Alzheimers Disease Essay, Research Paper
Running Head: ALZHEIMER’S DISEASE
Alzheimer’s Disease, The Disease of the Century
Abstract
Alzheimer’s disease is the disease of the century. This disease is affecting many lives, families, and caregivers. This research presented is to help educate on the topic of Alzheimer’s disease, which many people aren’t aware enough about. Statistics are given to show how extreme this disease is, and how many people it’s affecting in society. Also statistics are presented that give the amount of money being spent relating to Alzheimer’s disease. This research explains the symptoms, diagnosis, and treatment of the disease. Also giving advice and strategies to help caregivers manage and support their loved one if they are struck with this disease. Not much is known for sure on what causes this disease, so everyone should be aware of what it is and what the signs are, because it can affect anyone, maybe even someone very close to you one day. It’s better to be aware, to be able to help, than to be unaware and put someone down for having difficulties in old age.
The advantage of a bad memory is that one enjoys several times the same good things for the first time (Soukup, 1996).
-Nietzsche
Alzheimer’s disease is not a new disease, nor one confirmed to this century. In fact, the earliest documented mention of a condition that now looks like Alzheimer’s disease was in 500 B.C. when Solon, the famous Greek lawyer and philosopher, wrote that impaired judgement from old age could cause a will to be invalid (Gray-Davidson, 1996). It is only our awareness, which is new. One of the possible reasons why we hear so much about Alzheimer’s disease is because of the huge increase in the number of people living longer. While the actual span of human life has not really extended, the percentage of people living to its extent has megajumped. Alzheimer’s disease is perhaps the best-known, most-feared disease of this century. Essentially, Alzheimer’s causes the computer of the brain to go down, and the whole of life becomes gradually disarrayed (Gray-Davidson, 1996).
The American Psychiatric Association’s definition of Alzheimer’s disease contained in the diagnostic manual DSM-IV, is as follows:
The essential feature of the presence of Dementia of insidious onset and gradual progressive course for which all other specific causes have been excluded by the history, physical examination, and laboratory tests.
The Dementia involves a multifaceted loss of intellectual abilities, such as memory, judgement, abstract thought, and other higher cortical functions, and changes in personality and behavior (Gray-Davidson, 1996).
Alzheimer’s is a disease of the brain that causes a steady decline in memory. This results in dementia, loss of intellectual functions such as thinking, remembering, and reasoning, severe enough to interfere with everyday life (Gwyther, 2000). As with all dementia’s, the rate of progression in Alzheimer’s patients varies from case to case. From the onset of symptoms, the life span of an Alzheimer’s victim can range anywhere from 3 to 20 or more years. The disease eventually leaves its victims unable to care for themselves. While a definitive diagnosis of Alzheimer’s disease is possible only through the examination of brain tissue, which is usually done at autopsy, it is important for a person suffering from any symptoms of demetia to undergo a thorough clinical examination. In fact, after such an evaluation, approximately 20 percent of suspected Alzheimer’s cases prove to be a medical condition other than Alzheimer’s, sometimes treatable (alzsf.org).
When German physician Alois Alzheimer first described the disease in 1907, it was considered rare (Gwyther, 2000). During the 1960s researchers also considered Alzheimer’s a rare disorder. But over the last 30 years, scientists have recognized that it’s fairly common. In fact, Alzheimer’s disease is the leading cause of age related dementia (Alzheimers.com). Today, Alzheimer’s affects 10 percent of people 65 years old, and nearly 50 percent of those ages 85 or older. An estimated 4 million Americans have Alzheimer’s (Gweyther, 2000). Slightly more women than men have Alzheimer’s (Alzheimers.com). Alzheimer’s is found all over the world. Researchers have found it in China, India, the South Sea Islands, Japan, and Western Europe. It cuts across all socio-economic levels and across all races (Gray-Davidson, 1996). Many famous people have had Alzheimer’s disease such as, British statesman Winston Churchill, actress Rita Hayworth, and most recently, former President Ronald Regan (Alzheimers.com).
Currently the U.S. population is aging, with people over 85 becoming the nation’s fastest-growing age group. Because this is also the group most affected by Alzheimer’s disease, experts warn that unless researchers discover how to prevent the disease, by the year 2050, as many as 15 percent of those over 65 might have Alzheimer’s (Alzheimers.com). Alzheimer’s affects not only the person with the disease, but his or her loved ones. According to the Alzheimer’s Association and the National Institute on Aging, about 2.7 million spouses, relatives, and friends care for people with Alzheimer’s. Some 19 million Americans say a family member has the disease, and about 37 million Americans say they know someone with Alzheimer’s. Half of all nursing home residents have Alzheimer’s disease or some other dementing illness (Alzheimers.com).
Alzheimer’s disease is a brain disorder, which gradually destroys the ability to reason, remember, imagine, and learn. It’s different from the mild forgetfulness normally observed in older people. Over the course of the disease, people with Alzheimer’s no longer recognize themselves or much about the world around them. Depression, anxiety, and paranoia often accompany these symptoms. Although there is no cure, new treatments help lessen Alzheimer’s symptoms and slow its progression (Alzheimers.com).
Alzheimer’s is marked by abnormal clumps called senile plaques and irregular knots called neurofibrillary tangles of brain cells. For reasons not well understood, these plaques and tangles take over healthy brain tissue, devastating the areas of the brain associated with intellectual function (Alzheimers.com).
Normally, the nerve cells in the brain are arranged in an orderly manner. In Alzheimer’s they become extremely disorganized and tortured looking and they stop functioning. As brain cells stop working, part of the brain dies, and the activities those cells control, memory, reasoning, and ability to take care of oneself, fade away. As more neurofibrillary tangles form, mental abilities deteriorate further, a state called progressive dementia (Alzheimers.com).
Scientists are still not certain what causes the disease. Age and family history with Alzheimer’s disease are identifiable risk factors for the disease. Scientists are still exploring the role of genetics in the development of Alzheimer’s, focussing on chromosome 19, rarer forms of the disease, which strike people in their 30’s and 40’s, often run within families and appear to be related to chromosome 1, chromosome 14, and chromosome 21 (Gwyther, 2000). Many researchers and physicians are coming to believe that Alzheimer’s is a complex disease, probably caused by a variety of influences (Gwyther, 2000). There is no sure-fire way to prevent the onset of Alzheimer’s disease. But some preventative treatments, such as estrogen for women, are promising (Alzheimers.com).
Cases where several members of a single family have had autopsy confirmed diagnosis’s of Alzheimer’s disease are rare. Much more common is the situation where a single family member is diagnosed as having probable Alzheimer’s, meaning that physicians are 80 to 90 percent certain that it is Alzheimer’s (Gwyther, 2000). A person’s risk of developing the disease seems to be slightly high if a first-degree relative, brother, sister, or parent, has the disease. This situation is called “familial”, which means there could be a genetic factor involved, or perhaps family members were exposed to something in the environment that caused the disease (Gwyther, 2000).
The disease can occur in people in their 30’s, 40’s, and 50’s, however, most people diagnosed with Alzheimer’s are older than 65. This is called “early onset” and represents less than 10 percent of Alzheimer’s cases. When a younger adult has Alzheimer’s disease, the issues related to care, financial planning, work, family, children, etc., can be very different than with older adults with the disease (Gwyther, 2000). The youngest person ever diagnosed with Alzheimer’s was 27 years old, this is a very rare case (Gray-Davidson, 1996).
Symptoms of Alzheimer’s
Everyone has forgotten where they’ve parked the car or the name of an acquaintance at one time or another. And many healthy individuals are less able to remember certain kinds of information as they get older. The symptoms of Alzheimer’s disease are much more severe than such simple memory lapses. Alzheimer’s symptoms affect communication, learning, thinking, reasoning, and can have an impact on a person’s work and social life. For example, a person with Alzheimer’s forgets whole experiences and rarely remembers them later. A person with age associated memory problems forgets parts of experiences and often remembers them later (Gwyther, 2000).
Typically, loved ones notice gradual- not sudden- changes in a person who is in the early stages of Alzheimer’s. It usually takes months to realize that something serious might be wrong (PlanetRx). At its onset, Alzheimer’s disease is marked by simple forgetfulness,
The next stage of the disease is characterized by greater difficulty in doing things that require planning, decision making, and judgement. For example, during this stage, one may have difficulties working, balancing a checkbook, or driving a car. Everyday skills such as personal grooming aren’t affected, but social withdrawal begins (Alzheimers.com). Perhaps driving ability is one of the first skills lost to the disease, presumably because it demands so much information processing, and requires constant decision making (PlanetRx).
Eventually, people with Alzheimer’s disease can’t do simple tasks of daily living such as eating, bathing, and using the toilet. They may lack interest in personal hygiene and appearance, and lose their usual sexual inhibitions. They may have a hard time recognizing all but their closest daily companions. Communication of all kinds becomes difficult as written and spoken language dwindles. Withdrawal from family members begins and the person may become agitated, displaying belligerence and denial of the illness (Alzheimers.com). Memory problems also frequently result in interpersonal problems. The victim tends to ask the same question repeatedly (Soukup, 1996). Persons with Alzheimer’s often make constant demands and ask incessant questions in effort to understand where and who they are and what is happening to them (Check, 1989). Alzheimer’s sufferers also tend to become angry and irritable when they misplace items of significance (Soukup, 1996).
In the last stages of the disease, a person with Alzheimer’s becomes bedridden, unable to recognize themselves or their closest family members. They make small, purposeless movements and communicate only by screaming out occasionally. Essentially, the brain forgets how to live. Death often results from pneumonia and complications of immobility (Alzheimers.com).
Diagnosis and Treatment of Alzheimer’s
At the New York University Medical Center, Dr. Reisbery and colleagues have shown that the decline typical of Alzheimer’s disease is the flip side of normal skill acquisition by infants, children, and young adults (Alzheimers.com). Currently doctors can’t diagnose Alzheimer’s disease with 100 percent certainty until a brain autopsy after the persons death reveals the disease’s markers: abnormal clumps and irregular knots of brain cells. So diagnosis of Alzheimer’s rests largely of the judgement of physicians experience in dealing with dementing illness. But that judgement has become quite sophisticated. Experts estimate current diagnostic accuracy at around 90 percent (Alzheimers.com).
Most people with Alzheimer’s live for seven to ten years after diagnosis, and spend about five years under vigilant care either at home or in a nursing home. More than 70 percent of people with Alzheimer’s live at home (Alzheimers.com).
Some possible –though not definitive – tests for Alzheimer’s disease include brain scans and pupil dialation. New brain imagining technologies: positron emission tomography (PET) and single photon emission computed tomography (SPECT), can help diagnose early stages of Alzheimer’s disease, but by themselves, they are not definitely diagnostic (PlanetRx). The pupil dialation test is based of dialation of the pupil of the eye. In routine ophthalmologic exams using standard chemicals to dialate the pupil, the pupils of people with Alzheimer’s disease seem to dialate unusually quickly (PlanetRx).
Although currently there is no drug that can cure Alzheimer’s, families need to consider several options in ongoing treatment of the person with Alzheimer’s. The primary care physician should be intricately involved in making recommendations about medications that may slow or temporarily delay progression of the disease, such as, Donepezil and Cognex. Additionally, if there are medical or behavioral symptoms that are treatable, such as agitation or depression, options are available that may provide relief for the patient and allay some of the difficulties the family members deal with on a daily basis (alzsf.org). Families may also want to consider non-traditional forms of treatment that may involve anti-oxidants, massage, art and other therapeutic mediums, among others. Involving the patient in regularly scheduled and routine activities may also provide continuity and allow the patient to function more independently for a longer period of time (alzsf.org).
Costs and Research Funding Statistics
-Experts estimate that Alzheimer’s disease costs the United States $80 billion to $100
billion a year in lost productivity, medical care, and personal caretaking.
-For people with Alzheimer’s cared for at home, the average out-of-pocket cost to family
caregivers (excluding lost wages) is $12,500 per year.
-For people with Alzheimer’s in nursing homes, the average cost is $42,000 per year per
person.
-The average cost of caring for a person with Alzheimer’s from diagnosis until death is
$174,000, making Alzheimer’s disease the nation’s third most costly illness, after heart
disease and cancer.
-The Alzheimer’s disease federal research budget has grown substantially over the past
decade, to more than $400 million in 1999. But that figure represents only a small
fraction of what the disease costs (Alzheimers.com).
Typically, people with Alzheimer’s express their longings for deep emotional security and unconditional love all the time. Often, we do not choose to hear what they say. Either at home or in care situations, it is typical for these words to be dismissed as the babbling of dementia, but if we stop and listen, we can hear the longings clearly expressed: “I want to go home”, “I want to see my mother”, “I’m lonely”, “no one ever comes to see me”. These are not just nonsense or meaninglessly repeated complaints. They are the deepest longings of the human being, to be cared for and accepted, to be cherished and protected, to be loved (Gray-Davidson, 1996).
In the early and middle stages of Alzheimer’s disease, people with the illness may be painfully aware of their intellectual failings and what is yet to come. At this stage and throughout the course of the illness, it’s vitally important to support their mental and emotional well being with the help of the doctor, social worker, or psychological counselor. Show them love affection and warmth as they make their journey (Alzheimers.com).
Discussion
Age is a state of mind.
Do not regret growing old.
It is a privilege denied many ( Soukup, 1996).
-Author unknown
Since there are so few treatments for Alzheimer’s disease, many of the available therapies attempt to improve the quality of patients lives, keep them safe, and make caring for them easier. Support for the main family involved in caring for the victim is also important, and a doctor will help determine at what point the person with Alzheimer’s may need professional nursing care outside of the home. The responsibilities may become to stressful mentally and physically on the family, and they may need help.
Most of us know very little about Alzheimer’s, and what we know is often incorrect. It will be helpful to the current author and to others to have an accurate body of knowledge in coping with a relative who has the disease. There will probably be no “magic cures” for Alzheimer’s disease, but considerable time and money are being spent to understand this illness, how it’s caused, and how best to care for people who have it.
In society today, people are so worried about growing old, but it is a fact of life. Everyone will grow old, and everyone will die, some sooner than anticipated. We can’t spend our lives dwelling on the fact of becoming old some day. We should enjoy life to its fullest, and love, share, and spend time with family and friends. There shouldn’t be such a stereotype of old people, making it out to be such a horrible thing. The elderly should be admired and looked up to for everything they’ve seen and been through in there lives, and if someone close falls victim to Alzheimer’s or any other disease, we should be there for them to love, support, and care for them. Finally, Alzheimer’s disease is an extremely prevalent issue in the late 20th century. Public awareness of the disease is expanding rapidly, and it needs to be, since this disease is striking more and more, and effecting many families and lives.
References
Alzheimers.com. (2000). What Is Alzheimer’s Disease
http://www.alzheimers.com/health_library/basics/basics_01_what.html
Alzsf.org. (2000). About Alzheimer’s Disease
http://www.alzsf.org/abtalz/abtalz.html
Check, W. (1989). Medical Disorders and their Treatment
Alzheimer’s Disease. New York: Chelsea House Publishers
Gwyther,L. (2000). Care of Alzheimer’s Patients: A Manual for Nursing Home Staff
Available: http://www.alzsf.org/abtalz.abtalz.html.
Gray-Davidson, F. (1996). The Alzheimer’s sourcebook for Caregivers
Los Angeles, CA: Lowell House
PlanetRx (2000). The eCenter for Alzheimer’s
http://www.planetrx.com/ecenter.alzheimers.diagnosis.0325_totell.html
Soukup, J. (1996). Alzheimer’s Disease: A Guide to Diagnosis, Treatment, and Management Westport, CT: Praeger Publishers