Alzheimer Disease

There are many diseases that affect the brain, we also have disorders that affect the brain and the nervous system. Dementia is a common symptom of brain diseases. Dementia is the loss of mental functions such as thinking, memory, and reasoning that is severe enough to interfere with a person’s daily functioning such as paying bills. Dementia is not a disease itself, but rather a group of symptoms that are caused by various diseases or conditions. Alzheimer’s disease is the most common cause of a progressive dementia.

Alzheimer’s Disease is a condition that affects the brain too. Alzheimer destroys the brain memory slowly, affecting thinking ability and with time the patient then get to a state where performing simple tasks becomes a big problem. It is very hard for a patient to notice that they are developing the Alzheimer disease since if starts as a simple memory loss and with time the patient then develops a dementia which progresses slowly and after several years, the affected person finds it hard to think and remember things and eventually cannot remember the basic things that a three-year-old child can remember. Mild cognitive impairment can also result to Alzheimer since, this is an intermediate stage between cognitive impairment and the dementia stage which is common among the old age. Cognitive impairment leads to dementia and after some years Alzheimer then arises.

There exists less research to understand the root causes of Alzheimer disease. Scientific researches in existence have only established that the disease develops in stages as stated above. Alzheimer was first described by Alois Alzheimer in 1907. According to him, presenile dementia, cognitive impairment, the existence of senile and neurofibrillary tangles have been defined as the key features and the tracking factors that can help in diagnosing a patient with Alzheimer (Armstrong, 2013). These features are now regarded as the clinical pathological features of the disease that is affecting the brain.

There have been reasons speculated since 1907 about the disease and some include; acceleration of aging. There is an age related to reduced brain capacity thus when one ages very fast the brain capacity tends to reduce faster. This has never been proven scientifically thus it remains a theory. Also, some argue that degeneration of anatomical pathways reduces one’s ability to think and as days go by one loses his memory and eventually he or she is diagnosed with Alzheimer. Studies in 1980s sowed that there are losses in Acetylcholine in the brain reduced one’s ability to think (Armstrong, 2013). Degeneration of one’s anatomical pathway comes as a result of reduced cholinergic system inter affecting the neural system thus resulting in memory loss cases. Another cause is linked to genetics where one may be a carrier or has the Alzheimer disease and passes it to the unborn child who then experiences the symptoms as he or she grows.

Despite lack of scientific proof on the exact cause of Alzheimer disease, scientists have linked it to the core brain proteins which at one-point fail to work normally. Abnormal functioning of these core proteins then affect the functioning of the brain releasing a series of toxic events (Lin, et al, 2018). The neurons get damages and end up losing connection to each other in return causing damage to the memory of the brain. This process is said to begin years before the signs of Alzheimer disease starts to manifest. The region of the brain which controls memory is the one that gets damaged first before the loss of neurons spreads to other parts of the brain. Since the signs are hardly felt at an early stage, when the memory part of the brain is completely destroyed, then the brain shrinks significantly and one’s memory is destroyed.

The two proteins linked to the dementia are plaques and tangles. Plaques is a beta amyloid leftover of larger proteins which when they cluster together they interrupt the functioning of the neurons and in return affecting cell to cell communication in the brain (James and Bennett, 2019). When cell to cell communication is lost it becomes hard for one to absorb and release information thus what is referred to as memory loss. The clusters form amyloid plaques which are larger clusters that also contain cell debris.

Tangles on the other hand are the Tau proteins which aid in neural transport and internal support by carrying nutrients to other parts of the brain. A person who happens to develop Alzheimer as a result of Tau changing their shape by collecting themselves into tangles which then forms structures known as neurofibrillary structures which are toxic to the brain (James and Bennett, 2019). Interrupting supply of nutrients to the brain hinders normal brain functioning which then causes cognitive impairment and as the condition last one then gets Alzheimer.

Even though the causes are not specific, there are people who are at a high risk of getting the disease. We have the old age where as you grow old the chances of the brain memory depreciating are always high. People between age 65 to 75 are at a high risk of getting Alzheimer. Also, if there is history of Alzheimer in the family then there is a chance of one out of five children might get the disease.

The Apo lipoprotein E gene (APOE) is the best understood gene factor liked to Alzheimer. A variation in APOE e4 increases the risk factor of one getting Alzheimer (Lin et al, 2018). The gene is hereditary just the same way we understand how DNA is passes from parents. However, not all the people with APOE e4 get Alzheimer it is just a few but it is good to frequently visit a physician if one experiences the symptoms and has the same gene.

A good number of those with Downsyndrome happen to be diagnosed with Alzheimer at an old age. The issue is explained by one having three copies of the 21 chromosomes thus one has three copies of the protein that lead to formation of beta amyloid. With gender less is to be explained however, there are more females with Alzheimer because they tend to live longer compared to the males. Nearly everyone with mild cognitive impairment develops Alzheimer after some years, thus this category is also at risk. Also people who have severe past head trauma can easily get Alzheimer because of the frequent interruption of the neurotransmitter cells. Lifestyle for example; non nutritional diet and lack of physical exercise, and long-term health conditions, like high blood pressure and diabetes, plays a role in risking one to get Alzheimer disease.

A person who has Alzheimer disease will always have difficulties in communicating. For instance, one cannot tell the signs and symptoms of the disease he or she is suffering from. One cannot follow medical prescriptions because they keep forgetting. One cannot adhere to instructions. In short, the affected patients will need help from family, friends or anyone willing to help them with the daily routine especially taking drugs after taken to the hospital.

At an early stage, there are symptoms like; short term memory, disturbances in sleep patterns, difficulties in doing normal routines such as getting dressed, washing hair, and generally lack of proper grooming. One will always get disoriented to normal surroundings, have problems with language including the first language (mother tongue), one will always lack a motivating factor and is fool of mood swings. When it gets to middle stage, one will always forget to properly groom themselves in the morning. One is always paranoid, full of anger, having hallucinations and keeps wandering. At the final stage, there is loss of ability to respond; one withdraws from the environment including friends. One gets bedridden because of memory loss and there are high chances to cause accidents when left alone in the environment.

Diagnosis of Alzheimer is a big problem, but one dies true diagnosis can be obtained from the autopsy done to carry out examinations if he brain is damage or a person’s mind was affected and one had Alzheimer disease. However, testing allows for 90% accuracy that a patient has “probable Alzheimer disease. The rest of the diagnosis is through studying the symptoms stated above and if they keep recurring before one gets medicine then there are very high chances one has Alzheimer disease.

Diagnosis is very important because, through diagnosis, one’s family and the doctor can help manage the symptoms of the patient. Diagnosis helps to curb problems such as incontinence and depression. If family in unsure, ruling out Alzheimer disease as cause for memory deficit in family member, diagnosis can ease concerns. Diagnosis is done to help family have as much time to prepare and learn how to care for family member with Alzheimer disease (Alzheimer’s, 2015). Some treatment medications are only used in early stage, so the earlier you can diagnose, the better the treatment options.

The treatment options that exist do not treat the disease but the symptoms of Alzheimer. The drugs offered do not stop the progression of Alzheimer but to some point, they just slow down the progress. Among the drugs given include; cholinesterase inhibitors where there are four types given that is, Tacrine (Cognex), Donepezil (Aricept), Rivastigmine (Exelon) and Glantamin (Razadyne). Antidepressants are also given, anxiolytics, and antipsychotic drugs.

Cholinesterase Inhibitors slow progression of disease via preventing breakdown of acetylcholine Donepezil (Aricept)

Antidepressants— citalopram, fluoxetine, paroxetine, and sertraline-to treat irritability and mood disorders in AD pts

Anxiolytics – Lorazepam (Ativan)-to treat any anxiety or difficulty sleeping.

Antipsychotic medications aripiprazole (Abilify) and olanzapine(Zyprexa)-To treat any hallucinations, delusions, agitation, and aggression.

Nondrug therapies: Vitamin E; Hormone therapy—estrogen in women; Music and art therapy

LITERATURE CITED

Armstrong, R. (2013). What causes Alzheimer’s disease?. Folia Neuropathologica, 51(3), 169-188.

Lin, Y. T., Seo, J., Gao, F., Feldman, H. M., Wen, H. L., Penney, J., … & Rueda, R. (2018). APOE4 causes widespread molecular and cellular alterations associated with Alzheimer’s disease phenotypes in human iPSC-derived brain cell types. Neuron, 98(6), 1141-1154.

James, B. D., & Bennett, D. A. (2019). Causes and Patterns of Dementia: An Update in the Era of Redefining Alzheimer’s Disease. Annual review of public health, 40.

Alzheimer’s, A. (2015). 2015 Alzheimer’s disease facts and figures. Alzheimer’s & dementia: the journal of the Alzheimer’s Association, 11(3), 332.