Alzheimers Disease

Word Count: 3272ALZHEIMERS 1

Katrina Lindsey
Florida Atlantic University

Advanced CPR
John Picarello
March 18, 2000


ALZHEIMERS 2
Alzheimers disease is a complex illness that affects the brain tissue directly and undergoes gradual memory and behavioral changes which makes it difficult to diagnose. It is known to be the most common form of dementia and is irreversible. Over four million older Americans have Alzheimers, and that number is expected to triple in the next twenty years as more people live into their eighties and nineties. (Johnson, 1989). There is still no cure for Alzheimers but throughout the past few years a lot of progress has been made.

Doctors need a sure way to diagnose the disease before treatment or studies can be done. The diagnosis is an autopsy of brain tissue examined under a microscope. In addition, medical history, a physical exam, and mental status tests are used for diagnosis (Posen, 1995). Often, tests are done to rule out other potential causes of the dementia. This allows the identification of other causes of thinking and behavioral changes to be made before concluding that the patient has Alzheimers or another form of dementia. The tests that are requested to be done include CT and MRI scans to rule out strokes or brain tumors which could account for change in memory and behavior; thyroid and psychological tests which can also detect thinking and behavior problems (Posen, 1995).

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Alzheimers is a result from a combination of factors that cause progressive brain deterioration that affects the memory and behavior of an individual. There are two known risk factors. The first risk factor is age. Alzheimers usually affects people older than 60, and rarely affects those younger than 40. The average age
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of diagnosis is about 80 years old (Johnson, 1989). The incidence is about the same for all races, but women are more likely than men to develop the disease, because they live longer. The second factor is heredity. Family history plays a role in about forty percent of people with early onset of Alzheimers (Johnson, 1989). If your parents or a sibling developed the disease, you are more likely to, as well. But there are cases of families with several people who have had this disease and other members are not affected. These two factors are the only proven factors, but environmental research is being done to help with a possible protective effect for the disease. As of now, more research is needed to confirm any benefit.

The causes of Alzheimers follows the same pattern as most other dementias. Neurons degenerate and lose their ability to communicate and die. Due to the inability of the brain to replace nerve cells, some brain function is lost. The key question in Alzheimers disease is, what causes the neuron degeneration (Johnson, 1989)? The focus for finding the cause is on abnormal structures found in the brain of people with Alzheimers. Unfortunately, the abnormal structures the brain undergoes still has researchers uncertain as to how they are involved in Alzheimers and exactly how the disease occurs.

Therefore, not knowing the exact causes of the disease, the signs and symptoms will help with the diagnosis. The first sign may be mild forgetfulness that progresses to affect language, reasoning, understanding, reading and
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writing. There has been known cases of people with Alzheimers who become anxious, aggressive and wander away from home (Wallace, 1998). These individuals have a severe case of the disease and must be taken care of on a daily basis. Alzheimers progresses and affects individuals differently. Many signs are shown in the individual with the disease, which allows you to classify which stage the individual is in. Some of the signs to look for are, difficulty learning and retaining new information, reasoning and abstract thought, judgment and planning, poor language skills, inhibition and impulse control and short term memory loss (Wallace, 1998). If any or all of these signs occur, the individual most likely has Alzheimers.

Unfortunately, there is no cure for Alzheimers but there are treatments for the disease to help with reducing or retarding the mental and behavioral processes. The first treatment is a drug called Tacrine, which slows the loss of mental abilities in about 30 percent of people with a mild or moderate case of Alzheimers disease (Posen, 1989). Another drug is Aricept, which increases the availability of acetycholine to decrease the symptoms of the disease. However, neither one of these drugs can stop or reverse the disease. It remains unclear how long patients should take them or even how long the drug will be effective in the individual.

To decrease the risks of getting Alzheimers there are certain prevention task that can be done. First of all, consumption of nonsteroidal anti-inflammatory
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drugs(NSAIDS) reduces the risk of Alzheimers by 30-60 percent (Johnson, 1989). Inflammation of the brain is one stage that causes the development of Alzheimers and taking NSAIDS may prevent this. Vitamin E and selegiline may also help in prevention. These substances prevent nerve cell damages and slow the rate of decline in those with moderate Alzheimers. Another factor related to women is estrogen. Recent studies show that estrogen replacement after menopause reduces the risk of developing Alzheimers by 30-40 percent (Johnson, 1989). The final task is mental fitness. Leading an intellectual life can keep the mind fit and decrease the risks due to the increase in synapses when learning, which can delay the onset of Alzheimers.

In conclusion, Alzheimers is a mental disease that cannot be cured. Fortunately, treatments and drugs are available to help slow the rate of progression of the disease. In addition, the risk factors and preventive measures are quite clear. These can help those who are unaware of what Alzheimers disease is or how it progresses. Future studies may prove to be beneficial in preventing the occurrence of Alzheimers, or at least the severity of its progression. Informing people of this disease, the risk factors, and preventive measures at a younger age, can only prove beneficial in the decrease or possible elimination of this physically and mentally altering disease. Living a healthy life now can only increase your chances of having a healthier life in old age.
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Remember: A rolling stone gathers no moss, So exercise your brain now to reduce future loss.



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References
Johnson, Barbara S. (1989). Psychiatric mental health. (2nd ed.). New York. J.B. Lippincott Company.


Posen, P.B (1995, Apr.). Alzheimers disease. www.document.(Visited March 12, 2000). URL:Http://www.mayo.edu/research/alzheimers.center.


Wallace, Robert. (1998, March). Alzheimers disease. www.document. (Visited March 12, 2000). URL: Http://www.alzheimers.org/pubs/adfact.htm).

Alzheimers Disease

Alzheimer’s Disease Alzheimer’s Disease With all of the advanced technology that the medical field possesses today, there is still suffering that occurs from incurable diseases. Alzheimer’s Disease is one of those incurable diseases that take the lives of many today. This paper will examine this disease thoroughly by looking at its definition, and discussing general information, facts, and figures. The cause of Alzheimer’s Disease, and the much thought about question of if it is genetic or not will disputed. Also the symptoms, diagnosis, and treatment of Alzheimer’s Disease will be addressed.

Included will also be tips on how to make the life of an Alzheimer’s patient easier. What is Alzheimer’s Disease? Alzheimer’s Disease (AD) is the most common form of dementia, a neurologic disease characterized by loss of mental ability severe enough to interfere with normal activities of daily living, lasting at least six months, and not present from birth. AD usually occurs in old age, and is marked by a decline in cognitive functions such as remembering, reasoning, and planning.(Robinson, 1999). A summary of other definitions found in other sources is: Alzheimer’s disease is a little known-about, but common, incurable or chronic brain disease that destroys the cells of the brain, and causes gradual loss of mental function and troublesome changes in behavior. The disease is thought to attack the parts of the brain that are responsible for controlling thought, memory, and language.

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Along with this complex definition comes abundant general information, facts and figures. From the time in which a person first develops symptoms of Alzheimer’s Disease to the time of their death is on average eight years, although this time may be as little as one year to as long as twenty years. Following only heart disease, cancer, and strokes, Alzheimer’s Disease is the fourth leading cause of death in adults. Currently there are approximately two to four million Americans that have AD, and due to the fact that the population as a whole will age, by the middle of the 21st century, that number might reach 14 million. Rarely does AD strike people in their 40s or 50s, and when it does it is considered to be a subdivision called early-onset AD. Elderly people age 65 or older is the class most often effected by Alzheimer’s Disease.

Three percent of all people age 65 to 74 have Alzheimer’s. Nineteen percent of those between the ages of 75 and 84 are affected, and for those over age 85 forty-seven percent are affected. The average cost of caring for someone with Alzheimer’s Disease is considerable, and is approximately $174,000 per person over the course of the disease. This figure is for those persons who can be cared for at home by a friend or family member. If the condition is bad enough and the person’s caregiver has to seek outside help, such as a nursing home, the cost rises.

(Robinson, 1999) By reading all of these startling facts one may wonder what causes such a horrible disease. In the year of 1906, Dr. Alois Alzheimer, the man in which the disease is named after, conducted an autopsy on a woman who died from an unusual mental illness. His findings showed changes in the women’s brain tissues. He found abnormal deposits, now called senile plaques, and tangled bundles of nerve fibers, now called neurofibrillary tangles (U.S.

Department of Health and Human Services, 1993). Senile plaques are simply chemical deposits that contain degenerating nerve cells along with a protein called beta amyloid, and neurofibrillary tangles are malfunctions in nerve cells caused by twisted masses of protein fibers. These two abnormal structures are common between autopsies done on patients with Alzheimer’s symptoms. It is not clear how these cause problems, but presumably they interfere with the communication between nerve cells. This interference causes a person not to be able to respond normally to a message being sent to the brain (National Institute of Mental Health, 1994).

A common concern that is thought of when talking about the cause of Alzheimer’s Disease is that of it being genetic or not. Although this question is still being researched, and is not yet fully understood, it is believed that early-onset AD is more likely to run in families than AD that strikes later in life. A belief that genetics has a roll in early-onset AD is supported by genetic markers that have been found on chromosome 21 and 14, but remember early-onset AD affects a small subgroup of people. A small amount of evidence points to the relationship of chromosome 19 to that of Alzheimer’s Disease that affects the elderly. Although there is this evidence, there is only a slim chance that a close relative of an afflicted individual will develop Alzheimer’s. If one has a family member with AD their chance of getting the disease is only slightly higher than that of the general public (National Institute of Mental Health, 1994). Alzheimer’s Disease progresses in stages, therefore the symptoms depend on in which stage the affected person is. The onset of the disease is slow, but gradually over time it becomes more aggressive and harmful to the person’s health.

At first the person will experience short-term memory loss which results in the forgetting of simple daily activities. For example, the persons might forget to take his or hers daily medicine. Also during this stage mild personality changes may occur, along with withdrawal from social interaction. The person will also experience memory loss that could effect their job, and the often misplacing of things. As the disease progresses the person will begin to have problems with abstract thinking and intellectual functioning, and they will become agitated, irritable, and quarrelsome.

Considered to be in the later stages of the disease are symptoms such as disorientation and confusion of what month and even year it is, as well as the person not knowing where he or she lives. The forgetting of the names of close relatives or even their own names, becoming violent, wandering off, not being able to engage in a conversation, having erratic moods and behaviors, and loss of bladder control are among the many symptoms an Alzheimer’s patient suffers in the later part of the disease. In extreme cases the patient becomes totally incapable of caring for themselves. Not being able to walk, talk, or eat (Robinson, 1999). Even with such a long list of symptoms the diagnosis of Alzheimer’s is very complex. In most cases a person must go to see several different specialist, undergo many extensive test, and the result might take several months to receive.

The first thing doctors do is obtain a medical history on the patient. This is important because there are prescription drugs as well as over-the-counter drugs that can cause AD-like symptoms. Since other medical conditions such as tumors, infections, and dementia caused by mild strokes can also cause AD-like symptoms, tests must be used to rule these out. Such tests might include appropriate blood and urine tests, brain magnetic resonance imaging (MRI), computed tomography scans (CT), tests of the brain’s electrical activity (electroencephalographs or EEGs), and other tests must also be preformed. Even after all of this only a provisional diagnosis can be made.

A final, positive diagnosis can not be made until death, and only if an autopsy is preformed to look for senile plaques and neurofibrillary tangles (Robinson, 1999). There are some treatments for Alzheimer’s disease, but none are totally effective seems how Alzheimer’s remains to be incurable. There are only two drugs that the FDA has approved for the treatment of Alzheimer’s Disease, although there are other drugs being tested daily. These two are tacrine or Cognex and donepezil hydrochloride or Aricept. Both increase the levels of the neurotransmitter acetylcholine in the brain.

Neurotransmitters are chemicals, released by nerve cells, that carry information to the brain (Baron, 1998). The neurotransmitter acetylcholine is involved in sending messages that have to do with muscle action, learning, and memory. So when theses drugs are given and acetylcholine is increased the communication ability of remaining neurons are increased. These drugs can not however stop the deterioration of nerve cells, nor can they regenerate damaged or deteriorated cells. Therefore, the most effective treatment of a patient with Alzheimer’s is good nursing care that provides both emotional and physical help.

The person’s symptoms can be treated. There are certain drugs that can be used to control some behavioral symptoms and to make patients more comfortable (Robinson, 1999). With all that has been said about the cause, symptoms, and lack of cure surrounding Alzheimer’s Disease one might wonder what could be done to help someone with AD. A person who is a caregiver to someone with Alzheimer’s Disease should reduce stress in the patients life and have routines that keep the environment as much the same as possible. Allow a person with AD to do for himself or herself what ever is possible, and the caregiver should do only those things that the patient can no longer accomplish. Do not tease or argue with the person, and do not let them become overly tired.

Limit the number of new people that are around the patient, and watch for situations that trigger unwanted behavior. Celebrate with the person what he or she can do well and always listen to what he or she has to say. Also, never forget that the person’s behavioral symptoms are not directed towards the caregiver or others. These what seem to be small things can make the life of an Alzheimer’s patient easier and less complicated (Norrgard, 1999). After reading about what Alzheimer’s Disease is, its causes, symptoms, diagnosis, and treatment, it could be considered one of the curliest diseases that affects the world today. It takes away a persons self-confidence as well as their dignity.

The person has total loss of control of what use to be the center of their life, their brain. Previously they depended on the use of their brain to live a normal life, but when struck with Alzheimer’s they must face the fact they are losing control, and will eventually end up not being able to care for themselves. Possibly the worst part is that there is no cure, but there is hope for the future, because research is being done daily. Science.

Alzheimer’s Disease

Alzheimer`s Disease (AD) is one of the most common of the dementing illnesses. A
progressive, degenerative disease that attacks the brain, causing impaired
memory, thinking and behavior. A person with Alzhiemers Disease may experience
personality and behavior changes, impaired judgment, confusion and difficulty
finishing thoughts, following directions or even finding the right word to say
in a conversation. Once advanced the sufferer may require a caretaker as daily
chores become very difficult to accomplish. Evidence points toward amyloid as
one of the main causes for the occurring cytotoxic processes. Researchers have
found that degeneration appears to be caused by interference with intracellular
calcium homeostasis via activation of calcium channels, intracellular calcium
stores, and further production of free radicals by calcium-sensitive enzymes.

The glutamatergic system seems to be involved in mediating the toxic processes.

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In the brain, the nerve cells in the part that controls memory and thinking are
damaged, this interrupts the passage of messages between communicating cells.

The cells undergo distinctive changes, these are called neuritic plaques (groups
of degenerating nerve cell ends) and neurofibrillary tangles (groups of twisted
filaments which accumulate in previously healthy nerve cells). The cortex (used
for thinking) of the brain shrinks, the spaces in the center of the brain become
enlarged causing reduction of the surface area in the brain. Symptoms of AD
usually occur in older adults and are the ones most at risk, although people in
their 40s and 5Os may also be affected. The symptoms include a loss of
intellectual capacity, loss of language skills which may include having trouble
finding words, poor or decreased judgment, problems with abstract thinking,
disorientation in place and time, changes in mood or behavior and changes in
personality. AD does not discriminate, it affects any race, socio background or
sex equally. The classic symptom of forgetfulness is part of the normal aging
process and usually begins in early middle age, however, normal forgetfulness
differs from Alzheimer’s Disease in many important ways. The cause of
Alzheimer’s Disease is not exactly known. Suspected causes undergoing research
are neurological damage, chemical deficiencies, viruses, environmental toxins
and malfunctions in the body’s disease defense systems and genetics. There is
also evidence of a slightly increased risk of heridity of AD amongst children,
brothers and sisters of patients with this disease. It is also important to note
that AD can only be diagnosed 100% after death through an autopsy of the
affected subjects brain tissue. About a third of autopsies turn up a different
diagnosis and thus family members are encouraged to ask for an autopsy as a
contribution to the study of the disease and about the genetics of AD. There is
no single clinical test for AD. It is usually diagnosed by ruling out all other
curable or incurable causes of memory loss. A positive diagnosis of this disease
can only be made by microscopically studying a small piece of brain tissue after
death. The cerebral cortex of an Alzheimer sufferers brain will have
characteristic abnormalities such as cells marred by plaques and tangles. A
working diagnosis can be made though through various testing procedures that
include a complete physical as well as neurological and psychological
examinations. At this time there is no definite cure or treatment for AD,
although there are many suppliers of products which claim to help sufferers, but
the products are more like over-priced placebos with no documented evidence of
alleviation of the illness amongst sufferers, but glutamate receptor-selective
drugs, some antioxidants, nitric oxide synthase inhibitors, calcium channel
antagonists, receptor or enzyme inhibitors, and growth factors promise future
help in curing this disease. Combinations of drugs that act at different levels
may also prolong the sufferers life/health. People diagnosed with Alzheimer’s
Disease can live anywhere from 2 to 20 years after memory loss symptoms start to
surface. It shortens the sufferers expected life span, but through appropriate
care and medical attention the patients oftenlive for many years. Death can’t
usually be predicted until the end stages where symptoms are nearing their
worse. Some patients in late or terminal-stage Alzheimer’s tend to lose weight
and have difficulty swallowing, difficulties with bladder control, walking and
talking. They are also known to curl into a fetal position. Sufferers most often
die through a series of repeated infections such as bladder infections or
pneumonia. Although the following estimations are from American literature, as
explained earlier we know that AD has a more or less universal effect amongst
the populations, ratio wise. Alzheimer’s afflicts approximately 4,000,000
Americans and it’s estimated that one in three of us may have a relative that
will suffer from this degenerative disease. More than 100,000 die annually which
makes AD the fourth largest cause of adult death in the US. It is also a very
costly disease monatary wise in that about half of the patients in nursing homes
have this illness with an estimated $80 billion spent annually on the care of,
diagnosis, treatment, etc. People who suffer from AD often require 24-hour care
and supervision, this is mostly provided by family and friends in a home.


Bibliography
Bliss T. V. P Collingridge G. L (1993) A synaptic model of memory: Long-term
potentiation in the hippocampus, Nature 361 31-39 * Clarris H. J. et al (1994)
Secretion of nerve growth factor from septum stimulates neurite outgrowth and
release of the amyloid protein precursor of Alzheimer’s disease from hippocampal
explants J. Neurosci. Res. 38 248-258 * Disterhoft J. F et al (1994) The calcium
rationale in aging and Alzheimer’s disease Calcium Hypothesis of Aging and
Dementia, Annual Academy of Science. N.Y. New York 382-405 * Holschier,C (1998)
Neurobiology of disease, Academic Press 5 121-159 * http://www.ahaf.org/alzdis/about/adabout.htm
* http://www.alzheimers.com/ * http://www.zarcrom.com/users/yeartorem/index4.html
Health Care

Alzheimer’s disease


Alzheimers Disease
Noah Rodman
Helen Packey
English 120
November 5, 2001

Alzheimers Disease
Imagine waking up one morning and you cannot remember where you are or your own childs name. This could be a direct sign that you or a family member has Alzheimers disease. Alzheimers disease is a form of dementia, which means that it affects certain functions of the brain such as memory, logic, and everyday bodily functions. This disease was first described by a doctor named Alois Alzheimer in 1906. He discovered unusual growths of fibers in the brains of woman that had died from an unusual mental illness (National Institute, 1995).
Many people do not realize how severe this disease really is. These people also do not realize how much of a risk there is of developing the disease. Four million people in the United States today are afflicted with Alzheimers disease. It is estimated that about 22 million people around the world currently have this disease (St.George-Hyslop, 2000). Another very interesting fact about Alzheimers is that the changes in the brain take place 20 to 40 years before the patient shows any symptoms. About ten percent of Americans have this disease by the age of 65, and about 50 percent of Americans have the disease by the age of 85. People can live well into their 90s, and they still retain most of their memories and control of their bodies (Kahn, 1998). This disease is a disease that everyone in the United States should be concerned about.
Scientists believe that they know what causes this disease to occur. It is caused by proteins in the brain that go terribly wrong. These proteins form clusters inside the brain, and they produce a toxin that affects nerve cells. These nerve cells are then lost, and this affects certain parts of the brain that control certain functions. This directly affects two parts of the brain, the hippocampus and the cerebral cortex. These two parts of the brain control memory, reasoning, language, and other bodily functions (St. George-Hyslop, 2000). Alzheimers disease has a major effect on not only the patients life, but on the lives of the patients family as well.

This disease takes a very slow path in its development. It may start as just some short-term memory loss. This means that a person with Alzheimers may forget little things, like what he or she ate for dinner last night or why they went to the refrigerator. These symptoms can be overlooked as just a part of the aging process. As the disease progresses, however, the symptoms get much worse. Sometimes people with Alzheimers forget where they are, and they can even forget what they are doing half way through a simple task, like making toast (National Institute, 1995). A few years ago, I went to Thanksgiving dinner at my grandmothers house. My whole family knew that my great aunt had Alzheimers, but no one knew how bad it had gotten.
My aunt and I always had great conversations about life, but when I went to say hello to her, she did not even know my name. She could hardly remember anybodys name, and we were all her closest family. What made things look even worse was half way through dinner she remembered my name, only to say, Noah can you pass the mashed potatoes? About two minutes later, she had once again forgotten my name.
Believe it or not this disease gets even worse. People with Alzheimers can eventually start forgetting to do their everyday tasks such as brushing their teeth, combing their hair, and a person can even forget when to go to the bathroom. After a while, a person may need 24 hour a day care. Many times a spouse or an offspring will take the job of a patients caretaker.
The job of the caregiver is a very tolling one. This person needs to totally devote him of her self to the job. Shenk (2001 p. 15) interviewed a caregiver, who stated, She needs to be watched every second, as she wants to go home and has attempted to walk there many times. Of course home is always in a different place, depending on where her memory of her life happens to be. Shenk (2001) also points out that patients often become very angry and blame the majority of the anger on their caregiver. For example, when my cousin was taking care of my aunt, she would often get very mad at him like a child would get mad at his parents because they would not let the child buy a piece of candy. My aunt would become furious, and sometime she would even try to hit him. This point was illustrated by Shenk (2001) in the following passage:
All her anger is focused on me; she calls me fat and no good. She says I dont even care if she lives or dies. She accuses me of stealing her things, and accuses my children, who dont smoke of taking her cigarettes. When she gets into repetitive complaining about me, Ive often felt that I would love to place her somewhere else, anywhere but hereif I could find someone who would take good care of her. (p. 16)
As the Alzheimers Fact Sheet (1995) points out, patients will eventually begin to wander away from home. Several times the police have been enlisted to help track her down. Once she was found with mud up to her knees. She had tried to walk across a swamp (Shenk, 2001, p. 16). This happened only when the caregiver took her eyes off of her mother for a couple of seconds. The caregiver cannot be blamed for this, but it shows how much responsibility the caregiver really has. One day my cousin fell asleep while my aunt was taking a nap. A couple of hours later he awoke to the phone ringing. The call was from a supermarket about ten miles away. They said that my aunt had gone shopping, but she did not have any money to pay for what she wanted. My cousin had taken my aunt shopping the previous day.
In my aunts case, and in most other cases, this disease will kill the patient. The brain will lose the ability to command certain organs in the body. In my aunts case, her liver stopped functioning. She died about two days later. Every patient will eventually meet a similar doom. The worst part is that nothing can be done about this. There is no way to stop the disease from taking its path.

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Alzheimers will eventually lead to death, if something else does not happen along the way. There are no ways to prevent the disease, and there has yet to be a cure found for the disease. The most difficult part of this disease is that a person does not need to have the disease to suffer from it. The caregivers are doomed to watch his or her family slowly turn back into a toddler like state. The caregivers are also faced with being reeducated. Every few months, the caregiver must learn to deal with the new changes that have occurred in the patients disease. Eventually, the caregiver is responsible for all of the following: makeshift remedies, negotiating impossible requests and insults, financial responsibilities, shopping and cooking, dressing, and bathing. This can cost a caregiver tens of thousands of dollars a year (Shenk, 2001).

There are currently two drugs to aid in the treatment of Alzheimers disease. These drugs are only effective during the first couple years of the disease. The drugs are called Cognex and Aricept. Both of these drugs work by increasing a chemical in the brain that works with memory. They do not cure the disease, but they do produce some improvement in patients. In Kahns story (1998) a daughter of a patient was very pleased with Aricept, the reversal of her condition was remarkable. For over a year, I kind of got my mom back (p,18).
This disease is obviously a horrible one. It can rip a family apart, and there is nothing that can be done about it. Hopefully, one day a cure will be found, but in the mean time, Alzheimers disease has total control over a person who is afflicted with it. It also has control over the family of the person afflicted with it. Almost everyone in this country has some sort of tie to this disease, and this is why more research should be done in hopes of finding a cure.


References
Kahn, C. (1998, November, 8). New drugs and hope for Alzheimers patients. Parade Magazine, 16-19.

National Institute on Aging. (1995). Alzheimers Disease Fact Sheet. RetrievedOctober 22, 2001, from the World Wide Web: http://www.alzheimers.org/pubs/adfact.html
Shenk, D. (2001, November-December). The War on Alzheimers. My Generation, 15-20.

St. George-Hyslop, P.H. (2000). Piecing Together Alzheimers. Retrieved October 22, 2001, from the World Wide Web: http://www.sciam.com/2000/1200issue/1200stgeorge.html


Alzheimers Disease
Noah Rodman
Helen Packey
English 120
November 5, 2001

Alzheimers Disease
Imagine waking up one morning and you cannot remember where you are or your own childs name. This could be a direct sign that you or a family member has Alzheimers disease. Alzheimers disease is a form of dementia, which means that it affects certain functions of the brain such as memory, logic, and everyday bodily functions. This disease was first described by a doctor named Alois Alzheimer in 1906. He discovered unusual growths of fibers in the brains of woman that had died from an unusual mental illness (National Institute, 1995).
Many people do not realize how severe this disease really is. These people also do not realize how much of a risk there is of developing the disease. Four million people in the United States today are afflicted with Alzheimers disease. It is estimated that about 22 million people around the world currently have this disease (St.George-Hyslop, 2000). Another very interesting fact about Alzheimers is that the changes in the brain take place 20 to 40 years before the patient shows any symptoms. About ten percent of Americans have this disease by the age of 65, and about 50 percent of Americans have the disease by the age of 85. People can live well into their 90s, and they still retain most of their memories and control of their bodies (Kahn, 1998). This disease is a disease that everyone in the United States should be concerned about.
Scientists believe that they know what causes this disease to occur. It is caused by proteins in the brain that go terribly wrong. These proteins form clusters inside the brain, and they produce a toxin that affects nerve cells. These nerve cells are then lost, and this affects certain parts of the brain that control certain functions. This directly affects two parts of the brain, the hippocampus and the cerebral cortex. These two parts of the brain control memory, reasoning, language, and other bodily functions (St. George-Hyslop, 2000). Alzheimers disease has a major effect on not only the patients life, but on the lives of the patients family as well.

This disease takes a very slow path in its development. It may start as just some short-term memory loss. This means that a person with Alzheimers may forget little things, like what he or she ate for dinner last night or why they went to the refrigerator. These symptoms can be overlooked as just a part of the aging process. As the disease progresses, however, the symptoms get much worse. Sometimes people with Alzheimers forget where they are, and they can even forget what they are doing half way through a simple task, like making toast (National Institute, 1995). A few years ago, I went to Thanksgiving dinner at my grandmothers house. My whole family knew that my great aunt had Alzheimers, but no one knew how bad it had gotten.
My aunt and I always had great conversations about life, but when I went to say hello to her, she did not even know my name. She could hardly remember anybodys name, and we were all her closest family. What made things look even worse was half way through dinner she remembered my name, only to say, Noah can you pass the mashed potatoes? About two minutes later, she had once again forgotten my name.
Believe it or not this disease gets even worse. People with Alzheimers can eventually start forgetting to do their everyday tasks such as brushing their teeth, combing their hair, and a person can even forget when to go to the bathroom. After a while, a person may need 24 hour a day care. Many times a spouse or an offspring will take the job of a patients caretaker.
The job of the caregiver is a very tolling one. This person needs to totally devote him of her self to the job. Shenk (2001 p. 15) interviewed a caregiver, who stated, She needs to be watched every second, as she wants to go home and has attempted to walk there many times. Of course home is always in a different place, depending on where her memory of her life happens to be. Shenk (2001) also points out that patients often become very angry and blame the majority of the anger on their caregiver. For example, when my cousin was taking care of my aunt, she would often get very mad at him like a child would get mad at his parents because they would not let the child buy a piece of candy. My aunt would become furious, and sometime she would even try to hit him. This point was illustrated by Shenk (2001) in the following passage:
All her anger is focused on me; she calls me fat and no good. She says I dont even care if she lives or dies. She accuses me of stealing her things, and accuses my children, who dont smoke of taking her cigarettes. When she gets into repetitive complaining about me, Ive often felt that I would love to place her somewhere else, anywhere but hereif I could find someone who would take good care of her. (p. 16)
As the Alzheimers Fact Sheet (1995) points out, patients will eventually begin to wander away from home. Several times the police have been enlisted to help track her down. Once she was found with mud up to her knees. She had tried to walk across a swamp (Shenk, 2001, p. 16). This happened only when the caregiver took her eyes off of her mother for a couple of seconds. The caregiver cannot be blamed for this, but it shows how much responsibility the caregiver really has. One day my cousin fell asleep while my aunt was taking a nap. A couple of hours later he awoke to the phone ringing. The call was from a supermarket about ten miles away. They said that my aunt had gone shopping, but she did not have any money to pay for what she wanted. My cousin had taken my aunt shopping the previous day.
In my aunts case, and in most other cases, this disease will kill the patient. The brain will lose the ability to command certain organs in the body. In my aunts case, her liver stopped functioning. She died about two days later. Every patient will eventually meet a similar doom. The worst part is that nothing can be done about this. There is no way to stop the disease from taking its path.

Alzheimers will eventually lead to death, if something else does not happen along the way. There are no ways to prevent the disease, and there has yet to be a cure found for the disease. The most difficult part of this disease is that a person does not need to have the disease to suffer from it. The caregivers are doomed to watch his or her family slowly turn back into a toddler like state. The caregivers are also faced with being reeducated. Every few months, the caregiver must learn to deal with the new changes that have occurred in the patients disease. Eventually, the caregiver is responsible for all of the following: makeshift remedies, negotiating impossible requests and insults, financial responsibilities, shopping and cooking, dressing, and bathing. This can cost a caregiver tens of thousands of dollars a year (Shenk, 2001).

There are currently two drugs to aid in the treatment of Alzheimers disease. These drugs are only effective during the first couple years of the disease. The drugs are called Cognex and Aricept. Both of these drugs work by increasing a chemical in the brain that works with memory. They do not cure the disease, but they do produce some improvement in patients. In Kahns story (1998) a daughter of a patient was very pleased with Aricept, the reversal of her condition was remarkable. For over a year, I kind of got my mom back (p,18).
This disease is obviously a horrible one. It can rip a family apart, and there is nothing that can be done about it. Hopefully, one day a cure will be found, but in the mean time, Alzheimers disease has total control over a person who is afflicted with it. It also has control over the family of the person afflicted with it. Almost everyone in this country has some sort of tie to this disease, and this is why more research should be done in hopes of finding a cure.


References
Kahn, C. (1998, November, 8). New drugs and hope for Alzheimers patients. Parade Magazine, 16-19.

National Institute on Aging. (1995). Alzheimers Disease Fact Sheet. RetrievedOctober 22, 2001, from the World Wide Web: http://www.alzheimers.org/pubs/adfact.html
Shenk, D. (2001, November-December). The War on Alzheimers. My Generation, 15-20.

St. George-Hyslop, P.H. (2000).

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