychiatric symptoms such as delusions and hallucinations can occur. The person can become anxious, restless, agitated, and may even appear to be depressed. His personality will change. In fact, he may not seem to be the same person (Gruetzner, 9).
Alzheimers disease begins insidiously and progresses slowly but inexorably, until the sufferer cannot attend to the simplest details of self-care and may not even remember his or her name. Although the symptoms may vary from patient to patient and from day to day in an individual, there are certain common features in all patients, and the disease follows a somewhat predictable path. Initially, the victim may just exhibit a lack of energy, drive, and initiative, and neither he nor his family may be aware that anything is really wrong. The individual may just avoid new challenges and seek refuge in familiar situations. For example, he may want to visit only family members and close, old friends rather than go to new places and meet new people.
However, with time, greater changes in mental function and behavior begin to appear, and the disease can traditionally be divided into three clinical stages. The individual will forget the names of persons well known to him; he will also be unable to remember where he puts carious objects, such as the car keys or his wallet, or what day of the week, month or year it is. He will start forgetting to attend appointments he has made or get lost trying to find places that were once very familiar. In the beginning, such episodes of forgetfulness may just be minor annoyances to the individual and his family, and he may still be able to function reasonably well. Eventually though, lapses of memory will become debilitating (Weiner, 27).
The symptoms of Alzheimers disease include gradual declines in memory, learning, and attention, and judgement; disorientation in time and space: word-finding and communication difficulties: and changes in personality. These symptoms may be somewhat vague at first and mimic mental illness or stress-related problems. For example, an executive may not be managing as well as he once did, making bad decisions with increasingly frequency and missing deadlines. Insidiously but inexorably, the changes become unable to add two numbers together. Similarly, a previously talented hostess may no longer be able to set a table. The personality of the patient may change markedly: an outgoing, vivacious person may become quiet and withdrawn; a gentle, caring partner may become aggressive and indifferent. Emotional symptoms, including depression, paranoia, and agitation, may occur intermittently. During the course of the illness, the patients needs for care escalate.
Of the four-plus million Americans with dementia, one-third are so impaired that they can no longer manage without assistance in the simplest daily routine activities of eating, dressing, grooming, and toileting (Aronson, 6). Alzheimers disease appears to run in families. Immediate (“first-order”) relatives of a patient with the disease have a great risk of developing the disorder themselves. But the incidence of the disease as it occurs in both identical and fraternal sets of twins, though somewhat elevated, is not convincingly high enough to “prove” a hereditary link. It is thought that the disease may be inherited in some families as an autosomal (any chromosome other than those that determine the sex) dominant gene.