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Alzheimer's Disease

 
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Unfortunately, the humankind still remains helpless and vulnerable in front of many incurable and insidious diseases, despite the incredible development of the medicine nowadays. Alzheimer’s disease belongs to maladies that can slowly ruin normal human life. Any person may become a victim of the sickness regardless of ethnic, social or material status. Everybody knows such examples as former American President Ronald Reagan, former Prime Ministers Margaret Thatcher, Harold Wilson (United Kingdom) and Adolfo Suárez (Spain), writer Iris Murdoch, the actress Rita Hayworth, the actor Charlton Heston and others became sufferers of Alzheimer's (Who is affected by Alzheimer’s, 2013).

The purpose of this essay is to enrich one’s medical knowledge and make people more educated of recognizing such medical condition as Alzheimer’s disease, what happens inside the brain as the disease progresses, the possible causes and risk factors, its clinical manifestations and current treatment.

Alzheimer’s disease became known due to the research work made by a German psychiatrist and neuropathologist Alois Alzheimer. He discovered certain changes in the brain tissue of a dead woman. He detected suspicious lumps (amyloid plaques) and mixed threads of fibers (neurofibrillary fibers). The scientists have come to the conclusions that the presence of amyloid plaques and neurofibrillary fibers are closely interlinked with Alzheimer’s disease (What Happens to the Brain in Alzheimer’s?, 2013).

There are various definitions of the highlighted medical condition. Mayo Clinic characterizes Alzheimer's disease as “a progressive disease that destroys memory and other important mental functions.” Other scientists specify Alzheimer’s as an incurable degenerative disease of the central nervous system with gradual loss of mental capacities (logic thinking, memory and speech). Alzheimer’s disease is signified as “an age-related brain disorder caused by the injury and death of nerve cells in particular areas of the brain” (Alzheimer's disease: what is it?, n.d.). The Fisher Center for Alzheimer's Research Foundation defines the disease as “the most common form of dementia, a group of disorders that impair mental functioning.” All these definitions indicate a serious irrevocable impairment of vital intellectual functions as memory, attention and normal mentation. Alzheimer’s is characterized either as a variety of dementia, or as an independent disease. It occurs as far as both neurological disorders have notable pathophysiological and clinical similarities.

Dementia relates to a brain disorder that seriously affects human abilities to fulfill ordinary activities that are connected with physical and intellectual work. Alzheimer’s disorder is the most standard form of senile dementia amidst the old people. The mental deficiency in both disorders involves sections of the human brain responsible for the intellectual process, memory and speech. Alzheimer’s disease relates to atrophic process of senile dementias.

During a research work on the disease, the scientists have dissected specific risk factors that can provoke Alzheimer's. It is emphasized that Alzheimer’s disorder is not a typical or obligatory part of aging. Nevertheless, an increasing age is the greatly-provoking risk factor. The elder a person becomes, the bigger is the chance of developing this disease. The Alzheimer’s disease usually manifests at the presenile age. The majority of people with Alzheimer's are 65 and older, but approximately up to 5 % of people with the disease have early onset Alzheimer's, which often appears at the age of 40s or 50s (Alzheimer’s Disease & Dementia, 2013). More above, the quantity of elder people having Alzheimer’s constantly increases. “At current rates, 19 million Americans will have Alzheimer’s by the year 2050” (Who is affected by Alzheimer’s?, n.d.). Genetics also can play a definite role. In rare families, some genes can cause the disease. The geneticists mention about genetic susceptibility when the disease can be the fact of inheritance. People with "specific medical histories" have a great potentiality to develop Alzheimer's, including people with down syndrome and other intellectual and developmental impairments, multiple concussions resulted from falls, sports injuries, car accidents and traumatic brain injury (Alzheimer’s Symptoms, 2013). A category of people who suffer from high blood pressure, an increased level of cholesterol, deficiency of folic acid is also at a great risk of developing Alzheimer’s. To defend one’s body from Alzheimer’s disease or, at least, minimize its development is to stay proactive in physical and intellectual aspects.

People who suffer from Alzheimer’s disease gradually develop memory loss, a sufficient decrease in ability to think together with the visible changes in personality. These defects in cognitive function go together with physical changes of the brain, including the accumulation of amyloid plaques and tau-containing neurofibrillary tangles. Such formations may “result in the death of brain cells and the breakdown of the connections between them” (What Happens to the Brain in Alzheimer’s?, 2013). Amyloid plaques and neurofibrillary tangles are the initial distinguishing features of Alzheimer's disease. Plaques are mass protein deposits and cellular material outside and around the brain's nerve cells. Tangles are twisted fibers that compile the nerve cells. “The deposition of amyloid in the form of plaques is thought by many scientists’ is one of the main features that lead to ‘Alzheimer's pathology” (Alzheimer’s Is…, n.d.). As the disease advances, it is possible to observe shrinkage and gradual death of certain brain nerve cells, including some cells that produce critical neurotransmitters. These neurotransmitters transfer signals of brain from one nerve cell (neuron) to another. People with Alzheimer’s have deficiencies in such neurotransmitters. The deficiency provokes death of nerve cells and further shrinkage of the brain.

Alzheimer's disease is manifested in definite recognizable symptoms, which can be helpful for diagnostic, possible treatment and nursing. The below-given signs should not be neglected, especially at the first suspicions on such medical condition.  With age people eventually notice slow thinking process and occasional difficulties with remembering certain things. Alzheimer’s patients may also experience problems with remembering and learning, as the disease progresses. Loss of adequate judgements and troubles with abstract thinking are also signs of Alzheimer’s. We may observe problems with language use when a person suffers from forgetfulness of the words that should be used in a concrete situation. As a result, speech becomes less fluent and coherent, and it leads to social withdrawal and verbal restraint of a person. The aforementioned symptoms are explained by the fact that the malady seriously affects the part of the brain responsible for intellect. Besides, Alzheimer's patients suffer from increasingly severe symptoms, including memory impairment that is poured out into confusion, lack of concentration and normal performance of the usual, habitual obligations/job duties, disorientation in time and place, rapid mood swings, drastic changes in behaviour. Individuals with Alzheimer’s may neglect hygiene, become untidy or careless. At the advanced cases of Alzheimer’s patients may face with “more serious memory loss and behavior changes… and difficulty speaking, swallowing and walking” (Alzheimer’s & Dementia, 2013). Alzheimer’s patients may develop sleep disturbances, wandering impulses, delusions or hallucinations. People who may have aforementioned symptoms of Alzheimer’s refuse to recognize they have a problem. Signs of mental degradation are obvious to family or any other close surrounding. Ignorance of the first symptoms may deteriorate a patient’s condition and can lead to death.

The indicated clinical manifestations signify mild, moderate or severe stage of the highlighted sickness.

Regretfully, till today there is no cure for Alzheimer's, but scientific researchers actively work to find a solution. Knowledge about the complex processes in the brain as the Alzheimer’s develops, awareness about risk factors and disease-generating causes can be the ground for further researches and discoveries. Step by step doctors and pharmaceutics all over the world apply the best efforts to find effective treatments of Alzheimer’s disease which might prevent, postpone, stop or “even reverse the nerve cell damage that leads to the devastating symptoms of Alzheimer's.” (Treatment & Care, 2013). Various funds, medical institutes, laboratories do not leave a hope to puzzle out the mystery of Alzheimer’s. The researchers continue studying genes, a possible viral nature of the disease, test other drugs which might provide recovery to the sufferers.

As it is mentioned, humankind has not invented or discovered any remedy for Alzheimer's disease. Certainly, medicine offers drug and non-drug medication, but even the existing treatment cannot provide full recovery. Available medication can treat the symptoms of the disease, slow down its progression, and give some relief to Alzheimer’s patients. It is important to distinguish the sickness either at a mild or moderate stage for achieving the best possible result of the cure. In these stages, the body is more responding to treatment as far as the damages in the brain are not so deep and severe. Timely medication can prevent worsening of memory impairment, can be helpful to support mentation, speaking skills, improve everyday functioning and improve the quality of life. Other drugs may affect behavioral symptoms, such as sleep disturbances, feeling anxious, or avoid depression. Drug therapy, in its turn, may help to return a person to social communication and revive one’s cognitive functions. Although, some side effects can be present during treatment such as “nausea, vomiting, diarrhea, and loss of appetite” (National Institute of Health, 2012). More so, medication itself may not be equally effective for everybody.  

There are such widely-known medications which may help people with mild or moderate Alzheimer’s, some of those are "Donepezil (Aricept), Galantamine (another name Razadyne) or Rivastigmine (or Exelon)" (Alzheimer’s disease: treatments, 2012). Donepezil is also tested and approved for treatment of moderate and severe Alzheimer's. “Another drug, memantine (Namenda), is used to treat symptoms of moderate to severe Alzheimer’s, although it also has limited effects” (Alzheimer’s disease: treatments, 2012).

Non-drug treatment is also practiced for rehabilitation of the cognitive abilities, though, sometimes, can be of no use. However, treatment should involve all possible variants to improve a patient’s condition. In case, an Alzheimer’s patient experiences either mild or moderate symptoms of the disease, additionally it is required to encourage the person, provide healthy nutrition rich of vitamins and microelements to keep him or her physically active. Care givers should involve such people into interaction to remove the status of social outcasts.

In spite of the developed medication, none of the therapies has become a panacea as yet, and no drug can be acknowledged as a remedy. Alzheimer’s disease remains an incurable and life-shortening disease that brings sufferings to a patient, his or her relatives. More so, it incurs a huge financial burden for the states. Richard J. Hodes, a director of the NIH's National Institute on Aging (NIA), says "the national costs further compel us to do all we can, to find effective treatments for Alzheimer's disease and related dementias as soon as possible" (NIH-supported study finds U.S. dementia care costs as high as $215 billion in 2010, NIA, 2013).

The scientists and physicians put their heads together to study the genetic, environmental, and biological factors that might result in Alzheimer’s disease. Recently the scientists of Washington University School of Medicine detected several genes that relate to the tau protein, which is present in the brain as Alzheimer’s advances and patients may develop aging disorder – dementia. The scientific revelation may help to “provide targets for a different class of drugs” that could be required for treatment. Alison M. Goate, a professor of genetics, dealing with neurological disorders, states "We measured the tau protein in the cerebrospinal fluid and identified several genes that are related to high levels of tau and also affect risk for Alzheimer's disease." (ScienceDaily, 2013). It is a curious fact that several scientific teams have been working to develop a vaccine, when body's own immune system can “attack the amyloid plaques that build up in the brains of those with Alzheimer's disease” (Alzheimer’s & Dementia, 2013). Though, the work in this direction was stopped. Nevertheless, on-going researches should give us some answers about Alzheimer’s disease. Newly-discovered treatment is supposed to decrease a high level of mortality from Alzheimer’s, stop further expansion of the disease when we may observe increased quantity of the patients every year. 

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