Alzheimer’s disease (AD) is a brain disorder which is commonly associated with the elderly. It affects the cognitive faculties because it causes a progressive decline in: language skills; memory; space and time; and ability to take care of one self and others (AA, 2011). AD is described as the most common cause of memory loss in people aged 65 and above. As one gets older, the risk of developing AD increases. Symptoms of AD may be mild or severe, depending on the disease progression and other factors. AD has the potential to severely limit the normal functioning of the patient. This usually takes a heavy toll on the family, as it is an uphill task to take care of an AD patient.
Symptoms and Signs of Alzheimer’s Disease
While memory loss is a normal sign of aging, it is important to differentiate between age-related memory loss and that caused by AD. An AD patient suffers from losing memory of information which has been learned recently (UPMC, 2005). An AD patient also finds it hard to finish everyday tasks or to plan anything. They often lose track of steps to follow when carrying out basic activities like cooking, playing games or making telephone calls.
Another sign of AD is loss of language or words to describe basic items. They often do not remember simple words and may substitute them with unusual words. This may often make hard to comprehend what they say or write. AD also causes a patient to become disoriented with regards to place and time. They often lose their way in their neighborhoods, forget who they are and may be unable to find their way home. The patient also demonstrates judgment which is decreased. An example of this is that a patient may give away too much money to telemarketers or they may wear inappropriate clothes (Brice, 2004).
AD also causes abstract concepts likes numbers to become unclear. The patient may be unable to remember how numbers are used and may be unable to remember how numbers work and may be unable to perform complex mental calculations. The patient may also misplace items or put them in strange places like putting a toothbrush in the refrigerator. AD also interferes with hormonal balance which causes fast mood swings usually without solid reasons. This may lead them to experience personality changes. They may also lose initiative and zest for life and may become extremely passive. This is shown by oversleeping, laziness or watching too much television (Valo and Wabler, 2006).
Causes and Risk Factors
The main risk factor for Alzheimer’s disease is age. Many patients are aged 65 years and above. After 65 years, the chances of AD development double every five years. At the age of 85 years and above, the risk is about 50% (AA, 2011). Another risk factor is the family genetics and history. Research studies have indicated that if AD has occurred in the family, then chances of developing it is multiplied by two or three (UPMC, 2005). A certain gene has been identified which increases risk of developing AD but does not guarantee development (AA, 2011). Some rare genes are definite indicators that Alzheimer’s will develop.
Disease Progression- the Stages of Alzheimer’s
Alzheimer’s disease becomes worse with increasing time. Although the symptoms differ from one person to another, there are general guides to the stages.
Stage One: In this stage, there is no memory loss. The patient functions normally.
Stage two: This stage causes mild memory lapses.
Stage three: At this stage, memory lapses become noticeable to those around the patient. This indicates a mild reduction in cognitive functions. For some people, medics may be able to detect memory problems. At this point, according to Brice, (2004), the patient may exhibit the following:
- Forget the right word
- Unable to recall names of new people
- Forget recently read material
- Unable to organize or plan
- Misplace objects
Stage four: In this stage, there is moderate decline in the patient’s cognitive faculties. The patient may exhibit the following:
- Unable to perform complex mental arithmetic
- It becomes more difficult to plan events like dinner and paying bills.
- Forgetting personal history
- Mood swings and withdrawing from social situations.
- Medical examination is necessary (Valo and Wabler, 2006).
Stage five: This is stage is mid-stage Alzheimer’s. There are clear and noticeable gaps and lapses in memory. Patients need assistance with daily activities. Cognitive degeneration is moderately severe (AA, 2011). Patients at this stage demonstrate:
- May forget their own phone number, address or college
- Have poor judgment- may wear winter clothes in summer
- Completely unable to perform easy mental arithmetic
- May lose track of date or time
Stage six: The patient suffers from degeneration of cognitive faculties. Personality changes can also be noted. They exhibit the following:
- Trouble with personal history
- Changes in sleep patterns
- May forget spouses or caretaker’s name but can distinguish faces
- Need help with dressing and going to the toilet and others.
- Cannot recall neighborhoods, tend to wander around and get lost
Stage 7: This is late stage Alzheimer’s disease. Individuals are unable to respond to their surroundings. They may be unable to control movements or hold conversations. They require assistance in personal care especially in the bathroom and eating. Their muscles become rigid and their reflexes abnormal (Brice, 2004).
Diagnosis of AD may require the services of a psychologist, psychiatrist and neurologist. A psychologist tests memory while a psychiatrist investigates how the mind works. The neurologist understands the mental and nervous system diseases. The following steps will be taken:
The doctor will review medical history to find out the family has incidences of genetic, physical and mental diseases.
An evaluation of the mental and mood status
Physical examination and tests. Overall health will be assessed to ensure other diseases are not causing the memory losses.
A neurologic exam-This will check for coordination, reflexes, speech and sensation. These are done to eliminate occurrence of other ailments like Parkinson’s disease.
This involves treating the symptoms because there is no cure for AD. Cognitive symptoms are treated by drugs which slow down the degeneration of the brain cells. An example of these drugs are cholinesterase inhibitors. These ensure that levels of acetylcholine remain high supporting communication between nerve cells. According to AA, (2011) mild or moderate Alzheimer’s may be treated by the following drugs: Doneprezil (Aricept®); Rivastigmine (Exelon®); and Galantamine (Razadyne®). Another drug type works by regulating glutamate activity. Glutamate is a chemical messenger which is involved in processing information. The only drug used of this kind is Memantine (Namenda®). Memantine is used to treat severe or moderate AD (AA, 2011). Vitamin E may also be prescribed under certain conditions to treat cognitive symptoms. It protects cells from particular forms of wear and tear.
Behavioral symptoms may be as a result of medications, medical conditions or environmental situations. Behavioral symptoms are controlled by interventions to create a comfortable environment. Non drug and drug treatments may help alleviate behavioral symptoms based on the causative factors. It is vital that the patient receive loving care from family and friends (UPMC, 2005).
AD is a progressive mental disorder common among the aged population. It degenerates the cognitive faculties of the patient causing memory loss which worsens a time moves on. Other symptoms may be confusion, misplacing objectives, language trouble or inability to recall familiar places. The main risk factor for AD development is age, and this risk increases as one grows older. The disease progresses in several stages, each stage displaying distinct characteristic behavior. Diagnosing AD requires careful monitoring and evaluation of physical, psychiatrist and psychological functions. Unfortunately, there is no cure for AD but it is controlled by managing the symptoms (AA, 2011).
Alzheimers Asssociation (2011).Basics of Alzheimer’s Disease. Available at http://www.alz.org/national/documents/brochure_basicsofalz_low.pdf
Brice A. (2004). Alzheimer’s Disease. Available at http://www.orpha.net/data/patho/Pro/en/Alzheimer-FRenPro631.pdf
University of Pittsburg Medical Centre (2005).Alzheimer’s Disease. Available at http://www.upmc.com/HealthAtoZ/patienteducation/Documents/AlzheimersDisease.pdf
Valo J. and Wabler S. (2006).Alzheimer’s Disease. Available at http://www.cdc.gov/excite/ScienceAmbassador/ambassador_pgm/lessonplans/Valo-Wabler_Alz.pdf