What is Alzheimer's Disease?

• Dwight Coleman
• Wendt L. Eddy

In 1906 Alzheimer’s disease was discovered by Alois Alzheimer, a German neurologist. The disease was originally observed in a middle-aged woman named Auguste D. He studied and recorded her care for five years, until her eventual death in 1906. After her death, Dr. Alzheimer performed an autopsy. He discovered senile plaques and neurofibrillary tangles, which have become indicative of Alzheimer’s disease. The condition was first discussed in 1907 and named after Dr. Alzheimer in 1910.

Alzheimer’s disease (AD), is a degenerative disorder that leads to memory loss and bodily functions and is the most common form of dementia. AD affects more than 5 million Americans and is one of the top ten causes of death within the United States. The disease has been grouped into two “main” forms. Familial AD, which affects people younger than 65, adding up to nearly 500,000 AD cases in the United States. The rest of AD cases are categorized as Sporadic AD, and transpire in adults ages 65 and older. The severity of AD varies, as there are many different factors, including genetics, age, even education level. Currently there is no cure for Alzheimer’s disease, however; there is promising research being conducted and early detection and treatment is available.

AD is a complex illness that affects the brain tissue directly as it undergoes gradual memory degradation and the patient demonstrates behavioral changes. There are 3 stages of Alzheimer’s disease the “Early Stage” usually lasts 2-4 years and is usually when the disease is diagnosed. During this stage friends and family may have noticed a decline in the patient’s cognitive abilities. Common symptoms may include:

• Misplacing belongings or getting lost. Patients may even have difficulty navigating familiar surroundings.
• Difficulty retaining new information.
• Difficulty expressing thoughts and personality changes.

During “Moderate Alzheimer’s” Patients will experience an increase in memory degradation and may need help performing their everyday activities. This stage lasts 2-10 years. Symptoms include:

• considerable memory loss. Patients may forget their personal history and have trouble recognizing family members.
• Trouble completing tasks, such as grocery shopping and managing their finances.
• Lose orientation to time and space, patients may begin to wander.

“Severe Alzheimer’s” is the diseases final stage, lasting 1-3 years. The brain continues to decline and physical capabilities are severely affected. During this stage the patient is in a nursing home due to the family’s inability to effectively care for the patient. The final symptoms include:

• Dependence on others for personal care, such as bathing, eating, toileting
• Physical capabilities hindered. Patient needs help walking and may be unable to sit independently patient’s ability to swallow can be challenged
• Communication. Patient limited to speaking short phrases.

Although, the way that Alzheimer’s disease affects the brain is drastic it is not the primary cause of death. AD causes many handicaps, like immobility and difficulty swallowing, which leads to malnutrition and pneumonia, resulting, in the patient’s death.

Currently there is not a single diagnostic test for detecting Alzheimer’s disease any other forms of dementia. There is only one true way to diagnose someone with AD unfortunately it only come after death while performing an autopsy and examining the brain tissue. Instead of an autopsy the diagnostic we perform on the living consists of thorough assessments by experienced physicians to discern the absence and presence of certain symptoms. Effectively ruling out all other possibilities until Alzheimer’s is the only option left. When done thoroughly, the diagnostic can result in a highly accurate diagnosis.

The diagnostic is often called the comprehensive assessment consists of the patient’s full clinical history such as past and current medical conditions, all medication prescription and over the counter, ability to perform daily activities and personality changes. Neuroimaging to look for metabolic (PET), structural (MRI, CT, etc.), or disease related changes. Lab test of blood and neuropsychological assessment which measures the patients time and space orientation, attention and recent memory. Although certain findings through the assessment may support a diagnosis of AD, as previously stated their main focus is to rule out other possibilities, strokes, head trauma or tumors.

Once the tests are completed the clinical team reviews the results and creates and individualized treatment for the patient. The diagnosis, test results, and treatment plan are presented to the patient and family during a family conference. The most evident way someone with AD can benefit is financially. AD treatment is very costly and an early diagnosis would help the patient plan for the future. LTC (long term care) insurance substantially decreasing the money needed for medical costs.

Early diagnosis can benefit the patient personally, everyone has a goal in his or her life, however; with the debilitating effects of AD patients may not be able reach them. An early diagnosis gives the patient an opportunity to make future plans and accomplish their goals. Most patients do not have the luxury to make such decisions before the severe symptoms appear. Alzheimer’s disease takes an emotional toll on the patient and family. It becomes increasingly difficult to watch a family member slowly deteriorate and forget the things they used to love. Early diagnosis can give the patient and family time to learn about the progression of the disease and how to prepare for their future trials. Families will have enough time to come to terms with their feeling and what is happening, this relieves some of the stress of an uncertain future and makes the patients final years more enjoyable.

References

“How Alzheimer’s is diagnosed?” UCIrvine, 2015, https://www.mind.uci.edu/alzheimers-disease/what-is-alzheimers/how-is-alzheimers-diagnosed/

“Alzheimer’s disease fact sheet” National Institute of Aging, August 2016, https://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-fact-sheet#causes