Fighting Alzheimer's: Understanding & Managing the Disease - Essay Sample

Introduction

Alzheimer's disease (AD) is a progressive neurodegenerative disorder that affects behavior and cognition. The disease has a clinical duration of approximately 8-10 years and affects individuals and families. According to Neugroschl & Wang (2012), Alzheimer's disease is the most common type of dementia that accounts for approximately 60-80% of all the diagnosed dementias. According to the Diagnostic and Statistical Manual of Mental Disorders-IV, Text Revision, proper control of AD requires; a cognitive disturbance, i.e., agnosia, apraxia, aphasia, or executive functioning; a new onset of memory impairment, and a gradually progressive course whose result is a significant functional impairment (Neugroschl & Wang, 2012). Alzheimer's results in a decline in one's abilities to think, remember, judge, solve problems, move, express themselves, speak or find words.

Etiology and Risk Factors

Developing AD is a multifactorial risk. Some of the preventable risk factors for mental disorders include hypertension, type 2 diabetes, sedentary lifestyle, smoking, head injury, and obesity. However, the nonpreventable risk factors include age and genetics. In the case of genetics, the gene for apolipoprotein E (ApoE) (e4 allele) is the biggest causal factor, accounting for 60% of the individuals with AD (Ulep et al, 2018). Age is the most prevalent risk factor for the diseases with people over 65 years having a significantly higher chance of developing all types of dementia compared to their younger ones ("Alzheimer's Association," 2020). The development of Alzheimer's disease can be broken into seven stages. The framework provides an understanding of the disease progression that has been adopted by various healthcare providers and Alzheimer's Associations.

Stages of Alzheimer's Disease

The major stages in the development of Alzheimer's disease include:

Stage 1: Normal Outward Behavior

At this stage, the affected person does not display any symptoms that can be easily noted. Here, the Alzheimer's is not detectable with no signs of deficit or impairment. A physician evaluation would, however, help in diagnosing the disease. An imaging test and a PET scan would help to show how the brain is working to reveal any signs of Alzheimer's ("Alzheimers.net," 2019).

Stage 2: Very Mild Changes/Decline

This stage is marked by a mild loss in short-term memory. The changes may be small with lapses that present as age-related being noticeable, i.e., momentary forgetfulness. Minor loss of language skills may also be evident, such as selecting incorrect words or difficulty in recalling words or names of places that are familiar. However, at this stage, subtle symptoms of Alzheimer's do not interfere with the victim's ability to work or live independently.

Stage 3: Mild Decline

This stage is marked by noticeable changes in one's thinking and reasoning. This is evident when they display symptoms such as forgetting what they just read, asking the same question repeatedly, experiencing trouble planning or organizing, and inability to remember names when meeting people among others. They may also record an increase in language deficit and experience difficulties in performing social work or other work-related tasks that were initially easy to perform. While the entire stage may take about seven years, the symptoms become clearer within two to four years ("Alzheimers.net," 2019). The stage may require more intense interviews by a clinician to identify any cases of memory loss. At this stage, the victim may require counseling and may experience denial and moderate anxiety.

Stage 4: Moderate Decline

At this stage, the problems associated with thinking and reasoning that were noted in stage 3 become normal and new issues appear. The stage is marked by:

• Heightened forgetfulness, i.e., trouble recalling any recent activities.
• Limited to no abilities to perform mental math
• Experiencing trouble paying bills, organizing events, performing daily social activities, and planning.
• Forgetting past events and personal history
• Frequent mood changes such as exhibiting antisocial behaviors, anxiety, depression or mild irritability.
• A decrease in emotional response may also be evident, especially in the case of a challenging situation.

Stage 5: Moderately Severe Decline

At this stage, the victim may require help with their daily activities. Lapses in their memory and functioning are noticeable. They are unable to recall vital personal details such as their address, phone numbers, and workplaces among others. They experience confusion in their daily life, i.e., forgetting where they are and what day it is. They also experience trouble computing simple arithmetic. However, people at this stage still maintain their functionality. They can comfortably bathe and toilet independently. They also still know their family members and some detail of their personal histories, i.e., their childhood and youth histories.

Stage 6: Severe Decline

At this stage of Alzheimer's, the victim requires constant supervision and professional care. He/she may experience loss of awareness of their surroundings and experiences, changes in their sleep patterns, i.e., sleeping during the day and being awake at night, inability to dress themselves by taking on inappropriate clothing, forgetting personal history, and difficulties remembering their names and that of their relatives and caregivers ("Alzheimers.net," 2019. They may also experience delusions and hallucinations such as thinking that some it coming to get them, tend to become lost, loss of bladder and bowel control, and experience potential behavior problems and personality changes.

Stage 7: Very Severe Decline

This is the last stage of Alzheimer's disease. The victim loses many basic abilities such as walking, eating, and sitting up. They also lose their verbal skills, motor skills and ability to control movement. They are unable to dress, bathe, or feed themselves. Since the disease is terminal, people at this stage are in their later years in life. They need assistance in all their daily life activities.

Diagnostic Criteria

For diagnosis of potential AD to commence, the symptoms have to meet the criteria for dementia, the onset must be insidious with a gradual progression, there should be evidence of cognitive worsening by observation or report, and the initial symptoms should either be amnestic or non-amnestic. The process of diagnosis may start with a history of the present illness, a pertinent systematic review, a physical examination of the patient, and a bedside cognitive testing (Ulep et al., 2018). A further screening may also be conducted for inclusion or exclusion in the process of diagnosis. These may include laboratory studies, tests of biomarkers if necessary, and neuropsychological testing among others. However, the patient should be referred to a dementia specialist for a more accurate diagnosis and efficient management of the disorder (Neugroschl & Wang, 2012). Although there is no cure for Alzheimer's, the prevention and treatment processes help to slow each of the stages of the disorder. The objective of the treatment is to manage the mental functions and behaviors while slowing down its associated symptoms.

References

"Alzheimer's Association" (2020). Causes and risk factors. Alz.org. https://www.alz.org/alzheimers-dementia/what-is-alzheimers/causes-and-risk-factors

"Alzheimers.net" (2019). What are the 7 stages of Alzheimer's disease? Alzheimers.net. https://www.alzheimers.net/stages-of-alzheimers-disease/

Neugroschl, J. and Wang, S. (2012). Alzheimer's disease: Diagnosis and treatment across the spectrum of disease severity. Ncbi.nlm.nih.gov. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3315348/

Ulep, M. et al. (2018). Alzheimer disease. The journal for Nurse Practitioners. https://www.npjournal.org/article/S1555-4155(17)30819-X/fulltext