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ALZHEIMER'S DISEASE.
Term Paper ID:19050
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Essay Subject:
History, incidence, diagnosis, sysptoms, cause, caring for patient, future outlook.... More...
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8 Pages / 1800 Words
13 sources, 22 Citations,
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Paper Abstract:
History, incidence, diagnosis, sysptoms, cause, caring for patient, future outlook.
Paper Introduction:
Alzheimer's Disease: A Slow Death of the Mind
Introduction
This report is a study on the effects of senile dementia, also known as Alzheimer's disease, often abbreviated SDAT for Senile Dementia of the Alzheimer Type. Once divided into two different diagnoses, today Alzheimer's disease and senile dementia are regarded as one disease (Heston and White, 1983, p. 15). While there is much information today on the scientific and medical aspects of Alzheimer's disease, information about how it affects not only the victim, but also others concerned is just now beginning to become available.
Alzheimer's, the "slow death of the mind," is one of the cruelest diseases because it kills its victims twice. First, the mind dies, taking with it the personality and all that was the
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These include Harvard, Johns Hopkins, theUniversity of California, the University of Southern California, and NewYork's Mt. The later stages' symptoms are the most devastating both to patientand family; during this period, the financial burden also begins pressingthe family hard. 59). Geropsychological assessment andtreatment. Geriatric psychiatry. REFERENCESAlzheimer's disease: The new epidemic? Alzheimer's, the "slow death of the mind," is one of the cruelestdiseases because it kills its victims twice. Actress Rita Hayworth, movie director Otto Preminger and actorEdmond O'Brien all suffer from Alzheimer's disease. Another method is the administration of cholinethrough a small tube directly into the brain. Families are torn apart physically, emotionally and financially asthey struggle to cope with watching a beloved, once dynamic and integralmember of their family gradually forgetting dates and names and eventuallyfailing to recognize even the closest members of his or her own family. (199 ). for [symptoms] toemerge. . Anelderly parent would live and die with his family members in the home,effectively "hiding" the problem of Alzheimer's disease. Less severe methods include psychological testing,electroencephalogram, cerebrospinal fluid examination, X-ray examinationand computerized axial tomography (CAT) scan (Teri and Lewinsohn, 1986,Chaps. . There are several methods of treatment on the horizon today, but eachneeds many more years of testing. As the populationages and more and more people survive into their eighties, we're going tosee a higher prevalence rate for dementia. Alzheimer's disease knows no racial or socioeconomic boundaries.Among its victims are artist Norman Rockwell and mystery writer RossMcDonald. Nevertheless, caregivers who are family members experiencedepression and demoralization in great numbers, and these problems are justbeginning to be studied by scientists (Biegel, Sales, & Schulz, 1991, pp.151-163). So far, there have been fewimprovements with any of these methods. NY: Springer Publishing Co.----------------------- 11 (1982). This is often followed by markedpersonality changes and communication difficulties. The 36-hour day. The middle class is completely wiped out (Clark, 1984, p. He "identifiedtwo primary neuropathological hallmarks of the disease: neurofibrillarytangles (NFT), described as 'a tangled bundle of fibers "indicating" thesite where once neurons had been located,' and structures that were latercalled plaques . Recently it has become apparent that this braindisease is not nearly as rare as once thought and that onset has alreadyoccurred or is just beginning in as many as 13 percent of the populationover 65 years (Cotman et al., 1991, p. Thirty to 4 years ago, our social structure was quite different. Researchers in one study found that "it likelytakes an extensive amount of cell destruction . For the patient, involvement and stimulation of almost any type maysometimes slow the progression of the disease. .(Cotman, Cummings, & Whitson, 1991, pp. At this point, most families elect to place the Alzheimervictim in a nursing home. 166). Thus, the greatest challenge now is having allthree work together. Beforequalifying for Medicaid, a family's income must be at the poverty level.Supporting an Alzheimer's patient requires either great wealth or greatpoverty. 118). When this occurs, Alzheimer's disease maybecome more feared than cancer is today, according to Dr. Robert Butler ofthe National Institute on Aging. . Three years later, shewas dead, and Alzheimer obtained her brain for examination. (1986). . Cambridge, MA: MIT Press.Herbert, W. 27 ). The age-specific prevalence rate rises by age 85 to 3 percent(Mortimer and Schurman, 1981, p. In M.F. 6). Often, families withan Alzheimer's victim will recall symptoms, such as continued memory loss,that surfaced in the past and simply went unnoticed or were disregarded.It is important for families to be sensitive to changes in their elderlyfamily members but not to a point of paranoia. The drug naloxone,which binds certain receptor sites in the brain, received the followingsummary from its researchers: "These results indicate that . Once divided into two different diagnoses, todayAlzheimer's disease and senile dementia are regarded as one disease (Hestonand White, 1983, p. Dementia: A practical guide to Alzheimer's and related disorders. A., Corby, N. 133) and above age 85 to 47 percent(Biegel, Sales, & Schulz, 1991, p. Long-term care facilitiesprovide specialized units for Alzheimer's patients. Schwartz (Ed.), Issues in the biology of language and cognition: Modular deficits in Alzheimer-type dementia (pp. Reflections on the selectivity of neuropathological changes in Alzheimer's disease. 13 ). 5). Whenadministered in the necessarily high doses, choline produces severalunwanted side effects. Newberry Park, CA: Sage Publications.Clark, M. (1991). It is such a common condition that manypracticing physicians have regarded it as a normal consequence of aging, asa previous generation of clinicians regarded arteriosclerosis orhypertension as a normal consequence of aging, rather than as diseaseprocesses. The more they understand what is happening,the more likely they are to accept it (Mace and Rabins, 1981, p. Baltimore: Johns Hopkins University Press.Martin, A. This enzyme is necessary to produce the neurotransmitteracetylcholine, or ACH. With the problemsassociated with Alzheimer's becoming more obvious and serious, families andrelatives of Alzheimer's victims organized the Alzheimer's Disease andRelated Disorders Association, based in Chicago, as an information centerand an advocacy group. . . The first symptom of Alzheimer's disease is almost always, asmentioned before, memory loss. In M.F. Physioligmine, a drug whichprevents the destruction of ACH, may help to improve memory but isconsidered too toxic to be given in beneficial doses. The ADRDA now has 12 chapters and 3 self-helpcenters across the United States. Participation is suchactivities as exercise, riding in cars, taking walks, listening to music,or even just looking out a window can often be helpful. 181). A Brief History of Alzheimer's Disease In 19 6, a German neurologist named Alois Alzheimer encountered awoman with all the symptoms of severe dementia--memory loss, disorientationand hallucinations--even though she was only 51. Cambridge, MA: MIT Press.Mortimer, J.A., & Schuman, L.M. Family caregiving in chronic illness: Alzheimer's disease, cancer, heart disease, mental illness, and stroke. Alzheimer's demands nearly 24-hour care as it progresses.Unfortunately, the custodial care that it requires is not covered by mostprivate health insurance companies. In the final stage of Alzheimer's, thepatient developed contractures of the face and limbs and curls into a fetalposition, gradually slipping into coma and then death. E., Sales, E., & Schulz, R. NY: Oxford University Press.Teri, L., & Lewinsohn, P.M. The role of misdirected plasticity in plaque biogenesis and Alzheimer's disease pathology. Coping With and Caring for the Alzheimer's Patient One of the many problems thrust on the families of an Alzheimer'spatient still in the early stages is worrying about what to tell people.Relatives are most often the first to be told that a family member has beendiagnosed with Alzheimer's. Senility: Sitting on a time bomb.Science News, 27 .Heston, L., & White, J. Freeman & Co.Lindeman, D. Children should also be told, and the diseaseshould be explained to them. (1981). 152).Families are often most embarrassed to tell their friends or neighbors,even though these people are usually the most available for help andgenerally very understanding. naloxonemay have at least temporary positive effects on cognition in patients withSDAT, and the drug may merit further investigation" (Heston and White,1983, p. NY: W.H. The neurofibrillary tangles mentioned earlier are comprised of these deadneurons which form lesions. Because of this, misdiagnosis presents a problem. The epidemiology ofdementia. (1976). 1 4). The cause of Alzheimer's disease is not known. (199 ). In F. (1983). But if one considers that theamount spend on research is a minute proportion of the amount now beingspent on treatments, which are largely ineffective, or for custodial care,then support of research is a wise investment in the best, humanisticsense. A highproportion of nursing home inhabitants have this condition, which may verywell account for more than one-half of the expenditures in the federalgovernment's Medicare program (Mortimer and Schuman, 1981, p. The health care delivery system is alsoreceiving more attention. . 148).It accounts for 52 percent of all cases of senile dementia. 143- 175). The patient becomes incontinent, loses mostjudgmental abilities and experiences extreme difficulty in performing eventhe simplest rote gestures. Family support centers such as these provide emotional support,psychological counseling, and legal advice. Will, & Y. While there is much information today on thescientific and medical aspects of Alzheimer's disease, information abouthow it affects not only the victim, but also others concerned is just nowbeginning to become available. The past few decades have seen anincrease in the prolongation of life and in the absolute number of olderpersons that is absolutely unparalleled in history (Alzheimer's disease,1982). Brachet, B. We're sitting on a time bomb"(Herbert, 1982, p. The effects canbe devastating. 15). The Future: A Brighter Outlook Thanks to increasing public awareness, federal research spending onAlzheimer's disease increased tenfold since 1976 from less than $4 millionto $37 million in fiscal 1984. The importance of Alzheimer'sdisease and its ramifications as a major public health problem are just nowstarting to be appreciated. the damage may well compromise more than half of local neuronavailabilty before any . 148). Neuropsychology of Alzheimer's disease: The case for subgroups. No treatment of the basic disease process has yet proved effectivefor Alzheimer's disease or any other dementia. These three often conflict in their efforts tosolve Alzheimer's problems. Diagnosis of Alzheimer's disease is very difficult, since so many ofthe symptoms--short-term memory loss, lack of enthusiasm, slight motordifficulties--are the same as would be expected in normal, healthy benignaging. However, scientistsare beginning to understand what occurs during the disease process. Breitner of Johns Hopkins Alzheimer's Research Centerputs it this way: "We're seeing the tip of the iceberg. 1. Custodial care is general supervisionand help with daily activities such as grooming and eating. 222-233). Schwartz (Ed.), Issues in the biology of language and cognition: Modular deficits in Alzheimer-type dementia (pp. dysfuntion ensues (Damasio, Van Hoesen, &Hyman, 199 , p. Biomedicalresearch does cost money--a lot of money. Atthat stage, the patient must either be placed in a nursing home or be keptat home with the family, requiring nearly constant, 24-hour care. (1981). Christen (Eds.), Growth factors amd Alzheimer's disease (pp. (1991). Innormal aging, some of the cells of the brain, called neurons, begin to die. First, the mind dies, takingwith it the personality and all that was the person. . 83- 1 ). NY: Hemisphere Publishing Corp.Mace, N.L., & Rabins, P.V. Sinai School of Medicine (Clark, 1984, p. (23 October 1982). John C.S. 97-98)." The initial lesion sites are the amygdala and thehippocampus, those parts of the brain that involve new learning andremembering (Martin, 199 , p. The Alzheimer Victim Alzheimer's disease claims between 1 , and 2 , lives everyyear, making it the fourth leading cause of death among the elderly, afterheart disease, cancer, and stroke (Biegel, Sales, & Schulz, 1991, p. . Medical day carecenters and home health care free family members to work or take briefvacations. Newsweek, 56-62.Cotman, C.W., Cummings, B.J., & Whitson, J.S. 56). Seriesin death education, aging, and health care: Alzheimer's day care: A basicguide. (3 December 1984). . Unfortunately,these numbers are on the rise as the baby boom generation rapidlyapproaches retirement age. While there is nocure for Alzheimer's disease, doctors are usually able to treat many of theearly symptoms, such as depression, with drugs or other therapeuticmethods. NPR JournalSeries [Tape].Bellak, L., & Karasu, T.B. Family caregiver applications series: Vol. A survey in 199 revealed 1,118 adultday care centers, of which most have participants with Alzheimer's: one-third to one-half of their participants (Lindeman, Corby, Downing, &Sanborn, 1991, p. But in the196 's, scientists using electron microscopes rediscovered thecharacteristic brain cell degradation and lesions of the syndrome thatAlzheimer first described. In November 1984, the NationalInstitute on Aging granted $16.5 million to five medical schools designatedas Alzheimer's research centers. 56). Alzheimer's Disease: A Slow Death of the Mind Introduction This report is a study on the effects of senile dementia, also knownas Alzheimer's disease, often abbreviated SDAT for Senile Dementia of theAlzheimer Type. 222-23)." For the next six decades, physicians regarded Alzheimer's disease asa relatively rare disease that occurred only at a younger age. The patient often becomes agitated and, insome cases, even sociopathic. 222). The most widely studied treatment camefrom the discovery that the activity of an enzyme called "choline acetyltransferase" was greatly reduced in the brain tissue of Alzheimer'spatients. Increasing theawfulness of this disease, the degenerative process lasts from five to 1 years, and cases as long as 2 years have been recorded (Bellak and Karasu,1976, p. Hefti, P. The actual treatment involves choline in a pillform or lecithin, a natural fatty substance rich in choline. Attention to patients through medical efforts is increasing, as isattention to family caregivers. Despite this fact, theatmosphere in many research centers is one of hopefulness and expectancy.An effective treatment for Alzheimer's may be discovered within the next 2 years (Teri and Lewinsohn, 1986, p. Alzheimer's affects upto three million Americans, and about 7 percent of the 27 million peopleover 65 in the United States are severely disabled by the disease (Clark,1984, p. The only way to obtain a certain diagnosis is by brainbiopsy; however, this procedure is rarely done except under very specialconditions. NY: Grune &Stratton.Biegel, D. (1991). Berlin: Springer-Verlag.Damasio, A.R., Van Hoesen, G.W., & Hyman, B.T. 1 and 2). The agony of Alzheimer's disease. H., Downing, R., & Sanborn, B. Then the body diesafter a long degenerative process robs it of the ability to walk, talk orcontrol elemental functions. As mentioned above, many ofthese changes are normal; therefore, a brief consultation with a competentphysician trained in geriatric medicine will help dispel any unnecessaryfears. By 1989, the state of California alone wasspending more than $2 million a year on 36 day care centers (Lindeman,Corby, Downing, & Sanborn, 1991, p.
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