Biology 103
2001 First Web Report
On Serendip

"Alzheimer's disease is a progressive, degenerative disease that attacks the brain and results in impaired memory, thinking, and behavior, and subsequently death" (1). It was first discovered by Alois Alzheimer in 1906(7). Alzheimer's disease is a type of dementia, in fact it accounts for almost fifty percent of all dementia cases (3). Dementia is a term given to a few disorders that affect the brain causing problems with memory, speech, and perception. Dementia causes the victim to forget everyday occurrences, and the person may have problems in understanding concepts or words, and may have horrible mood swings (4).

While a person has dementia, their brain goes though many changes. Basically dementia attacks the cells, nerves, and transmitters in the brain, causing the nerve cells to die. As a result, the brain shrinks and gaps are formed, mainly in the temporal lobe and hippocampus. These are the parts of the brain that control the memory of a person. When these areas are destroyed a person loses the ability to speak, think, and make decisions. Also the production of certain chemicals discontinues. A common observation in the brain of people who have died form Alzheimer's is that plaques and tangles made from protein fragments are present (7).

Alzheimer's is the fourth largest cause of death in America. It usually affects people over the age of sixty, but there have been cases with younger people being affected (1). Alzheimer's affects each individual in a different way, which is one of the reasons this disease is so complex to understand. But, "it is not a disease linked to gender, social class, ethnic group or geographic location" (3). Alzheimer's isn't infectious and there is very little information that suggests that it can be hereditary. Those who have Down's syndrome, severe head or whiplash injuries, and those who have high blood pressure or high cholesterol, or smoke are at a greater risk of getting Alzheimer's (10).

Alzheimer's disease can only be detected in the brain after death. But, it can be sense it by carefully examining a person's physical and mental status, and by talking to the person's friends and relatives about their background and common personality. If detected early, the results can be very beneficial. It can help the person with the disease fight it better, and understand their options (3).

Although the disease has different effects on different people, there are some definite symptoms. The symptoms occur on a series of three stages. The first stage is when the disease actually starts, and usually people think the symptoms in this stage are because of old age. The middle stage is when the people around the victim realize that something is wrong because of problems in daily life. And in the last stage, the victim is totally dependent on outside help. They have serious memory problems and become physically inactive (3).

The basic symptoms of Alzheimer's disease include memory loss, difficulties in speech, difficulties in performing familiar tasks, disorientation to time and place, poor or decreased judgment, misplacing things, changes in mood or behavior, changes in personality, and a loss of initiative (5). There are two types of symptoms, cognitive and behavioral. Cognitive symptoms include memory loss, disorientation, confusion, and problems with reasoning and thinking. Behavioral symptoms include agitation, anxiety, delusions, depression, hallucinations, insomnia, and wandering (6). By the last stage of the disease, the victim has difficulty eating, walking, suffers bladder and bowel problems, may display inappropriate behavior in public, and is usually confined to a wheelchair or bed (3).

A lot can be done by family members and friends for someone who is suffering from Alzheimer's. The caregiver should try to make the person be independent as long as possible. In the beginning the person with the disease will be aware of the fact that they are becoming weaker and more dependent on others. This may be a blow to their dignity. The caregiver should try to avoid these types of situations by not being too sympathetic or discussing the problems (2).

A daily routine may help the victim because then they don't have to make as many decisions and they will feel more secure. The caregiver should try to simplify tasks. The patient is already having a tough time remembering things, so by limiting choices their life will be easier and they won't get as frustrated (2).

Safety becomes a major issue for a person with Alzheimer's. As the disease progresses, the patient loses hand eye coordination and control over their physical actions, which makes the person prone to injury (2).

Communication and confrontation also become problems. It becomes difficult for the victim to express themselves. The caregiver can help by speaking slowly, clearly, and face to face. Also it is beneficial to get the victims eyesight and hearing checked, to make sure they aren't suffering anymore. An Alzheimer's disease patient may experience horrible mood swings, and that is why the caregiver should avoid confrontation. Basically, it isn't good to point out mistakes and failures of the patient. This will only lead to the patient becoming more frustrated and defensive (2).

It is has been discovered that the effects of Alzheimer's can be slowed down if there is constant brain activity. The caregiver can provide an environment in which the patient is encouraged to interact. For example, it would be beneficial to play games, read, and draw with the patient. But the caregiver should realize that the victim may get tired and overwhelmed easier, so they shouldn't push the patient (2).

The victim isn't the only person who suffers from Alzheimer's, so do relatives and friends. Friends and family members may go through a list of emotions, which include grief, guilt, anger, embarrassment, and loneliness. All these are natural emotions, which everyone may feel at some point or the other. Grief may hit relatives when they first realize that they have lost a family member. Relatives and friends may get embarrassed at the actions of the victim, and then they may feel guilty about their emotions. This is a customary reaction, and it's ok to feel this way (9).

Caregivers may also suffer with the person who has Alzheimer's. They should turn to their family for support. Sometimes it's better to share and let go of stresses that are irritating. By sharing problems, a caregiver releases strains and becomes more effective in fulfilling the needs of the patient (9).

It can get overwhelming and annoying for the caregiver, to always provide and get nothing in return. The caregiver must know their limits. It can be beneficial to just back away and take some time off. This time away from the patient, gives the caregiver time to reflect. When the caregiver returns to the patient, they will be more supporting and understanding (9).

It is important that the caregiver doesn't blame themselves for the suffering the patient is going through. It is also important the caregiver doesn't in any way give the patient the idea that the disease is their fault. It is no ones fault. If either the patient or the caregiver feels this way, they should immediately seek advice. Getting a new perspective and facing problems can be very helpful in this situation (9).

Caregivers are extremely crucial for people fighting with this disease because there is no known cure. But through extensive research, scientists have found that there are certain drugs that can delay and treat some of the symptoms associated with Alzheimer's, such as depression (8).

It is known that people suffering from Alzheimer's have a shortage of acetylcholine, a chemical that makes it possible for messages to be passed from one nerve cell to the other. Aricept, Exelon, and Reminyl are new drugs known as cholinesterase inhibitors, they maintain and reduce the breakdown of this chemical in the brain. These drugs are usually administered to people in the middle stage of the disease. It is important to realize that these drugs may work for a limited time and don't work on everyone. There are some side effects to these drugs, which include diarrhea, nausea, insomnia, and a loss of appetite(8).

Alzheimer's is a very complex disease to understand. That is why scientists have still not found any cure for it. People with Alzheimer's suffer for almost twenty to twenty five years before their death. But the saddest thing about the disease is that the patient doesn't even remember their family or friends, and they don't know the meaning of life by the time they die. People suffering from Alzheimer's are emotionally dead long before the physically die.

WWW Sources

2) Living with and caring for a person with dementia.

3) Information about dementia .

4) Alzheimer's society- What is dementia?.

5) Alzheimer's Association/ Ten Warning Signs .

6) Alzheimer's Association/ Cognitive and Behavioral Symptoms.

7) Alzheimer's disease - Alzheimer's Disease International.

8) Drug treatments -Alzheimer's Disease International.

9) The personal and emotional stress of caregiving and looking after yourself .

10) Alzheimer's Society Information sheet- What is Alzheimer's disease?.

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