Alzheimer’s disease

Alzheimer’s is a progressive brain disorder which slowly destroys the brain cells and this cellular destruction is irreversible. The brain cells responsible for memory and cognitive functioning of the brain are targeted in this disease. Consequently, the brain is unable to carry out simple motor skills and cannot perform cognitive functions which correspond to display of behavior and memory function. Alzheimer’s disease is common among elderly people of ages 60 years and older, and is the sixth leading cause of death among older adults. According to an expert survey, more than 5.5 million Americans are suffering from Alzheimer’s disease which is a major cause of dementia among older adults. Dementia among older adults is mostly associated with Alzheimer’s disease as it is the progressive loss of cognitive functioning with age. Hence, this disease impairs the normal brain functioning such as thinking, reasoning and remembering among elderly patients to an extent where they are unable to perform their daily life activities. This Alzheimer’s associated dementia ranges in severity i.e. mild, moderate and severe depending on the rate of progression of the disease (Alzheimer’s Association, 2018).

Alzheimer’s disease was discovered by Dr. Alois Alzheimer in 1906 when the doctor noticed slow progressive changes in a woman’s brain which became a cause of her death. These changes in her brain cells produced symptoms of memory loss, irritated behaviors and language problems. Upon examination, amyloid plaques and tangled neuro-fibers were found in her brain. Moreover, a loss of neuronal connection was observed which furthermore impairs the transmission of messages into the brain and to the muscles of the body (Kumar & Singh, 2015).

In the light of research-based evidence, it is suggested that the memory changes and cognitive delays are apparent after a decade of living with this disease (Dubois, Feldman, Jacova et al. 2014).  This shows that the disease is asymptomatic in the start and symptoms of dementia start appearing after many years. It is observed that abnormal deposition of protein in the form of amyloid plaque and tangled neurons occurs progressively and once the neurons lose connection with each other, the symptoms of the disease start to appear. Alzheimer’s first affects the hippocampus which is the memory center of the brain and reaches other parts of the brain with time. By the time the disease has entered into the final stage, the damage to the brain is widespread and the brain tissue is shrunk significantly (Kumar & Singh, 2015).

In the first stage, Alzheimer’s patients display mild cognitive impairment (MCI) which is presented in the form of memory problems but these symptoms do not affect the daily life functioning of the patient to a huge extent. At this stage, the damage could be restricted and cognitive decay could be prevented for years. However, the damage to the brain is irreversible and the brain cells cannot be completely healed. This decline in the memory functioning is often known in word-finding, vision issues, impaired judgment etc. which are the pre-clinical disease symptoms (Dubois, Feldman, Jacova et al. 2014)

In the clinical stage, the language centers, cognitive reasoning and the conscious thought-process of the patient is also damaged. Hence, memory loss, agitation and confusion are worse and patients are unable to recognize people and places. However, patients are still able to carry out daily living tasks without help at this stage. In the last stage, different parts of the brain are affected and the brain tissue start shrinking. Hence, patients are unable to perform their daily tasks and they are confined to the bed most of the time (Dubois, Feldman, Jacova et al. 2014).

The exact cause of Alzheimer’s is still unknown but it is said that some genetic component is associated with the early onset of disease. However, late onset of Alzheimer’s is merely a pathological change in the brain which is a combination of genetic and socio-environmental factors. Recent advancements in the brain imaging techniques have allowed clinical researchers to understand the steps of development of abnormal amyloids and proteins in the brain, and resultant changes in the brain function. The genetics of the disease is suggested to be associated with the abnormal aging or apoptosis in humans. Hence, Alzheimer’s occurs in people who are progressing towards old age and their overall body function is deteriorating (Kumar & Singh, 2015).

Research has also revealed that cognitive decline is also associated with chronic lifestyle diseases such as heart disease, stroke, high blood pressure and Diabetes (Simone Tranches Dias & Viegas, 2014). It is therefore suggested that physical activity, nutritious diet intake and social engagement are the factors that reduce the risk of Alzheimer’s among older adults. A healthy lifestyle reduces the risk of chronic diseases which in turn reduces the risk of cognitive decline among the aging population. Alzheimer’s disease can be diagnosed by conducting standard laboratory tests and blood and urine tests to rule out any other diseases. Brain CT scan and MRI are also performed to understand the causes of cognitive decline symptoms. Patients could mimic Alzheimer’s like symptoms in other psychiatric and systemic diseases such as Parkinson’s disease, tumor and stroke (Simone Tranches Dias & Viegas, 2014).

Treatment of Alzheimer’s disease is complex and it is unlikely to manage the disease symptoms with single drug therapy. Some of the medications given in combination include Donepezil, rivastigmine and galantamine which are approved by the US Food and Drug Administration (FDA). Aricept and Namzaric are also used in combination for managing severe Alzheimer’s disease symptoms. These medicines are administered for managing symptoms of sleeplessness, agitation and anxiety among patients and make the patients comfortable for some time period. The families of the patients should be well-informed, should know the long-term disease outcomes,  and should be trained to deal with the emotional and cognitive instability of the patient (Simone Tranches Dias & Viegas, 2014).

References

Alzheimer’s Association. (2018). 2018 Alzheimer’s disease facts and figures. Alzheimer’s & Dementia14(3), 367-429.

Dubois, B., Feldman, H. H., Jacova, C., Hampel, H., Molinuevo, J. L., Blennow, K., … & Cappa, S. (2014). Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. The Lancet Neurology13(6), 614-629.

Kumar, A., & Singh, A. (2015). A review on Alzheimer’s disease pathophysiology and its management: an update. Pharmacological Reports67(2), 195-203.

Simone Tranches Dias, K., & Viegas, C. (2014). Multi-target directed drugs: a modern approach for design of new drugs for the treatment of Alzheimer’s disease. Current neuropharmacology12(3), 239-255.

Written for

Empowering People with Invisible Chronic Illness-The EPIC Foundation
14-Dec-2018

Created By
HOI Solutions – Hub of Innovation