Question

write a paper about Alzheimer's disease and its preventions.

Answer 1

Alzheimer’s disease is a progressive, irreversible, degenerative neurologic disease that begins insidiously and is characterized by gradual losses of cognitive function and disturbances in behavior and affect.

Risk factors

• Age,
• Gender
• A family history of Alzheimer’s disease
• Presence of Down syndrome.
• Head injury
• Other factors such as high cholesterol, hypertension.

Pathophysiology

Specific neuropathologic and biochemical changes are found in patients with Alzheimer’s disease. These include neurofibrillary tangles and senile or neuritic plaques (deposits of amyloid protein, part of a larger protein in the brain. This neuronal damage occurs primarily in the cerebral cortex and results in decreased brain size. Similar changes are found to a lesser extent in the normal brain tissue of older adults. Cells that use the neurotransmitter acetylcholine are the ones principally affected by this disease. Biochemically, the enzyme active in producing acetylcholine, which is specifically involved in memory processing, is decreased.

Clinical manifestations

• In early stages of Alzheimer’s disease, forgetfulness and subtle memory loss occur. The patient may experience small difficulties in work or social activities but has adequate cognitive function to hide the loss and can function independently. Depression may occur at this time. Forgetfulness is manifested in many daily actions. These patients may lose their ability to recognize familiar faces, places, and objects and may get lost in a familiar environment. They may repeat the same stories. Conversation becomes difficult. The ability to formulate concepts and think abstractly disappears. The patient is often unable to recognize the consequences of his or her actions and will therefore exhibit impulsive behavior. The patient has difficulty with everyday activities. Personality changes are usually evident. The patient may become depressed, suspicious, paranoid, hostile, and even combative.
• In progressive stage of disease, speaking skills deteriorate to nonsense syllables, agitation and physical activity increase, and the patient may wander at night. Eventually, assistance is needed for most ADLs, including eating and toileting, since dysphagia occurs and incontinence develops.
• The terminal stage, in which the patient is usually immobile and requires total care, may last for months or years. Occasionally, the patient may recognize family or caretakers. Death occurs as a result of complications such as pneumonia, malnutrition, or dehydration.

Assessment and diagnostic finding

• The health history, including medical history; family history; social and cultural history; medication history, and the physical examination, including functional and mental health status, are key in the diagnosis of probable Alzheimer’s disease.
• Diagnostic tests, including complete blood count, the Venereal Disease Research Laboratory (VDRL) test for syphilis, HIV testing, chemistry profile, and vitamin B12 and thyroid hormone levels, as well as screening with electroencephalography (EEG), computed tomography (CT), magnetic resonance imaging (MRI), and examination of the cerebrospinal fluid may all support a diagnosis of probable Alzheimer’s disease.
• Tests for cognitive function, such as the Mini-Mental State Examination and the clock-drawing test, are useful for screening.
• CT and MRI scans of the brain are useful for excluding hematoma, brain tumor, stroke, normal-pressure hydrocephalus, and atrophy but are not reliable in making a definitive diagnosis of Alzheimer’s disease.

Medical Management

• Tacrine hydrochloride (Cognex), this medication can cause liver toxicity, patients must be closely monitored.
• Donepezil (Aricept), an acetylcholinesterase inhibitor.
• Rivastigmine (Exelon).  

Nursing Management

Nursing interventions are aimed at maintaining the patient’s physical safety; supporting cognitive function, reducing anxiety and agitation; improving communication; promoting independence in self-care activities; providing for the patient’s needs for socialization, self-esteem, and intimacy; maintaining adequate nutrition; managing sleep pattern disturbances; and supporting and educating family caregivers.

Preventive measures for Alzheimer's disease

By identify and controlling your personal risk factors and leading a brain-healthy lifestyle, you can maximize your chances of lifelong brain health and preserve your cognitive abilities.There are seven pillars for a brain-healthy lifestyle that are within your control:

• Regular exercise- exercise can also slow further deterioration in those who have already started to develop cognitive problems. Exercise protects against Alzheimer’s and other types of dementia by stimulating the brain’s ability to maintain old connections as well as make new ones.
• Social engagement and quit smoking- Staying socially engaged may even protect against Alzheimer’s disease , avoid all forms of tobacco.
• Healthy diet - Manage weight, cut down on weight, get plenty of omega-3 fat, eat more fruits and vegetables.
• Challenge your mind - Continue learning new things and challenging their brains throughout life are less likely to develop Alzheimer’s disease.
• Quality sleep -  the importance of quality sleep for flushing out toxins in the brain.
• Stress management -  stress management tools can minimize its harmful effects helps to reduce shrinkage in a key memory area, hampering nerve cell growth,
• Vascular health - Maintaining your cardiovascular health can be crucial in lowering your risk for Alzheimer’s disease.