What is Alzheimers Disease?

Alzheimers Disease, or senile dementia, is a degenerative brain disease to which elderly people are particularly prone. Not only does it cause great stress to sufferers, but it places massive demands on caregivers. World-wide, there are over 25 million sufferers in the present day.

The Disease

Alzheimer’s is the most common form of dementia. It causes damage to neurons and synapses that culminate in atrophy of key areas of the brain. It is believed that plaques and ‘tangles’ visible under the microscope are linked to protein abnormalities.

Researchers have pinpointed malfunctioning of the beta-amyloid peptide (a protein component) and tau proteins. Breakdown of the neurotransmitter acetylcholine is also implicated. Though genes that indicate a risk factor for Alzheimer’s have been identified, genetic factors do not fully explain its occurrence. Why the biochemical functioning goes wrong remains poorly understood.

Alzheimer’s is a progressive, terminal disease with no cure, though most sufferers die of complications (such as pneumonia) rather than the disease itself. Current drug treatments cannot prevent, slow or reverse the disease process, but are aimed at controlling and minimising symptoms.

Alzheimers Symptoms

Though symptoms vary amongst individual sufferers, early signs of Alzheimer’s are those we associate with normal ageing: memory loss, mild cognitive impairment and sometimes apathy and a loss of zest for life. Short-term memory is most seriously affected. These early symptoms are often misdiagnosed as normal ageing or as stress-related. As the disease advances, sufferers may experience confusion, language difficulties, mood swings and clumsiness.

These problems worsen over time, more severely affecting speech, attention span, physical dexterity and long-term as well as short-term memory. Sufferers may not recognize their surroundings. Psychological and mood problems, including bouts of sadness, aggression and even delusions, may manifest. Incontinence can place great stress on carers. The end result is typically loss of mobility, leaving sufferers bed-bound, physically wasted and dependent on carers for all functions, including feeding.

Diagnosis

Medical imaging (CAT scans, PET scans and MRI) can exclude other diseases and pinpoint the areas of the brain that are affected, and brain biopsy can provide conclusive proof. Usually diagnosis also depends largely on the sufferer’s recent medical history, including the degree of cognitive impairment and mental state. Sufferers may go undiagnosed for years, but once the symptoms are clear-cut, life expectancy is estimated at less than ten years, with few surviving for fifteen.

Treatment For Alzheimers

The standard drug treatment for Alzheimer’s disease is the administration of drugs that slow the breakdown of the neurotransmitter acetylcholine. This does not cure the disease but has some effect in many cases, particularly in the earlier stages. Managing levels of glutamate, another neurotransmitter, is a parallel treatment. Anti-psychotic drugs are used to manage behavioural and psychiatric problems such as aggression and delusional behaviour. All these drugs may have serious side effects in some individuals.

In the absence of a magic bullet, attention is paid to psychosocial support. A huge range of interventions, including psychotherapy, cognitive training and maintaining stimulation levels, has been tested. A balanced diet is recommended; there is in fact some evidence that a Mediterranean-type diet may help prevent Alzheimer’s in some instances.

Future Directions

With ageing populations, Alzheimer’s presents not only a massive expense for governments and health services, but a terrible burden for caregivers, whose plight has not always received the attention it deserves. Research has traditionally been underfunded, but this is improving, with many promising treatments in the development stages or nearing approval.

Even if no cure beckons, growing awareness of the problem has led to increased tolerance and improved care for sufferers in many countries. The twenty-first century may yet bring relief for sufferers of a disease only recognized a hundred years

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About the Author

Christie SartoriChristie Sartori RN, MSN, FNP-BC, OCN (Family Nurse Practitioner) Has been in the medical field for many years and has worked in Medical Oncology, GYN Oncology, Adult as well as Pediatric, and many other outpatient and inpatient settings.View all posts by Christie Sartori →

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    Hi Amy,I’m so sorry about all that you are managing and matnianniig. I understand about the sundowning. I experience this with my mother who has dementia. I’m so glad you wrote about it. The resources others have been sharing will be so helpful.Denise advised me a while back to write about the tough moments/days if only just a few sentences. I’ll pass that advice on to you about the sundowning. If there is a behavior that is upsetting to you and if you feel comfortable, please tell us about it. For me, the release in writing has been amazing. It sounds as though you may be able to talk with your sister too.Please take care of yourself Amy. You do so much for so many, just don’t forget how important you are. Add strength to yours through remembering you need help physically too.Thinking of you and your family. Please take care.

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