Alzheimer's Disease

Alzheimer's Disease

With all of the advanced technology that the medical field possesses today, there are still some diseases that are just incurable. One of those diseases that continue to takes the lives of many people each day is Alzheimer's disease. This paper will thoroughly discuss the disease by examining its definition, its causes, treatments, symptoms and how to make the life of an Alzheimer's patient easier.

Alzheimer's disease is the most common form of dementia, a disease in which the loss of mental ability is severe enough to interfere with daily activities, it last at least six months and it is not present from birth (Bronstein & Pulst, 1996). Many scientists believe that Alzheimer's results from an increase in the production or accumulation of a specific protein (beta-amyloid protein) that leads to the death of nerve cells. The loss of certain nerve cells in the brain causes defects in the neurotransmitters, which are the brains main form of chemical messengers. It is not simply something that happens later in life, it's one of the dementing disorders that result in a loss of mental and physical functions.

Certain risk factors can play a part in who gets Alzheimer's disease. Women are more likely to contract the disease then men, but this is due to the fact that women live longer. Those that have an immediate relative (parent, sister or brother) have a slightly higher chance of getting Alzheimer's then others, more about the genetics that is involved in Alzheimer's will be discussed later. You lifestyle can also play a part; recent studies show that you need to exercise your brain, perhaps doing a crossword puzzle each day (Stewart, 1998). Recent studies done by the J Neurol Neurosurg PsychiatryAssosaition are showing that there is a relationship between cardiovascular disease and Alzheimer's disease. The exact relationship has not yet be confirmed, but it is known that Alzheimer's disease can intensify the effects of a coexisting cardiovascular disease (Stewart, 1998). Some people believe that smoking and Alzheimer's are related, many studies have examined this yet none have come to a conclusion of whether it is a negative or positive factor. One study did discover that current smoking over a two year period is a risk factor with those who already have Alzheimer's disease (Off, Slooter & Hoffman 1998).

Alzheimer's is generally related to age. Early onset Alzheimer's disease is when someone as early at 40-50 develops symptoms. As age increases, the frequency of Alzheimer's does also. Ten percent of people over the age of 65 and fifty percent of those 85 and older have Alzheimer's disease. By 2050 it is expected that 14 million people will have Alzheimer's (Bronstein & Pulst, 1996). From the time one is first diagnosed with Alzheimer's disease they have on average eight years to live, but this can range from one year to twenty. Alzheimer's disease is the fourth leading cause of death in adults. The average cost of caring for someone with Alzheimer's disease is roughly $174,000 over the course of the disease. Although if the condition is so bad that outside help is need such as a nursing home, the cost rises (Robinson, 1999).

In 1906 Dr Alois Alzheimer, perfomed an autopsy on a women who died from an unusual mental illness. He discovered changes in the women's brain tissues; the brain became clogged with two structures, which are no known as neurofibrillary tangles and senile plaques. The senile plaques degenerate nerve cells that are surrounded by a protein known as beta amyloid, and the neurofibrillary tangles are simply twisted masses of protein fibers. It is not clear how these structures cause problems but it is believed that they interfere with communications between the neurons and the brain (Robinson, 1999).

The disease takes place in stages, at first one will experience short term memory loss which results in forgetting simple daily activities, they could forget to take their medicine or forget a doctors appointment. They also experience a slight personality change and a withdrawal from social activities. Simple things like these can affect their job or marriage. As the disease develops they have problems with abstract thinking, they may have trouble with numbers when trying to pay their bills, or just in general being organized. They become disoriented, not knowing where they live, who is around them. They begin to forget names of close relatives, become slightly violent and even wander off not knowing where they are going. In very extreme cases one can forget how to take care of oneself, they need help eating and walking and can even forget how to talk. Even with all the symptoms of Alzheimer's, the patients must undergo many tests. Their medical history must be checked because some prescription and some over the counter drugs can show symptoms similar to those of Alzheimer's disease. A final positive diagnosis can only be made after death during an autopsy when senile plaques and neurofibrillary tangles are present (Robinson, 1999).

There are a few treatments available, but none of which are completely effective seeing how Alzheimer's is still incurable. The Food and Drug Administration (FDA) has approved two drugs for the treatment of Alzheimer's disease, Tacrine (Cognex) and donepezil hydrochloride (Aricept). Both of these increase the levels of communication in the brain by increasing the neurotransmitter levels. Specifically they increase the amount of neurotransmitter acetylcholine, which is involved in sending messages that have to do with muscle action, learning and memory. They do this by inhibiting the enzyme acetylcholinesterase, which normally breaks down acetylcholine after neurons release it. They cannot stop the deterioration of the nerve cells they can only help increase the amount of communication done by the remaining cells. The Tacrine drug is effective in improving memory skills, but only for those with mild Alzheimer's disease. Its effects are usually mild and temporary but they can help delay the need of a nursing home, which saves a lot of money. The Tacrine has some side effects such as nausea, diarrhea abdominal cramps, ect. It costs roughly $125 a month but compared to the price of a nursing home it is worth the money. Donepezil on the other hand has a few advantages over Tacrine. It has less side effects and only needs to be taking one time a day rather then the three times that Tacrine must be taken. Several recent studies are showing that women who take estrogen have lower rates of Alzheimer's then those who are not taking estrogen. However those that develop it any way have less severe symptoms and a slower progression of the disease. It is also suggested