Abstract
Alzheimer’s disease is a psychological disorder that does not only affect the functioning of the brain, but also the nervous system leading to poor coordination of the body. The disease is incurable and progresses slowly through consecutive four stages of pre-dementia, early stage, middle stage, and late stage that ultimately leads to death.
A patient depicts major symptoms such as loss of cognitive ability, memory loss, and physical impairment due to inability to coordinate body functions. Advancing age and genes are dominant factors that can predispose individual to the disease.
Introduction
Alzheimer is a psychological disorder that affects normal functioning of the brain. It is a form of dementia that interferes with cognitive abilities and behavior of an individual. Dementia is a psychological disorder that is associated with other mental disorders but Alzheimer’s disease is an incurable and degenerative mental disorder that occurs mostly due to aging.
According to statistics, “about 4 million Americans, 90 percent of whom are age 65 and older, have Alzheimer’s disease and the prevalence of Alzheimer’s disease doubles every five years beyond age 65” (Hoffman, 2000, p.1). The statistics imply age is the major predisposing factor that leads to the Alzheimer’s disease although at some instances, there is an early onset attributed to genetic factors, but it is quite rare.
Alzheimer’s disease weakens the cognitive ability of the patient by destroying cells of the brain, unlike destruction that occurs in normal aging. Since the Alzheimer’s disease affects the brain, psychological characteristics of the disease include loss of memory, language interference, poor judgment, and change of personality. To understand psychological aspect of the Alzheimer’s disease, this essay explores literature review, development, symptoms, and causes of the disease in population.
Alzheimer’s disease
As aforementioned, Alzheimer’s disease is a form of dementia that occurs due to aging; a psychological disorder that affects brain cells leading to diminished cognitive abilities and changed behavior. Over the history, the disease mostly affected the old people with the ages above 65 years.
Hoffman argues that, “Alzheimer’s disease is an irreversible, progressive brain disorder related with the changes in nerve cells that result in the death of brain cells. It occurs gradually and is not a normal part of the gaining process” (2000, p. 2). Earlier before its discovery in 1906 by Alois Alzheimer, psychiatrists considered it as an aging disease because it only affected old people. Based on the time of onset, there are two types of Alzheimer’s disease, the early onset and the late onset.
Early onset of the disease affects individual who are below 60 years and appears to be more degenerative although very rare. The late onset of the disease affects individuals above 60 years and is the most common disease. The discovery of the early onset type of the disease confirmed that Alzheimer’s disease is not an aging disease.
Research studies have revealed that prevalence of the Alzheimer’s disease is increasing exponentially due to change in lifestyles and the incurable nature of the disease. Statistics show that approximately 4 million of the Americans who are above 65 years old are suffering from the disease, which forms about 90% of the old people.
In addition, since there are more old women than men, the statistics show that about two third of the old people who are suffering from the disease are women. Based on these findings, scientists have predicted that, the incidences of Alzheimer’s disease are going to increase exponential until a cure is available.
Kantor explains that, in recent past “scientists have made great progress in unraveling the mysteries of Alzheimer’s disease; however, much is still unknown. Unless prevention or a cure is found, the number of Americans with Alzheimer’s disease could reach 14.3 million 50 years from now” (2011, p.30).
Given the 14 million patients and the nature of healthcare that the patients need, it means that government is going to spend great deal of resources in building and expanding nursing homes in order to cater for the increasing needs of the patients.
Since the Alzheimer’s disease is incurable and degenerative, the patients need special care for they do not have sufficient cognitive abilities to perform normal duties. The patients need complete attention of the caregivers in terms of feeding, bathing, dressing and washing among other basic assistance.
“Compared to non-dementia caregivers, larger proportions of Alzheimer’s patient caregivers experience employment complications, have less time for their own leisure activities and other family members, and suffer from physical, mental, and emotional stress due to care giving” (Hoffman, 2000, p. 3). The disease does not only affect patients, but also care givers thus necessitating intensive research concerning prevention and cure of the disease.
Development of Alzheimer’s Disease
The development of the Alzheimer’s disease is a continuous process but there are three stages for the sake of understanding and classifying the extent of the disease. The four stages are pre-dementia stage, early stage, middle stage, and late stage, which consecutively follow the progression of the disease from its onset.
In pre dementia stage, one can easily confuse the Alzheimer’s disease with stress and aging process because signs and symptoms are not yet definitive for a psychiatrist to diagnose. Williamson argues that, during pre-dementia stage “nerve cell damage typically begins with cells involved in learning and memory and gradually spreads to cells that control other aspects of thinking, judgment and behavior, and eventually affects cells that control and coordinate movement” (2007, p.2).
At this stage, there are latent symptoms such as problem in language, slight change in behavior, and subtle change in movement. It is very hard for a psychiatrist to diagnose the disease at this stage unless with the use of diagnostic tools. In the early stage, patient’s cognitive ability continues to degenerate more as there is increased memory loss that is very evident. Moreover, there is increased language problem, poor reading and writing, impulses of aggression, instances of illusions, and irritability.
“Individuals at this stage have memory lapses, forgetting familiar words or names or the locations of keys, eyeglasses or other everyday objects, and these problems are not evident during a medical examination or apparent to friends, family or co-workers” (Berchtold, 1998, p. 5).
At this stage, the patients can feel the changes for they begin to realize that they have lost some ability to read, write, and even talk. Realizing that they have lost some abilities, the patients become dependent by asking for assistance in terms of reading, writing, and remembrance of important events. Psychiatrists can differentiate aging and the disease at this stage due to prevalence of the symptoms.
In the middle stage, the cognitive ability degenerates to the extent where the patient loses independence. Language problem become more evident at this stage as the patients have difficulties in fluency, reading, and writing.
Memory is also affected and the patients lose the ability to remember events and identity of even close relatives. At this stage, the patients also lose motor activity causing caregivers to move and guide them in their movements.
Williamson argues that, patients have “decreased capacity to perform complex tasks, such as marketing, planning dinner for guests, or paying bills and managing finances, reduced memory of personal history and become withdrawn socially” (2007, p.6). The gradual loss of memory and physical ability make the patient to become dependent on the caregivers in doing most of the activities.
In the late stage, the patient completely loses independence and begins to depend on caregivers on virtually all activities. The cognitive ability degenerates completely in that the patient cannot recall anything, speech reduces to mere utterances, and eventually reading and writing becomes impossible.
“At this stage, individuals may lose most awareness of recent experiences and events as well as of their surroundings and occasionally forget the name of their spouse or primary caregiver but generally can distinguish familiar from unfamiliar faces” (Williamson, 2007, p.7). The patients at this stage portray significant psychological and physical deficiency, as they become dependent on the caregivers until the day when they die.
Symptoms
Alzheimer’s disease has psychological and physical symptoms. Loss of memory, problem with language, poor judgment, change in moods and loss of cognitive abilities are some of the psychological symptoms associated with the disease. According to American Academy of Neurology (AAN), “memory loss that affects job skills is the main symptom of Alzheimer’s disease because frequent forgetfulness or unexplainable confusion at home or in the workplace may signal that something’s wrong” (2009, p.7).
Language impairment is also a psychological symptom since the patient loses ability to coordinate speech, thus complicating effective communication. Poor judgment is another symptom that shows cognitive impairment in a patient. Due to poor judgment, the patient cannot perform simple arithmetic calculations, misplaces valuable things, or even dress awkwardly. Moreover, the patient also experiences intermittent mood swings and deficiency cognitive abilities that are evident in the change of behavior.
Physical symptoms associated with the disease include inability to perform normal tasks, change in personality, failure to recognize people or environment. Normally, the disease affects the brains cells making the patient lose ability to coordinate movement. At the late stage of the disease, the patient completely loses memory and subsequently coordination of the body.
Eventually, the patient becomes entirely dependent on the caregivers in order to fulfill daily activities such as washing, bathing, eating, and walking. “People’s personalities may change somewhat as they age, but a person with Alzheimer’s can change dramatically, either suddenly or over a period of time, for instance someone who is generally easygoing may become angry, suspicious, or fearful” (AAN, 2007, p.8).
Change in behavior is very evident to the people who are close to the patients as they depict unusual behaviors such as dressing wrongly, becoming aggressive, withdrawing from friends and losing ability to perform daily activities. In addition, the patient cannot perceive people or the environment, for example failing to recognize friends, usual places, and losing direction.
Causes
Advancing age and genes are two main predisposing factors associated with the development of Alzheimer’s disease. Statistics show that the disease mostly affects older people of about the age 60 years and above. Michelle argues that, “advancing age is the most significant risk factor for Alzheimer’s disease since most people who develop the disease are over the age of 65, although the disease process is thought to begin years before cognitive and memory impairments are apparent” (2009, p.21). Therefore, old age is the most important predisposing factor of the Alzheimer’s disease because there are no incidences of the disease in young people.
Other research studies have also shown that occurrence of the Alzheimer’s disease in the population can be due to the genetic factors. The early onset of the disease in some instances is due to genetic effects while late onset may be due to aging. “The familial Alzheimer’s disease, which is passed on directly from generation to generation, accounts for only about 7 percent of the total incidence of Alzheimer’s disease” (Michelle, 2009, p.22).
Genes contribute significantly to the cases of early onset since late onset occurs due to sporadic nature of the disease. Despite the fact that Alzheimer’s disease is mostly sporadic in occurrence, studies have revealed other predisposing factors that contribute to the development of the disease in the population. These factors are unhealthy eating habits, stress, depression, smoking, brain injury, stroke, hypertension, diabetes, and inadequate exercise. These and other related factors affect production and functioning of neurotransmitters in the brain leading to impaired brain function and ultimately cause Alzheimer’s disease.
Conclusion
Alzheimer’s disease is a disorder of the brain characterized by loss of memory and cognitive abilities making the patient unable to perform usual duties of life. The disease commonly affects old people of age 65 years and above due to decreasing cognitive ability. In American, the disease has affected approximately 4 million old people with a high percentage of women, while the scientists are predicting exponential increase in the incidences because it is incurable.
The Alzheimer’s disease is a terminal illness that progresses slowly through four stages of pre-dementia, early stage, middle stage, and late stage, which eventually leads to death. The major symptoms of the disease are loss of memory and physical impairment of the patient. Most research studies have established that the cause of the disease is sporadic old age and genes in young age.
References
American Academy of Neurology. (2009). Alzheimer’s Disease. Alzheimer’s Association, 1-9.
Berchtold, C. (1998).Evolution in the Conceptualization of Dementia and Alzheimer’s Disease: The Journal of Mental Disorders, 1-33
Hoffman, M. (2000). Alzheimer’s Disease and Dementia. National Academy on an Aging Society, 1-17.
Kantor, D. (2011). Alzheimer’s Disease. National Institute of Health, 23-67.
Michelle, P. (2009). What Causes Alzheimer’s Disease. Alzheimer Society of Canada, 1-24
Williamson, J. (2007). Stages of Alzheimer’s Disease. Alzheimer’s Association, 1-43.