Alzheimer's Disease

Alzheimer's Disease

Alzheimer's is the most common form of dementia. Dementia is caused by destruction

of brain tissue. Alzheimer's Disease (AD) has an insidious onset and symptoms are progressive. It is not a part of normal aging, it is a disease. This usually affects older adults over 65 years old. An estimated 4.5 million Americans have AD. Since Americans are living longer lives, more people will have Alzheimer's. I chose AD as my topic because I believe most of us will be affected by the disease at some time in our lives either personally or professionally. This disease slowly robs people of their memories, relationships, and eventually their lives.

AD destroys proteins of nerve cells of the cerebral cortex by diffuse infiltration with nonfunctional tissue called neurofibrillary tangles and plaques. The tangles and plaques

represent the death of nerve cells throughout the brain (Ebersole, Hess, Touhy, Jett, 2005). Neurofibrillary tangles are seen in the cytoplasm of abnormal neurons in those areas of the brain (hippocampus, cerebral cortex) most affected by AD. In the cerebral cortex they are found in those areas of the brain associated with cognition, learning, sleep and memory (Lewis, Heitkemper, Dirksen, 2004). AD is characterized by memory and cognitive impairment, language problems, changes in personality, and decreased ability to perform daily activities.

There is a genetic link to AD. Amyloid-beta protein overproduction is thought to be a risk factor. There is a higher risk of getting the disease if a parent, or sibling has the disease. Risk factors include age, female gender, serious head injury, heart disease, diabetes, stroke, hypertension, and hyperlipidemia.

The course of AD ranges from 1 to 15 years. It is a progressive disease that usually

starts with memory loss. Alzheimer's progresses slowly with additional cognitive impairments as the disease evolves. The nursing goals for patients with AD are to have them maintain as many activities of daily living (ADL's) as possible, keeping them in a safe environment, and to maintain their dignity.

In the preventive phase the patient would start to be forgetful, most would blame this on age. There may be problems with language, the patient may forget simple words. They may have trouble dressing appropriately for the season or for an event. There may be changes in mood, behavior, or personality. This is the phase that sends signals to the family members that something is wrong which leads them to investigate further with their physician.

The definitive (diagnostic) phase would include anxiety for the patient and family while waiting for a diagnosis. This phase would involve physical and mental demands from the patient as they undergo tests. They would have a comprehensive evaluation with a complete health history, physical exam, neurologic and mental status assessments. They may have an electroencephalogram (EEG), computed tomography (CT) or magnetic resonance imaging (MRI). After learning about their diagnosis, the patient will go through many emotions if diagnosed in the early stages. These may include denial, anger, and depression. Feelings of powerlessness and hopelessness are also common.

The stable phase would probably be in the early stages of the disease. The patient would still be able to perform ADL's, participate in social activities, and recognize family members. They will be able to reminisce