It is a common degenerative brain disease that impairs mental and emotional functions in older adults from which there is no recovery, causing loss of memory and ability to care for themselves. Although there is extensive ongoing research, no cure has yet been found for Alzheimer’s.
Slowly, the disease attacks nerve cells in all parts of the cortex of the brain impairing a person’s abilities to recognize emotions, errors and patterns, coordinate movement, and remember. Eventually, an afflicted person loses all memory and mental functioning.
Causes Of Alzheimer’s Disease
Biological Factors In The Brain
- There is block in the activity of the flow of nutrients causing twisted nerve fibers in the neurons in the brain.
- There is a high concentration of plaques (sticky patches) of a protein known as beta amyloid, which forms patches called neuritic plaques. These plaques are found outside the nerve cells. High levels of beta amyloid are associated with reduced levels of the neurotransmitter acetylcholine. Neurotransmitters are chemical messengers in the brain. Acetylcholine is part of the cholinergic system, which is essential for memory and learning, and which is progressively destroyed in Alzheimer’s patients.
The inflammatory response, is a situation in which the immune system overproduces factors normally intended to fight harmful agents. There is an excessive production of prostaglandins, substances which can actually injure the body's own cells which may in turn cause increased levels of glutamate, an amino acid that is a powerful nerve–cell killer.
Environmental And Other Factors
- There has been one study that has indicated that Chlamydia pneumonia, a bacterium causes respiratory infections in parts of the brain affected by the late–onset Alzheimer’s. The presence of the bacterium may have been the result of Alzheimer’s disease rather than its cause.
- Some people exposed to intense electromagnetic fields have reported a higher incidence of Alzheimer’s. Some researchers believe that magnetic fields may interfere with the concentration of calcium inside cells, and others believe that they may increase production of beta amyloid.
- Injury to the head can accelerate the development of Alzheimer’s in people who are already susceptible to it. Poor nutrition in childhood may render the brain more susceptible to mental impairments later in life, including Alzheimer’s disease. Other recent studies suggest an elevated homocysteine level may be a risk factor for Alzheimer’s. Homocysteine is a substance in the blood that increases with deficiencies of vitamins B12 and folate. No evidence exists that supplements of these vitamins offer any protection against Alzheimer’s disease.
- Forgetfulness.
- Loss of concentration.
- Unexplained weight loss.
- Mild difficulties in walking.
- Fatigue.
- Grief.
- Depression.
- Illness.
- Vision or hearing loss.
Treatment In Early Stages
Telling the patient
If an Alzheimer’s patient expresses a need to know the truth, it should be disclosed to him/her. Both the caregiver and the patient can then begin to control the disabling disease through support groups and drug research.
Mood and emotional behavior
Alzheimer’s patients show abrupt mood swings, and can become aggressive and angry. This behavior is caused by chemical changes in the brain. It is important for the caregiver to control the environment by keeping distractions and noise at a minimum and to speak clearly. It has been suggested that Alzheimer’s patients respond well to clear, quickly spoken sentences. Certain factors that feel threatening (people talking outside the room) can cause agitation and aggression. Offering a distraction, such as an eatable or car ride, in response to shouting or other disruptive behavior may be helpful. Although much attention is given to the negative emotions of Alzheimer’s patients, some become extremely gentle, retaining an ability to laugh at themselves.
Appearance and cleanliness
Alzheimer’s patients resist bathing or taking a shower. Often the Alzheimer’s patient loses the sense of color and combination, and puts on odd or mismatched clothing. This may be very frustrating and embarrassing to a loved one.
Driving
As soon as Alzheimer’s is diagnosed, the patient should be prevented from driving as they tend to wander. For those who remain at home, locks should be installed outside the door, which the patients cannot open, but the others can.
Sexuality
Alzheimer’s patient may lose interest in sex. If sexual issues are a problem, they should be discussed openly with the physician.
Disturbed sleep
Treatment During Later Stages
Incontinence
Urinary incontinence (inability to control urination) may be controlled for some time by trying to monitor times of liquid intake, feeding, and urinating. Once a schedule has been established, the caregiver may be able to anticipate incontinent episodes and get the patient to the toilet before they occur.
Immobility and pain
As the disease progresses, Alzheimer’s patients become immobile, literally forgetting how to move, finally becoming wheelchair–bound or bedridden. Bedsores can be a major problem. Sheets must be kept clean, dry, and free of food. The patient’s skin should be washed frequently, kept dry and moisturizers be applied. The patient should be moved every two hours, and the feet kept raised with pillows or pads. Exercises should be administered to the legs and arms to keep them flexible.
Eating problems
Weight loss and the gradual inability to swallow are the two major related problems. The patient can be fed through a feeding syringe, or the caregiver can encourage chewing action by pushing gently on the bottom of the patient’s chin and on the lips. Dehydration can also become a problem, it is necessary to drink eight glasses of water daily. It should be noted that coffee and tea are diuretics and will deplete fluid, therefore should be avoided.