AlzheimersDiseaseAlzheimer’s Diseaseis a progressive, degenerative disease that attacks the brain and results inimpaired memory, thinking and behavior (Internet). It is a degenerative diseaseaffecting nerve cells of the frontal and temporal lobes of the cerebrum of thebrain.
The disease is the major cause of presenile dementia (i. e. , the loss ofmental faculties not associated with advanced age) and is thought to be thelargest single cause of senile dementia as well (Britannica, 306). It causes theconnections between cells to become ineffective and the cells themselves toshutdown and eventually die (Davies, 1).
Alzheimer’s is a progressive,irreversible, fatal neurologic disorder that affects an estimated 4 millionAmerican adults. It is estimated by 2040,approximately 14 million Americans willbe diagnosed with Alzheimer’s Disease. Approximately 9% of the populationolder than 55 years and 20% of those older than 85 years have Alzheimer’sDisease. The duration of AD averages 2 to 10 years but can be up to 20 years.
By1992, Alzheimer’s Disease was the fourth leading cause of death among adults(more than 100,000 American deaths per year). It is projected that the number ofpeople with Alzheimer’s Disease will triple in the next 50 years. Thisepidemic of dementia is not confined to sex, race, social, or economic class. The public knows this disorder as “senility”, although the termAlzheimer’s is becoming more common (Rosdahl, 1356).
According to a quote fromHasselbring ” Alzheimer’s disease. ” Medical Self-Care 53-57,January-February, 1986, a 61-year-old woman in early stages of Alzheimer’sdisease stated, “My mind goes to an empty and horrible place. When I comeback, I’m in a room full of strangers. I fell so lost and afraid. ” ManyAlzheimer’s patients echo these sentiments.
The disease is frightening anddisabling (1356). Alois Alzheimer, a German neuropathologist, originallydescribed the disease in 1906. In the autopsy of a 55-year-old patient who haddied with severe dementia, Alzheimer noted the presence in the brain of twoabnormalities (Britannica, 306). Recent studies have shown that in the autopsiesof the brain of people who have died from Alzheimer’s, there is much higherconcentration of aluminum than is normal (Weiner, 17).
Accounting for about halfof all dementia cases, Alzheimer’s is more common in certain groups. Women areat 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 failto recognize that these symptoms indicate something is wrong. They maymistakenly assume that such behavior is a normal part of the aging process; itisn’t. Or, symptoms may develop gradually and go unnoticed for a long time. Sometimes people refuse to act even when they know something is wrong.
It’simportant to see a physician when you recognize these symptoms. Only a physiciancan properly diagnose the person’s condition, and sometimes are reversible. Even if the diagnosis is Alzheimer’s disease, help is available to learn howto care for a person with dementia and where to find assistance. Ten warningsigns to watch for are: (1) memory loss, (2) difficulty performing familiartasks, (3) problems with language, (4) disorientation of time and place, (5)poor or decreased judgement, (6) problems with abstract thinking, (7) misplacingthings, (8) changes in mood or behavior, (9) changes in personality, (10) lossof initiative (Internet).
Typical problems that should alert us that a personneeds some kind of help are repeated car accidents, getting lost, losing thingsand not recalling the previous day (Davidson, 13). Symptoms of the illnessrepresent deficits in many areas of how a person remembers and thinks. Forinstance, 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 personis no longer a successful way to understand and deal with his problems. Judgement about common everyday situations is drastically diminished. Theindividual’s capacity to express himself verbally gradually shrinks. Neitheris he able to comprehend what others say to him. As the disease progresses, hemay gradually lose the ability to speak.
Psychiatric symptoms such as delusionsand hallucinations can occur. The person can become anxious, restless, agitated,and may even appear to be depressed. His personality will change. In fact, hemay not seem to be the same person (Gruetzner, 9). Alzheimer’s disease beginsinsidiously and progresses slowly but inexorably, until the sufferer cannotattend to the simplest details of self-care and may not even remember his or hername. Although the symptoms may vary from patient to patient and from day to dayin an individual, there are certain common features in all patients, and thedisease follows a somewhat predictable path.
Initially, the victim may justexhibit a lack of energy, drive, and initiative, and neither he nor his familymay be aware that anything is really wrong. The individual may just avoid newchallenges and seek refuge in familiar situations. For example, he may want tovisit only family members and close, old friends rather than go to new placesand meet new people. However, with time, greater changes in mental function andbehavior begin to appear, and the disease can traditionally be divided intothree clinical stages.
The individual will forget the names of persons wellknown 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 itis. He will start forgetting to attend appointments he has made or get losttrying to find places that were once very familiar. In the beginning, suchepisodes of forgetfulness may just be minor annoyances to the individual and hisfamily, and he may still be able to function reasonably well. Eventually though,lapses of memory will become debilitating (Weiner, 27). The symptoms ofAlzheimer’s disease include gradual declines in memory, learning, andattention, and judgement; disorientation in time and space: word-finding andcommunication difficulties: and changes in personality. These symptoms may besomewhat vague at first and mimic mental illness or stress-related problems.
Forexample, an executive may not be managing as well as he once did, making baddecisions with increasingly frequency and missing deadlines. Insidiously butinexorably, the changes become unable to add two numbers together. Similarly, apreviously talented hostess may no longer be able to set a table. Thepersonality of the patient may change markedly: an outgoing, vivacious personmay become quiet and withdrawn; a gentle, caring partner may become aggressiveand indifferent. Emotional symptoms, including depression, paranoia, andagitation, may occur intermittently. During the course of the illness, thepatient’s needs for care escalate.
Of the four-plus million Americans withdementia, one-third are so impaired that they can no longer manage withoutassistance in the simplest daily routine activities of eating, dressing,grooming, and toileting (Aronson, 6). Alzheimer’s disease appears to run infamilies. Immediate (“first-order”) relatives of a patient with the diseasehave a great risk of developing the disorder themselves. But the incidence ofthe disease as it occurs in both identical and fraternal sets of twins, thoughsomewhat elevated, is not convincingly high enough to “prove” a hereditarylink. It is thought that the disease may be inherited in some families as anautosomal (any chromosome other than those that determine the sex) dominantgene.
