Introduction
Brain is one of the most important body organs. Its failure or malfunctioning usually results into fatal cases that are complicated and costly to treat. Like any other disease of the human body, brain diseases manifest into different ways, displaying varying signs and symptoms together with diverse risk levels. Medical practitioners describe the loss of brain function as dementia, a condition caused by certain diseases, which affect the brain. In discovering diseases, which lead to this condition, Alzheimer’s disease is among them.
Abbreviated as AD, the disease starts mildly before worsening with time. Its greatest effects are that it affects the overall memory ability of a patient, thinking and ultimately behavior. Alzheimer’s disease results into a wide range of diagnosis features, including memory impairment, poor judgment ability, personality problems, improper decision-making and language problems (Turkington & Mitchell, 2009).
According to documented research, Alzheimer’s disease is the primary cause of dementia affecting close to half a million people in the United Kingdom and five million in the United States. Importantly, dementia is a general term which refers to a collection of symptoms, which may include poor reasoning, problematic communicating ability, mood changes and impaired memory among others.
These symptoms mainly occur following brain damage that could be caused by Alzheimer’s disease or other related infections. The disease is believed to have been first described by Alois Alzheimer, a German neurologist as a physical disease which predominantly affects the brain (Cohen, 1999).
As a practicing doctor, Alois Alzheimer noticed unusual symptoms manifested by one of his dead patients in 1906. Alzheimer’s disease is well known to affect the normal structure of brain, which may result into the death of some important cells. It is important to double emphasize that the disease is progressive and may lead to continuous damage and death of more brain cells. As a result, patients with Alzheimer’s disease worsen with time.
Like in other known cases, scientists have devoted their time discovering the treatment of the disease with results indicating that there is no exact cure for the disease yet (Brill, 2005). This research paper, therefore, gives an analysis of the treatment of the disease. Several segments covering the chemistry of the disease have been incorporated in brief with a thorough and elaborate synthesis of treatment procedures that have been found working and recommended in dealing with the disease.
Symptoms
Major signs and symptoms of the disease revolve around the memory of patients as their brain gets damaged with time. Although memory problems could also be attributed to other infections, which affect the brain, medical practitioners concur that most cases are Alzheimer-related.
A common condition which affects memory is amnestic mild cognitive impairment. People with MCI are likely to experience more memory complications as compared to their age mates who are normal (Callone, 2010). The main difference with those with Alzheimer’s disease is that MCI patients experience mild symptoms as compared to severe symptoms observed among Alzheimer’s disease patients.
Although not guaranteed, some researchers believe that old people with MCI are likely to develop Alzheimer’s disease. Apart from memory impairment, Alzheimer’s disease patients demonstrate low aspects of cognition, which is characterized by impaired reasoning and judgment, poor vision and word. As mentioned above, Alzheimer’s disease is progressive and shows varying symptoms depending on the development stage of the disease (Soukup, 1996).
During mild stage of Alzheimer’s disease, patients experience simple but dangerous problems like getting lost in a familiar neighborhood, inability to complete simple tasks even with plenty of time and inappropriate handling of money that may result into defaulting to pay bills. Some patients start repeating questions when asked and develop personality changes. Under normal circumstances, Alzheimer’s disease is diagnosed during this stage of development (National Institute on Aging, 2003).
In cases where Alzheimer’s disease is not controlled during its first stage, it generally advances to the moderate stage of development, which involves damage of some brain parts that are responsible for language moderation, conscious thoughts and reasoning among others.
At this stage, most patients experience severe loss of memory leading to a high level of confusion that makes them impossible to recognize their environment, family members and close friends (NHS, 2010). Ultimately, patients become unable to perform simple tasks which may involve a series of steps like dressing up, become unable to cope with new situations and learn anything new.
The last stage of Alzheimer’s disease development is considered dangerous since tangles, and plaques may have widely spread to most parts of the brain leading to severe shrinking of several brain tissues. At this stage, patients are described as dependents due to their inability to communicate and take care of themselves (Nordqvist, 2011).
During final levels of this stage, patients spent most of their time in bed helplessly as their body systems shut down slowly. Notably, these three stages are irreversible although intervention during the first stage can be helpful in reducing the severity of the symptoms manifested.
Causes of Alzheimer’s disease
According to Mayo Clinic Staff, Alzheimer’s disease has no single cause identified by medical experts throughout the world. It is believed to be caused by intertwined factors, which include environmental, lifestyle and genetic make-up, which progressively affect the normal body functioning (Mayo Clinic Staff, 2011).
Research further indicates that less than five percent of cases, which occur are gene-related. Importantly, some people show the symptoms of infection after the disease has developed to advanced levels that the severity of the symptoms cannot be regulated.
Although there are varying findings, Alzheimer’s disease people who are above the age of sixty years are always at a higher risk of developing the Alzheimer’s disease. In the United States, more than five million people live with Alzheimer’s disease today. The following segments describe some of the factors known to cause Alzheimer’s disease.
Age
Among all the factors, age is the greatest predisposing factor of Alzheimer’s disease. According to scientific research done by Alzheimer Society, Dementia is common in people who are above the age of sixty-five years with statistical analysis showing that one out of fourteen people who have attained this age is at risk of developing the disease(Alzheimer’s Society, 2011).
Genetic Inheritance
Although research is still underway, there have been cases where certain families show consistency and high risk of infection than others. Nevertheless, genetic factors rarely affect older people in spite of them having a higher risk of being infected by Alzheimer’s disease.
Those people who have close family members with the disease have a slightly higher chance of developing as compared to families, which lack traces of the disease (Alzheimer’s Society, 2011). With regard to environmental factors, no substantive research has been documented even though some experts have associated Alzheimer’s disease with high exposure to aluminum metal. Nevertheless, these claims have been discounted on several occasions, leaving room for further investigations.
Additionally, the majority of people who suffer from Down’s syndrome are highly susceptible due to the existing variations in their chromosomal make-up. The risk is considered higher among people who are above the age of fifty years.
Similarly, exposure to head injuries resulting from accidents and high pressure exerted during boxing and other related activities, which may cause injury of brain tissue leading to subsequent development of the disease. Lastly, cigarette smokers and people have developed high blood pressure are at a higher risk of developing the disease. Maintaining a holistic healthy life is highly recommended in lowering the risk of Alzheimer’s disease infection (Alzheimer’s Disease Research, 2011).
Tests and Diagnosis of Alzheimer’s disease
An important remark is that there are no specific tests, which have been recommended to be confirmatory. As a result, tests are usually determined by the doctor’s judgment based on the physical observations and other simple test, which may be carried out to give some form of clarity. Most doctors are able to identify patients with dementia and even go-ahead to evaluate whether the situation may have been caused by Alzheimer’s disease.
However, accurate diagnosis can only be established after the death of a patient through microscopic examination of brain tissues (National Institute of Aging, 2010). Such analysis usually reveals the characteristics of plaques and tangles that may have developed after the disease developed to advanced and severe stages. Moreover, there are several tests, which have been designed in order to establish a basis to differentiate other causes of memory loss from Alzheimer’s disease.
Physical examination
This involves the general analysis of the neurological health of a patient which among other things focuses on coordination, reflexes, balance, muscle tone, functionality of sense of touch and sight and locomotive ability. Laboratory tests are very important in eliminating other potential causes of observed memory impairment among patients like insufficient vitamins and thyroid disorders (Hill, 2011).
Additionally, mental tests are imperative in identifying the stability of a patient’s memory. This takes close to ten minutes before the neurologists can ascertain the exact condition of the memory of his or her patient. This test involves simple tasks like drawings, copying some design, writing and memory of some words uttered by the examining specialist.
Neuropsychological testing
Based on results obtained during initial stages of testing, doctors may recommend a broader assessment exercise that would lead to finer diagnostic results. These tests usually take longer hours and is considered helping in determining whether the disease is at its initial stages or that the patient could be suffering from another type of dementia. They also help in the identification of specific changes which occur as a result of different manifestations of dementia (Nazario, 2011).
Imaging
Brain imaging is rarely used in understanding the nature of brain abnormalities which could not necessarily be related to Alzheimer’s disease. These include tumors and strokes which have the ability to cause quantifiable cognitive variation in patients. Common imaging techniques used include Computerized tomography (CT), Magnetic resonance imaging (MRI) and Positron emission tomography (PET) (Nazario, 2011).
Although these techniques are used in testing Alzheimer’s disease, it is important to understand that they make use of radiations which have been found to have adverse effects on human beings. As a caution, doctors are not allowed to expose human brain to extreme radiations to avoid long-term damage of cells and emergence of other health complications.
Treatment
As mentioned above, Alzheimer’s disease is the most common type of dementia affecting millions of people around the world. With close fifteen million people suffering from the disease worldwide, there has been research efforts geared towards identifying methods of preventing the disease or reversing of progressive symptoms. However, these efforts have not bore substantive results (Alzheimer’s Association, 2010).
While this has been the case, there are drugs recommended for Alzheimer patients for lowering the severity of observed symptoms and prevention of other opportunistic infections, which may affect Alzheimer patients. The most important thing about management of Alzheimer’s disease is early diagnosis before it develops to unmanageable levels.
If management programs are initiated early enough, many neurologists argue that such patients may be able to manage their lives without necessarily depending on caregivers at home. Additionally, may live longer due to reduced effects of manifested symptoms. Of extreme significance is the need for doctors to observe specific symptoms and administer relevant drugs. Common symptoms to be observed and taken care of include but not limited to behavioral problems, aggression, depression and sleeplessness (Kantor, 2010).
Drugs
Even though no drugs have been discovered for treatment and prevention of Alzheimer’s disease, there are those that are administered to lower the severity of symptoms among patients. In many cases, the effect and overall benefit of these drugs may be quite small to go unnoticed by patients and family members. Before patients and caregivers decide to use recommended drugs, it is important for proper consultation to be done to know when to use the drugs (Delrieu et al., 2011).
In this respect, one is supposed to be aware of the side effects and some of the risks associated with it, having in mind that the expected change in functioning or behavior might be negligible. Patients also need to know the best time to use the drugs, and if there could be situations that would require the patient to discontinue drug administration. So far, there are two types of drugs, which have been approved for the management of Alzheimer’s disease. These are:
Cholinesterase inhibitors
Cholinesterase inhibitors
This class of drugs consists of four drugs, which are Razadyne, Cognex, Aricept and Exelon. Cholinesterase inhibitors are known for their ability to prevent the breakdown of acetylcholine, a chemical found in the human brain that is responsible for memory and learning. The drugs have also been found to slow down the usual progression of Alzheimer’s disease symptoms for a limited duration of time ranging up to twelve months (Delrieu et al., 2011).
In understanding these drugs, it is essential to know that Aricept is the only drug which has the approval of Food and Drug Administration for treating Alzheimer’s disease during its three stages of development discussed in the segments above. It is administered orally since it exists as tablets, which can be directly swallowed or dissolved in the mouth.
Additionally, Cognex is reported to have been the first Alzheimer’s drug to be recognized and recommended for use by FDA. However, it is the least used drug in managing Alzheimer’s disease as compared to the other members of this category of drugs (Delrieu et al., 2011).
Similarly, Exelon has been recommended for use mildly in moderating Alzheimer’s disease symptoms before they become severe and irreversible. Exelon exists is several forms; as liquid, skin patch and in capsule form. Lastly, Razadyne, formerly known as Reminyl is recognized and approved for its ability and effectiveness in Alzheimer’s disease management (Cummings, 2001).
It exists in three formulations, namely, liquid, immediate-release tablet and extended-release capsule. Like many other drugs used in treatment of diseases, Cholinesterase inhibitors have side effects, which have to be understood when a patient is using them.
These include vomiting, insomnia, weight loss, diarrhea, loss of appetite, fatigue and nausea. Likewise, the use of Cognex may result into liver damage. It is considered to be the most dangerous side effects described by doctors. In order to prevent liver damaging, it is highly advisable for the doctor in charge to carry out liver tests to determine its functioning and likelihood of being affected as a result of Cognex (Cummings, 2001).
Namenda
This drug has been approved to treat Alzheimer’s disease from moderate stage of development to the severe level. Unlike other drugs which have been approved for the treatment of the disease, Namenda has a unique mechanism in treating Alzheimer’s disease.
Its protective ability allows it to moderate the release and activity of certain brain chemicals referred to as glutamate (Growdon, 1992). This is quite important since glutamate regulates the learning and memory ability of human beings. It has been observed that Alzheimer’s disease patients usually release excess glutamate in their brain which consequently affects their cognitive ability.
In administering this drug, the brain would become capable of releasing normal amount of glutamate thus maintaining the ability of affected individuals to maintain their sense of memory and learning. Importantly, Namenda is the only drug which has proved to work this way and increases its efficiency when used with other drugs like Cognex, Aricept, Razadyne or Exelon. Common side effects associated with Namenda include headache, confusion, tiredness, constipation and dizziness (Kantor, 2010).
Supplements
There are several cases, which are been documented about people using vitamin E, B12 and B9, although no research has supported their efficiency in Alzheimer’s disease treatment. In other places, people believe that ginkgo biloba herb prevents the disease whereas scientific research has shown no correlation between the herb and Alzheimer’s disease. It, therefore, follows that drugs used as supplements in Alzheimer’s disease treatment should be recommended by a specialist since FDA does not approve over counter drugs.
Supportive environment
Patients with Alzheimer’s disease require supportive programs as part of the treatment plan. It is recommended that they be exposed to a safe environment that minimizes accidents due to their inability to support themselves and identify their surrounding correctly.
Simple things like proper arrangement of furniture are important in promoting their safety (Nazario, 2011). Others include fixing handrails for support during movement, proper shoes selection and reducing the number of mirrors in the house since mirror images may frighten patients.
Exercise and nutrition
Regular exercising is highly recommended for everybody, including Alzheimer’s disease patients. This helps to maintain healthy joints, muscles and improve their mood. It also prevents constipation and augments sound sleep. These patients need to be well identified while exercising for easy identification by the public and offer them assistance once needed.
Immobile patients can adopt stationary bikes and other approved machines (Mayo Clinic Staff, 2011). Regarding meals, Alzheimer’s patients need a balanced diet to maintain their deteriorating health. Reminding them to eat and giving them a hand in preparation and serving is healthy and encouraging.
Conclusion
From the above analysis of Alzheimer’s disease, clearly its prevention and treatment remain a major challenge for neurologists around the world. While efforts to discover drugs for preventive purposes are on, it is imperative for the public to understand the manifestation of the disease in order for them to seek medical attention or help affected individuals to access specialized treatment before the disease advances.
The use of FDA-approved drugs should be prescribed by a doctor to curb against negative side effects or wrong drug choice. Other healthy practices like excising and proper nutrition are equally essential in preventing the progression of symptoms (Mayo Clinic Staff, 2011).
References
Alzheimer’s Association. (2010). Alzheimer’s Disease. Alzheimer’s Association. Web.
Alzheimer’s Disease Research. (2011). Common Alzheimer’s Treatments. Alzheimer’s Disease Research. Web.
Alzheimer’s Society. (2011). What is Alzheimer’s disease?Alzheimer’s Society. Web.
Brill, M. (2005). Alzheimer’s disease. Singapore: Marshall Cavendish.
Callone, P. (2010). Alzheimer’s Disease: The Dignity Within: A Handbook for Caregivers, Family, and Friends. NYC: ReadHowYouWant.com.
Cohen, E. (1999). Alzheimer’s Disease. New York City, U.S.: McGraw-Hill Professional.
Cummings, J. (2001). Treatment of Alzheimer’s disease. Clinical Cornerstone, 3(4), 27-39.
Delrieu et al. (2011). Managing Cognitive Dysfunction through the Continuum of Alzheimer’s Disease. Article Review, (25)3, 213-220.
Growdon, J. (1992). Treatment for Alzheimer’s Disease? New England Journal of Medicine, 327, 1306-1308.
Harvard Health Publications. (2009). A Guide to Alzheimer’s Disease. New York City: Harvard Health Publications.
Hill, L. (2011). Drug treatments in Alzheimer’s. Royal College of Psychiatrists. Web.
Kantor, D. (2010). Alzheimer’s Disease. New York Times. Web.
Mayo Clinic Staff. (2011). Alzheimer’s disease. Mayo Clinic Staff. Web.
National Institute of Aging. (2010). Alzheimer’s Information. National Institute of Aging. Web.
National Institute on Aging. (2003). Alzheimer’s Disease: Unraveling the Mystery. NYC: Government Printing Office.
Nazario, B. (2011). A Treatment Overview of Alzheimer’s Disease. WebMD. Web.
NHS. (2010). Alzheimer’s Disease. NHS. Web.
Nordqvist, C. (2011). What Is Alzheimer’s Disease? What Causes Alzheimer’s Disease? Medical News Today. Web.
Soukup, J. (1996). Alzheimer’s disease: a guide to diagnosis, treatment, and management. Westport, Connecticut: Greenwood Publishing Group.
Turkington, C. & Mitchell, D. (2009). The Encyclopedia of Alzheimer’s Disease. New York City: InfoBase Publishing.