Petnuch Alexis 300526 Alzheimer's

7/29/2019 Petnuch Alexis 300526 Alzheimer's

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Alzheimers Disease

Alexis Petnuch


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History of Alzheimers

Disease Alzheimers disease was

named for the doctor who haddiscovered it.

In 1906, a German physician,Dr. Alois Alzheimer concluded

that a collection of brain cellabnormalities was a disease.

It wasnt until 1960, that themedical community recognizedAlzheimers disease as an

actual disease and not just anormal affect of aging.


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History Continued Dr. Alzheimer discovered the disease when autopsying the

brain of one of his patients that had died.

She had experienced severe confusion, memory problems,and the inability to comprehend questions up until her death.

During the autopsy of the patients brain, Dr. Alzheimernoticed dense deposits around the nerve cells and twistedbands of fibers inside the cells.

When this is seen during an autopsy, it is determined thatthe person had Alzheimers disease.

Alzheimers is a form of dementia that progressivelyworsens over time.


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Symptoms Common symptoms include:

confusion, short term memoryloss, problems with attention,personality changes, languagedifficulty, and mood swings.

These symptoms are usually mildand the because of this, it is hardto tell whether or not a patient hasthe disease.

People with Alzheimer's gothrough progressive stages. Some

say there are 7 stages, but these 7stages can be grouped into threeoverall stages.


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Stage 1 This stage can last from about 2 to 4 years.

During this stage, people with this disease maybecome less energetic and can display some mildmemory loss and mood swings.

They may withdraw from their surroundings and wouldrather be around people and places that are familiar tothem.

These individuals may become confused, get losteasily, and may have difficulty organizing andperforming every day tasks.


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Stage 2 This is usually the longest stage and can last anywhere from 2 to

10 years.

During this stage, a person with Alzheimers is noticeably changingand becoming increasingly disabled. A person may be able toperform small and simple tasks, but may begin to need help more

difficult tasks.

Symptoms may include: short term memory loss, forgettingpersonal history, disconnect from reality, inability to distinguishpast and present memories, inability to recognize familiar people,and speaking, writing and reading become difficult.

Individuals in this stage may become depressed, irritable andhave trouble eating and taking care of themselves.


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Stage 3 This stage lasts from about 1 to 3 years.

During this final stage, an individual with Alzheimers

may become incompetent.

They may lose the ability to feed themselves, speak,

control bodily functions and recognize people. Their

memory becomes almost nonexistent and many

individuals will sleep often.

At this stage, constant care is usually necessary.


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Causes There is still speculation about specific causes of Alzheimers but, the

disease is determined during autopsies of individuals brains. People withAlzheimers disease have a build-up of proteins in the brain.

This occurs by the formation of plaques, deposits of the protein beta-amyloidin the spaces between nerve cells and by the formation of tangles,deposits of the protein taufound inside nerve cells. Studies and autopsies

have shown that most people develop plaques and tangles in and aroundtheir nerve cells as they age, but individuals with Alzheimers developsignificantly more.


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Causes Continued There is no definite cause of Alzheimers yet; although

genes and environmental factors appear to be a part of

getting the disease.

You are at an increased risk of getting Alzheimersdisease if:

you are older

have a close relative with the disease

have certain genes linked to the disease


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Causes Continued There are two types of Alzheimers disease, early and

late onset Alzheimers.

Individuals with Early Onset have symptoms of the

disease before the age of 60. This type of Alzheimersis less common than Late Onset, but usually gets

worse in a shorter period of time. This type of

Alzheimers can be genetic and several genes have

been identified as possible causes of this disease.


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Familial Alzheimers Disease Most cases are inherited

and are known asFamilial Alzheimersdisease (FAD).

FAD is caused by anyone of a number of singlegene mutations onchromosomes 21, 14,and 1. Each of these

mutations causesabnormal proteins toform.


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Early Onset Alzheimers A mutation on chromosome 21 causes the formation of

abnormal amyloid precursor protein.

A mutation of chromosome 14 causes abnormal presenilin 1to be made and a mutation on chromosome 1 causes

abnormal presenilin 2 to be made.

It is known that these mutations play a role in breaking downamyloid precursor protein.

The function of this protein is not yet known. The breakdownof this protein is part of a process that creates harmful formsof amyloid plaques, a known cause of the disease


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Late Onset Alzheimers Individuals with Late Onset Alzheimers have symptoms of the

disease after the age of 60. This is the more common type ofAlzheimers and may run in some families, but there may be lessof a gene relation in this type.

Researches havent discovered a specific gene that causes LateOnset Alzheimers, but one genetic risk factor seems to increasethe risk of a person getting the disease.

The risk is related to the apolipoprotein E (APOE) gene found onchromosome 19. APOE codes for a protein that helps carry

cholesterol and other fats into the bloodstream. APOE comes inseveral different alleles: APOE 2, APOE 3 and APOE 4.


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APOE Alleles APOE 2 is pretty rare and is believed to provide some sort of protection

against the disease. A person bound to have Alzheimers disease andhas this allele, will develop the disease later in life than one with one ofthe other alleles.

APOE 3 is the most common allele and is believed to neither decrease

nor increase the risk of having Alzheimers disease.

APOE 4 is found in about 30 percent of the population and in about 40percent of all people with Late Onset Alzheimers. Studies have shownthat this allele increases the risk of developing the disease, but it is notconfirmed exactly why or how.

Genetic Testing can be used to identify which APOE allele theperson has, but this cannot predict whether or not the person

will develop Alzheimers Disease. It is unlikely that genetic

testing will ever be able to predict the disease fully.


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Treatments There is no cure for

Alzheimers Disease.

Drug treatments are usedto try and slow the

progression of thedisease and manage thesymptoms. The benefitsof these drugs are usuallysmall and familymembers may not notice

significant changes inbehavior or symptoms.Usually, side effects outweigh the benefits.


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Medicines used for

Alzheimers Donepezil, revastigmine, and galantamine.

Side effects of these drugs include upset stomach, diarrhea,vomiting, muscle cramps and fatigue.

Memantine may also be used and the side effects of this drug

include anxiety or agitation.

To control aggressive or dangerous behaviors, low doses of drugsincluding haloperidol, risperidone, and quetiapine are given topatients.

Side effects of these drugs include an increased risk of death.

Some believe that certain vitamins and herbs may prevent or slowdown progression of Alzheimers but there is no strong evidence toprove this.


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Identification A Doctor may diagnose Alzheimers by completing a

physical and neurological exam, questioning medical historyand symptoms, and evaluating mental state.

Tests that are used to rule out other causes of dementiainclude: anemia, brain tumors, chronic infection, intoxication from

medicine, severe depression, stroke, vitamin deficiency, andthyroid disease.

CT or MRI of the brain may be done to look for other causes ofdementia like brain tumors or strokes. Scans do not confirm

that a person has Alzheimers, but they exclude other causes ofdementia.

The only way Alzheimers is determined for certain is afterdeath during an autopsy of the brain.


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Risk Factors Familial Alzheimers Disease is genetic.

A child whose mother or father carries a genetic mutationfor Familial Alzheimers has a 50/50 chance of inheriting themutation.

If the mutation is inherited, the child will most likely develop thedisease.

If any persons parents, siblings, or children haveAlzheimers, the risk of getting the disease is elevated.

The risk increase if more than one of these relatives hasAlzheimers.


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Bioethical Considerations During early diagnosis, there are risks pertaining to the uncertainty

of diagnostic tools and treatments, and their consequences,diagnosing correctly or not.

As of right now, Alzheimers can only be confirmed with certaintyafter death.

Because of this, when Alzheimers is suspected, efforts are madeto try and prove this.

Otherconditions are ruled out using MRIs and CT scans.

False positive and false negative results do occur and can beharmful to the patient.

False negatives can lead to patients not seeking care for theircondition at the start of the disease. False positives can cause anexcess amount of fear in a person who does not even have thedisease.

Bi hi l C id i


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Bioethical Considerations

Continued In early diagnosis, some patients are asked to make

decisions concerning their future. The patients are offered ways to slow down the process of the

progressing disease and are also asked to consider makingarrangements for the future.

The problems with this are that the patient may misjudgewhat lies in their best interest for the future.

A benefit of this is that it allows the patient to make rationaland well-thought out decisions on what should happen tothemselves when they lose the ability to think and actrationally. This avoids the issue of hypothetical consent, what the

caregiver thinks the patient would have wanted.


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BibliographyBoard, A.D.A.M. Editorial. "Alzheimer's Disease." Ncbi.nlm.nih.gov. U.S. National Library of Medicine, n.d. Web.

24 Feb. 2013. .

"A History of Alzheimer's Disease." Brightfocus.org. BrightFocus Foundation, n.d. Web. 24 Feb. 2013.

.

Hill, Carrie. "What Causes Alzheimer's Disease?" About.com Alzheimer's / Dementia. About.com, 9 Nov. 2012. Web. 24

Feb. 2013. .

"Alzheimer's Disease Genetics Fact Sheet." Nia.nih.gov. National Institute on Aging, June 2011. Web. 24 Feb. 2013.

.

Thompson, Dennis, Jr. "Determining Your Risk Factors for Alzheimer's Disease." EverydayHealth.com. Everyday

Health Media, n.d. Web. 25 Feb. 2013. .

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Petnuch Alexis 300526 Alzheimer's