Report on Alzheimer’s Disease: History, Nature, Impact and Treatment

In the beginning, forgetting where one left their car keys, then forgetting one’s child's name, to lastly not having the ability to live on their own. Alzheimer’s disease creeps in, seeps and takes over the brain of the affected individual. This tragic disease decays the psychological state of the individual until they eventually are unable to function much less survive. Is Alzheimer’s disease curable? Is AD treatable? How does this horrible disease chemically work? What kind of symptoms should a patient expect? How is it affecting our population? What is being done to make a change? These are all questions that will be answered over the course of this article.

The name originated from a young psychiatrist, Alois Alzheimer, who married Auguste Deter. Alzheimer admitted Deter into a psychiatric hospital, where she remained until her death in 1906, at the age of 51 due to her paranoid and aggressive state of what is now known as Alzheimer’s. This simply began with her having increasing memory loss at the age of 50 (displaying early-onset Alzheimer’s disease). After her death, Deter’s brain was examined to discover amyloid plaques and neurofibrillary tangles. Most people develop these plaques and tangles as they age, but it occurs in AD patients at a higher rate with many more than the average person. Alzheimer concluded that there was a correlation between the evidence found on her brain and a clinical illness, this theory was frowned up by his colleagues. It seemingly was too hard to be distinguished and faulty in the research. In the 1980’s, Alzheimer’s became known as a common cause of dementia in senile people due to the distinction made between pre-senile and senile individuals in 1976.

Alzheimer’s disease is a form of dementia caused by the lack of a neurotransmitter called acetylcholine (the first neurotransmitter ever discovered). This neurotransmitter serves for both the peripheral (parasympathetic and sympathetic branches), and central nervous system. It plays an important role in neuroplasticity (the ability for the brain to adapt as a result of experiences), memory, and learning. The lack of acetylcholine causes Alzheimer’s disease as evidenced by weakened memory, inability to retain information, and adjust to new surroundings. Most people don’t understand the difference between dementia and Alzheimer’s. Dementia is the impairment in intellectual capacity and behavior that demonstrate a group of symptoms. It is not a disease, but rather a syndrome. While Alzheimer’s disease is the most common form of dementia, but dementia can occur due to many reasons. AD has evident decay in the brain while dementia is simply memory loss. Alzheimer’s disease can be genetic or caused by environmental factors. One of the biggest factors is age; the older an individual gets, the higher their chance is for getting Alzheimer’s. AD is considered early-onset if it affects anyone under the age of 65 and can affect people as early as in their 30s. Early-onset AD is a very rare form of the disease and tends to be genetic. It is caused by a mutation in one gene and the mutated gene is copied and inherited from one parent. At this point in time, technology is advanced enough to perform genetic tests to figure out if someone has the gene for Alzheimer’s disease or not.

Genetic testing might be a good idea for an individual worried about getting the disease, because if there is a chance of them getting it, they can take preventative steps to slow its progression. Examples of preventative steps would be reading and exercising. There are other risk factors for developing Alzheimer’s disease include gender, statistics have suggested that women are more likely to develop Alzheimer’s than men, and Down syndrome. People with Down syndrome have a higher chance of developing AD and faster than the rest of the population, they tend to develop the early-onset version of Alzheimer’s at about the age of 40.

There is no current cure to Alzheimer’s right now, but there are ways to treat the illness to slow down the progression. The main drugs used for the treatment of Alzheimer’s disease are rivastigmine, galantamine, donepezil, and memantine. These drugs help enhance the cognitive performance and enable the daily activities of the patient for the first year of treatment. While the other drugs’ potency decreases, memantine continues to be effective in patients in the middle and late stage. Though these drugs assist in the delay of AD, they unfortunately do not prevent the ultimate deterioration of the patient’s brain. Research in Alzheimer’s needs to accelerate quickly, it is affecting people every single day. Trials have been conducted on patients with mild to moderate Alzheimer’s disease using anti-amyloid (amyloid plaques are found in the brains of patients with AD) approaches. The results of these trials have been concluded to be unsuccessful in the prevention or delay of the symptoms of Alzheimer’s, though, upon further analysis, reasons for the failed trial include insufficiently targeting the wrong drug or possibly treating the patients too late. This leads to the incorrect conclusion that to prevent or treat Alzheimer’s the anti-amyloid drugs must be given early in the progression of the disease. Research suggests that blocking the proteases that create amyloid beta during the early stage decreases amyloid production. This slows down the deterioration of cognition in the affected individual. Individuals afflicted with the disease endure a slow progression through the symptoms.

One specific symptom that is constant throughout the progression of the illness is trouble sleeping or insomnia. Due to their lack of sleep at night, patients with AD sleep excessively during the day and become agitated during the evening. This affects between twenty five percent to forty percent of diagnosed patients. The insomnia as well as the circadian rhythm worsens as the AD progresses in the patient. The pathology of Alzheimer’s is present for about 10 to 15 years before symptoms appear. After being diagnosed with Alzheimer’s, a person tends to live between four and eight years. During the early stage, the individual has trouble remembering the names of people they are introduced to, performing tasks in social settings, remembering where objects are, organization skills, and more. In this stage, the person is still functioning at an independent level and is able to carry out tasks though it becomes increasingly difficult. During the middle stage of Alzheimer’s disease, the afflicted person has trouble recollecting pieces of their own life or personal information (such as phone numbers). They tend to have noticeable mood shifts as attempting to recollect information becomes frustrating. At this point, they need to be cared for significantly more as they have difficulty sleeping, clothing themselves appropriately, and a growing tendency to wander away. Someone with severe AD is considered to be in the late stage, they require around-the-clock care due to their inability to effectively communicate, walk, or eat. During the late stage, the patient is more susceptible to infections, because their immune system is no longer strong enough to fight off any sort of bacteria or intrusive entity.

AD is the sixth leading cause of death in the United States, but recent studies suggest that it may rank behind cancer and heart disease, coming in third. Since Alzheimer’s disease is also a leading cause of dementia in older adults, it interferes with a person's daily life and activities that they perform. It is also common for people to have mixed dementia (a combination of two or more disorders), for instance, Alzheimer’s and vascular dementia, affecting daily life even more. Alzheimer’s is also a common disease, holding more than three million US cases per year, impacting not only the person diagnosed with it, but their families and friends as well. Families and friends have been impacted so much by Alzheimer’s that they are often referred to as invisible patients. With primary caregivers (family or friends), they have to balance out their normal lives while also devoting their time to round-the-clock care and support to their loved one. Keeping an individual in institutional care results in limited exposure to the sun which may do further damage to the circadian rhythm therefore, a caregiver must make sure they get sufficient sunlight exposure.

Dealing with all of these things at once can weigh heavily on a person’s life and exhausts them mentally, physically, and emotionally. . The best thing someone can do as a caregiver to prepare for them, is to organize resources and develop a detailed plan to help. Resources a caregiver could utilize include therapists, specifically grief counselors, items to help the afflicted individual know where certain things are such as: sticky notes, reminders, and timers all to build a routine, and lastly support groups to remind everyone involved that they are not alone. Another thing caregivers can provide patients with Alzheimer’s disease is a predictable and consistent home environment to keep them from getting anxious. Being creatures of routine, the body and brain of a patient craves order in things to keep threats and disaster at bay. Primary caregivers often feel guilty for the way the patient was treated in the past which can put a large amount of strain on a person mentally. There is also a great deal of grief and loss involved in the process as well. Loss being the current decay and eventual death of the person they used to know and the loss of relationship. Grief and loss can result in depression as well, leaving major strain on a person's health and emotional wellbeing. A resulting impact of this can be a lack of attention on other people in the primary caregivers life. This lack of attention can cause chaos in family life with kids not knowing how to react or teenagers rebelling at the lack of attention.

In conclusion, there is no certainty that someone won’t be afflicted with AD, no matter how many preventative cautions they take. The risk runs in every human despite best efforts. Alzheimer’s disease continues to take the lives of loved ones slowly, therefore research must continue to progress in prevention or finding a cure so not only patients can stop suffering, but the family and friends of the individual as well. This disease is difficult for everyone involved, from the caregivers to the immediately family, to watch the slow way it consumes people becomes agonizing. The inevitable decay of the human brain will continue to be an issue unless there is intervention for a cure. A cure for Alzheimer’s may be far in the future but a deeper growth and understanding is now- in the present.