Alzheimer disease overview and clinical manifestations

ALZHEIMER'S DISEASE

According to the American Alzheimer's Association, Alzheimer's is a progressive and fatal brain disease which currently affects more than five million Americans and as a disease "destroys brain cells, causing problems with memory, thinking and behavior" and can negatively affect a person's overall lifestyle and social life. Alzheimer's is also the most common form of dementia, known in the past as senile dementia or common senility, and currently, no cure is known, yet researchers have managed to come up with treatments for the symptoms of Alzheimer's which can extend a person's life by many years if treatment is done early ("What Is Alzheimer's?" 2008, Internet).

DESCRIPTION of the DISEASE:

As to the disease of Alzheimer's as it relates to physiology and biology, the most striking abnormality in the human brain is its appearance as compared to a normal human brain. The amount of brain substance in the folds of the brain surface known as gyri is much less in the Alzheimer's brain and are greatly enlarged. The cerebral cortex which occupies the exterior portion of the brain and serves as the basis for thinking and rational thought, is also greatly shrunken or atrophied as compared to that of a normal brain (Cohen, 1999, 56).

The main culprit for these and other distortions of the human brain are due to what is known as amyloid plaques which are composed of a protein called B-amyloid protein which is a smaller part of a larger protein called amyloid precursor or APP. These proteins live in normal brain cell membranes and follow prescribed paths into the cell membranes, but in Alzheimer's, these pathways result in abnormal processes which leads to dementia (Powell & Courtice, 1993, 156).

Also, the brains of Alzheimer's patients are abnormal related to what is known as neurofibrillary tangles which are made of different proteins called tau protein. In ordinary human brains, these proteins are attached to structures called microtubules, but in Alzheimer's, these proteins become hyperphosphorated which then results in overactive enzymes called kinases. The byproduct of this overactive process allows hyperphosphorated proteins to bind together to form helical structures called paired helical filaments or tangles which eventually result in cell damage and death in the brain (Powell & Courtice, 1993, 158).

CURRENT STATISTICS:

Statistically, as of 2005, there is an estimated five million Americans who currently suffer from Alzheimer's disease with only about half of this number having been diagnosed. An unknown number have what is called "mild cognitive impairment" which is often a precursor to full-blown Alzheimer's. Also, according to Patricia B. Coughlin, by the year 2030 when the so-called "baby boomer" generation attains the beginnings of old age, the number of Americans diagnosed with Alzheimer's has been estimated to be around eight million and by 2050 over fourteen million. Of course, these numbers are dependent on whether or not a cure for Alzheimer's is found within the next ten years. Not surprisingly, the costs associated with these numbers will be staggering, due to increases in hospital costs, prescription drugs, vaccines and nursing homes/hospice care (1993, 184).

EXTERNAL -- INTERNAL EFFECTS:

Generally speaking, Alzheimer's disease does not affect any major body organs and/or systems, such as the circulatory, respiratory and muscular, simply because the disease is isolated within the human brain. However, there have been some cases in older persons with the disease in which the nervous system within the body has been negatively affected. One of the most common mental disorders linked to Alzheimer's is depression which according to Elwood Cohen manifests itself in three important ways. First, "There are higher rates of depression among Alzheimer's patients than among non-demented adults;" second, "Having a depressive episode is associated with an increased risk for developing Alzheimer's," and third, Depressive symptoms can be confused with dementia in older adults" (1999, 214).

In a recent study conducted by the Cardiovascular Health Initiative, based in Washington, D.C., more than one-third of 400 dementia patients and more than one-fifth of 300 patients with mild cognitive impairment (MCI) had experienced symptoms of depression during a one-month period prior to the study. Similar results were reported by the Multi-Institutional Research in Alzheimer's Genetic Epidemiology (MIRAGE) which discovered that "In the year prior to a patient being diagnosed with Alzheimer's disease, the same patient was almost five times more likely than their immediate family members to experience some type of symptoms linked to depression" (Powell, 1993, 182). Clearly, these links between Alzheimer's and depression should serve as a warning to those who are now experiencing some form of depression, especially if some members of their immediate family are suffering from Alzheimer's or has at some point in the past.

MEDICATIONS/TREATMENT OPTIONS:

Currently, there are a number of medications/pharmaceuticals that are being used to treat people with Alzheimer's disease. These include Cognex, "the first drug made available to treat Alzheimer's by inhibiting acetylcholinesterase and approved by the Food and Drug Administration in 1993" (Cohen, 1999, 215); Aricept, released in 1996 and a significant improvement over Cognex and Reminyl, approved by the FDA in 2001 and derived from daffodils which were used in years past as a herbal folklore medicine to treat memory loss. These and several other lesser-known drugs clearly show improvements in some patients with Alzheimer's, while other patients experience little if any improvement. Obviously, any type of improvement and/or progress in patients with this disease is far better than no improvement, even if these drugs only slow down the symptoms or help patients to remain in a stable condition.