Alzheimers symptoms are easily detectable once the stages are thoroughly studied.
However, in this article, we do not only focus on the symptoms of alzheimers disease, rather the totality of the disease itself. With this, we will tackle what Alzheimer’s disease really is, its progression, and its management as well.
What is Alzheimer’s Disease?
The most common form of dementia is Alzheimer’s disease. It is characterized by progressive impairment in memory, cognition, judgement and reasoning, language and activities of daily living. The Alzheimers symptoms tell it all. In the long run, the affected patients will not be able to perform self care activities and will ultimately be dependent on his or her care givers. It is very common among the old age, being the fourth leading cause of death. Alzheimers disease is chronic; with its long-standing health care needs, it has a huge impact on health care expenses.
Alzheimer’s Disease – Epidemiology
Sex is not an option as Alzheimer’s Disease affects men and women equally. It affects an estimated 4 million in the United States, and Americans with African and Hispanic blood are more likely to acquire the disease.
Alzheimer’s Disease – The Causes
The exact cause of Alzheimer’s Disease is unknown, but several important findings on its pathophysiology is known. Among of these are:
- Degeneration of neurons in the hippocampus which causes memory loss and in the cerebral cortex, resulting to speech, reasoning and higher function loss.
- Spherical bodies comprised of protein fragments and remnants of axons and dendrites form neuritic plaques
- Normal microtubular arrangement become tangled.
- Cortical athrophy, enlarged ventricles and basal ganglia wasting.
- Biochemically, there is impairment of neurotransmitter systems.
- Genetics may be a factor although research about this is still ongoing.
- Silent brain infarcts, head trauma, viruses, and environment toxins may play a role.
The onset of the disease is subtle, yet sinister. Among the very first Alzheimer’s symptoms is short term memory impairment. There are actually three stages of alzheimers disease.
- Early stage(2-4 years) – Cognitive deficits are still not recognized, but there are noticeable subtle changes in memory and personality. Forgetfulness, reduced interest in people and places, inability to grasp new information, word finding difficulty, inability to perform skilled motor activities, visual processing difficulty, concentration trouble and personality changes like irritability- these are some Alzheimer’s symptoms in this stage.
- Middle stage (2-12 years) – Changes in memory continue, as well as in speech and orientation. Inability to perform activity of daily living puts also occur. Patient shows repetitive actions (perseveration), inability to write (Agraphia), inability to speak (Aphasia), disorientation to time, place and events, difficulty in following simple instructions, impaired judgment, sleep-wake cycle disturbance or nocturnal restlessness, neglects of self hygiene are examples of symptoms in this stages of Alzheimers disease.
- Late stage (8-12 years) – During this stage the patient is totally dependent on others for care. Extreme weight loss, communication inability, urinary and fecal incontinence, increased irritability, emaciation are some symptoms of alzheimers disease in this stage. The patient may also become bedridden or may even enter into a comatose stage.
Along with Alzheimers symptoms, there are complications associated in the late stage. These include paranoia, dehydration, malnutrition, pneumonia, delusions and depression.
Alzheimers symptoms are just actually inklings if a person has Alzheimer’s disease. However, it would be more reliable if we allow the patient to undergo clinical tests to determine the extent of the disease and possible interventions for the patient’s treatment.
Here are some Alzheimer Diagnosis and assessment activities which are done for patients suspected to have or at risk for having the disease.
- Detailed patient history with corroboration
- CT scan (noncontrast), MRI, to rule out other neurologic conditions
- Neurological assessment and neuropsychological evaluation to identify areas of impaired functioning
- Cerebrospinal fluid commercial assays to confirm Alzheimer’s disease and risk in family members
Alzheimers Disease and Management
As soon as the Alzheimer symptoms are noticed, immediate care should be provided. Since Alzheimer’s disease is chronic, it is vital that health teachings be enforced. This includes, adjustment to lifestyle changes. In the case of muscle weakness, wherein swallowing is impaired, supplemental feedings may be required to maintain nutrition and weight of the patient must be monitored.
The primary goals of care for the patient is to maximize functional abilities and improve quality of life by enhancing behavior, mood, and cognition since no curative treatment is available.
To optimize the patient ability to function, physical therapy is often required.
Potential medications are prescribed and these include cholinesterase inhibitors to enhance cognitive function. These drugs help to enhance cholinergic neurotransmission to delay deterioration in function over time. Examples are Donepezil (Aricept), Galantamine (Reminyl) and Rivastigmine (Exelon). Antidepressants are also given since the patient is emotionally upset. Anxiolytics, antipsychotics or anticonvulsants can also be given as management for psychosis and behavioral disturbances.
Nonpharmacological interventions include music therapy, exercise, environmental manipulation and aroma therapy.
Nurses should also bear in mind the following as priorities in care: Improving cognitive response, preventing injury, providing adequate rest and relaxation, and emotional support to patient’s family.
It is vital to know what is Alzheimers disease and not just the Alzheimer’s symptoms that accompany it to prevent further trauma and complications to the patient, given that it is a progressive disease and no intervention can immediately lead to patient’s recovery.
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