Neuroscience

ALZHEIMER’S DISEASE AS A CAUSE OF DEMENTIA

Neuroscience

Summary 1: for Non-scientific Audience

Dementia is a condition that describes a collection of signs and symptoms that are associated with a decrease in an individual’s mental capability. It is a process that is slow and gradual, and its signs and symptoms get worse as the disease progresses. It

is associated with a significant reduction in a person’s ability to remember, their ability to use language in a proper way to communicate, and their ability to think in a logical manner. It is also associated with a significant reduction in their ability tom live an independent life where they can carry on with the daily activities without the support of others.

Dementia is caused by many underlying conditions that jointly lower the functioning capacity of one’s brain. The main condition that has been shown by researchers to lead to dementia is Alzheimer’s disease. This disease is characterized with the deposition and accumulation of proteins that are toxic to the neurons of the brain. These proteins destroy these neurons, causing their death. As the neurons die, brain functionality decreases, and the patient begins experiencing the earlier mentioned signs and symptoms (McAdams-DeMarco, et al., 2018). While the exact trigger of the Alzheimer’s disease is not known, research has indicated that there is a genetic component that plays a crucial role in the development of the condition such that this disease tends to be found across lineages of families (Rakesh, Szabo, Alexopoulos, & Zannas, 2017). Over 30 genes have been implicated in the development of Alzheimer’s disease. Out of

these, three have been shown to be inherited by children from their parents in a manner that is dominant, implying that a parent can pass these genes to their child and the child will eventually suffer from the disease, and eventual suffer from dementia (Robinson, Tang, & Taylor, 2015).

Age and gender play important roles in the prevalence of dementia caused by Alzheimer’s disease. This dementia affects older adults who are 65 years of age or older. Out of every ten individuals within this age bracket, one has dementia due to

Alzheimer’s in the United States. Additionally, about two thirds of the population that has dementia are women. Other than age and gender, race and an individual’s ethnic background also play an important role in the likelihood of one developing dementia due

to Alzheimer’s disease. African-American older adults are twice as likely to get this form of dementia, while Hispanics and 1.5 times as likely when a comparison is made with whites of the same age bracket (Fazio, Pace, Maslow, Zimmerman, & Kallmyer, 2018).

As mentioned earlier, dementia significantly impairs a person’s ability to function independently. These patients therefore need assisted living in terms of support to perform the daily activities of living. This puts significant level of burden to both the caregivers, the family members and friends of the patient and the society in general. It is fundamental therefore for caregivers and the society to work in collaboration in accurately diagnosing this condition as early as possible. The healthcare providers should then carry out their assessment and develop a care plan that with ensure

delivery of proper pharmaceutical care and a supportive environment that will promote the quality of health of the patient.

Summary 2: for Scientific Audience

Dementia is a term that denotes a syndrome that is associated with a decrease in cognitive functions of an individual in a manner that is progressive. It manifests through a series of symptoms, chief among them being depression, agitation, and apathy. As the loss in cognitive functioning increases, the patient gradually loses their ability to function independently and will require support from their family members, partners or friends. The impact of this is that significant burden is placed on both care providers, caregivers and the society in taking care of a patient suffering from dementia.

Dementia is caused by numerous factors, most of which are underlying health conditions. These underlying conditions are normally associated with a specific assemblage of signs and symptoms that are responsible for the neuropathology of the dementia. Alzheimer’s disease has been described as the cause of dementia that is most prevalent. This disease is neurodegenerative condition that is caused by an accumulation within the brain of neurofibrillary tangles and plaques that are neuritic (Solomon, et al., 2014). Two proteins have been implicated in the development of dementia due to Alzheimer’s disease. These are tau and beta amyloid proteins. These proteins accumulate in the brain causing a destruction to the neurons. This destruction eventually leads to neuronal death, worsening of the decline in brain function, and the

onset of symptoms of dementia. The patients begin experiencing challenges with their memory, skills in problem solving, language, and their ability to carry on with their daily tasks.

It is estimated that as of the year 2017, 5.5 million individuals within the United States of

America were living with dementia caused by Alzheimer’s disease (Fazio, Pace, Maslow, Zimmerman, & Kallmyer, 2018). In a population of Americans 65 years of age or older, one person out of every ten suffers from dementia caused by Alzheimer’s. In addition to the aforementioned, two-thirds of the population in United States that is suffering from dementia due to Alzheimer’s disease comprises of women (Fazio, Pace, Maslow, Zimmerman, & Kallmyer, 2018). Other than the disproportionate prevalence of such form of dementia based on gender, ethnicity and race also affects the prevalence. An older adult who is of African American origin is twice as likely to get dementia due to Alzheimer’s disease compared to a White older adult. Hispanics within this age bracket have a likelihood that is higher than that of whites by up to 1.5 times (Fazio, Pace, Maslow, Zimmerman, & Kallmyer, 2018).

Approximately 60 percent of the older adults living with dementia caused by Alzheimer’s disease live within the community dwellings. However, of this population, it is estimated that only 25 percent are living independently. About 42 percent of them live in assisted- living homes while 61 percent of them live in nursing homes with cognitive impairment level that is either moderate or severe. This requires a focus on provision of patient- centered care that begins with establishing accurate diagnosis and detection of the condition, followed by assessment and planning of care, pharmaceutical care, and patient support and education in an environment that is both therapeutic and supportive (Fazio, Pace, Maslow, Zimmerman, & Kallmyer, 2018).

References

• Fazio, S., Pace, D., Maslow, K., Zimmerman, S., & Kallmyer, a. B. (2018).

Alzheimer’s Association Dementia Recommendations. The Gerontologist,

58(S1), S1-S9. doi:0.1093/geront/gnx182

• McAdams-DeMarco, M. A., Daubresse, M., Bae, S., Gross, A. L., Carlson, M. C.,

& Segev, a. D. (2018). Dementia, Alzheimer’s Disease, and Mortality after Hemodialysis Initiation. Clin J Am Soc Nephrology, 13(2018), 1339-2018. doi:https://doi.org/10.2215/CJN.10150917

• BOEVE, B.F. & MILLER, B.L. (2016). The Behavioral Neurology of Dementia.

Cambridge, England. Cambridge University Press.

• BOSS, P. (2011). Loving someone who has dementia: how to find hope while coping with stress and grief. San Fransisco, CA, Jossey-Bass.

• DICKERSON, B. C., & ATRI, A. (2014). Dementia: comprehensive principles and practice. Oxford; New York: Oxford University Press.

• FACS, & FURMAN, R. (2018). Defeating Dementia: What You Can Do to

Prevent Alzheimer's and Other Forms of Dementia. Ada, Michigan. Baker Books.

• HICKEY, E. & BOURGEOIS, M.S. (2011). Dementia: From Diagnosis to

Management - A Functional Approach. Milton Park, Abingdon. Taylor & Francis.

• Rakesh, G., Szabo, S. T., Alexopoulos, G. S., & Zannas, a. A. (2017). Strategies for dementia prevention: latest evidence and implications. Therapeutic Advances in Chronic Disease, 8(8-9), 121 –136. doi:https://journals.sagepub.com/doi/10.1177/2040622317712442

• Robinson, L., Tang, E., & Taylor, a. J.-P. (2015). Dementia: timely diagnosis and early intervention. BMJ, 350(h3029), 1-6. doi:10.1136/bmj.h3029

• Solomon, A., Mangialasche, F., Richard, E., Andrieu, S., Bennett, D. A., Breteler, M., . . . Kivipelto, a. M. (2014). Advances in the prevention of Alzheimer’s disease and dementia. Journal of Internal Medicine, 275(3), 229-250. doi:10.1111/joim.12178

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Maryam Tariq
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