ALZHEIMER’SDISEASEAlzheimer’sdisease (AD), , is a chronic neurodegenerative disorder that usually startsslowly and worsens over time. This is why 60% to 70% of dementia cases.

Themost common early symptoms are the difficulty of remembering recent events(short term memory loss). As the disease progresses, symptoms may includespeech impairment, disorientation (including easy getting lost), mood swings,loss of motivation, concerns and behavioral problems. As one person’s conditiondeclines, they often withdraw from the family and society. Gradual loss ofphysical function, eventually leading to death. Although the rate of progressmay vary, the average life expectancy after diagnosis is three to nine years.

The cause ofAlzheimer’s disease is poorly understood. About 70% of the risk is thought tobe the inheritance of many normally involved genes. Other risk factors includehistory of head injury, history of depression, or history of hypertension. Thedisease process is associated with plaque and tangles in the brain. Onepossible diagnosis is medical imaging and blood tests based on medical historyand cognitive tests to rule out other possible causes.

Initial symptoms areoften mistaken for normal aging. Brain exams need a definitive diagnosis.Mental and physical activity Avoiding obesity may reduce the risk of AD;however, the evidence to support these recommendations is not strong. There areno drugs to cure.  Alzheimer’seffect on brain:The changesthat happen in the brain start at microscopic levels before begging signs ofmemory lost.  What goeswrong in the brain?The brainhas billions of neurons or cells. Each of them connects to other networks.

Thebrain supply and nourish cells. Some cells used in memory, thinking, seeing,hearing, and gives order to muscles. The cells receive power and get rid of itswastes out.  Signs andsymptoms : Signs andsymptoms composed of 4 steps.    Pre-dementia:The firstsymptoms are usually wrongly regarded to growing old or tension.

Neuropsychologicaltesting can make mild cognitive difficulties up to 8 years before a human completethe clinical criteria for diagnosis of AD. These early signs can affect themost difficult activities of daily life. The most easily seen disorder is shortterm memory loss, which shows up as difficulty in remembering recently learnedfacts and inability to acquire new information. Subtle problems with theexecutive functions of attentiveness, planning, flexibility, and abstractthinking, or impairments in semantic memory (memory of meanings, and conceptrelationships) can also be symptomatic of the early stages of AD.

Early: In peoplewith AD, increased learning and low memory eventually lead to definitivediagnosis. In a small percentage, language difficulties, executive functions,perception or execution of actions (apraxis) are more apparent than memoryproblems, and AD does not affect all memory capacities equally. old memories ofthe person’s life (episodic memory), acquired knowledge (semantic memory) andimplicit memory (such as cooking, using a fork or a cup of something the body’smemory on the way to do) less affected than new facts or memories.Languageproblems are often characterized by a decrease in vocabulary and a decrease invocabulary, so that oral and written language is usually poverty. At thispoint, a person with Alzheimer’s disease can often communicate enough basicideas. While performing fine motor tasks such as writing, drawing or dressing,some difficulties of coordination and movement planning (apraxia) may exist,but they are often noticed. As the disease progresses, people with Alzheimer’sdisease can often continue to perform many tasks independently, but may needhelp or denial with the most demanding activities on the site.

    Moderate: Advancedimpairment eventually stops deliverance, with subjects that is unable to makecommon activities of daily life.Problem indifficulty because of difficulty in recalling vocabula , That leads torecurrent wrong words . Complicated motor series becomes low hormonions aspassed and progression as AD , so the falling risk increase .Through this phase,problems of memory gets worse, ant the patient sometimes fails to know hisrelatives .

Advanced:Through thelast stage, The person is fully dependent on people who give him care .language is decreased to less phrases or small words , lastly leads to fullloss of talking .But  they can recognizeemotional signals ,excessive careless and fatigue are more common signs in thisperiod .

Patient with AD disease fails to do simple jobs alone, muscle mass,decrease and gets unable to nourish itself. The death happens usually due toexternal causes as virus or infection. Causes:The reasonof most AD cases is yet unknown .values for 2% to 6% of the cases due to geneticdifferences .many hypothesis are trying to explain the reason of AD.Genetic:Theheritability of genetic of AD disease, based on surveys of family and twinstudies, varies from 50% to 80% about 0.1 % cases due to familial forms ofautosomal intevituane.

That happens before age of 65. AD disease is known aspremature familial disease. Many of AD disease is due to mutations In one ofthe genes, which encodes presehilins 1,2 and amyloid precursor protein .Many of mutation that happens in amyloidprecursor protein and presenilin genes rises the production of little proteinwhich is called AB42, which is the master ingredient of semile plaques.  Cholinergichypothesis:The mostancient, in which drug therapies are based on, is cholinergic hypothesis .Thatsuggests that AD is due to reduction of synthesis of acetylcholine neurotransmitteron the wide scale medications wants to cure the deficiency in acetylcholine, socholinergic hypothesis doesn’t get a popular support.

Amyloidhypothesis:In the 1991,Amyloid hypothesis presumed that the deposition of amyloid beta extracellularis the primary cause of AD .The location of the gene of APP on chromatin 21 isthe advocacy of this assumption, together with the patients having dawnsyndrome that have additional copy as the gene special isoform of ApoE4 is themark risk factor of AD. Diagnosis:AD isdiagnosed by the history of the patient, relative history and attitudemonitoring. Progressive computed tomography with medical imaging, single-photonemission computed tomography and magnetic resonance imaging.

Is used toeliminate any other cerebral diseases or other types of dementia.Thediagnosis is proved by very high accurate post mortem when the brain substanceis found can be tested histologically. Prevention:Now daystheir is no proof that any measures can prevent AD. Some epidemiologicalstudies assumed that their  is connectionbetween some factors as diet, heart risk, pharmaceutical products and somemental activities of developing AD.

Only clinical trials will proof  that these factors can prevent AD or not.    Medications:Five typesof medication are recently used to cure the cognitive defitsal AD. Four of themare acetyl cholinesterase inhibitors such as 1-rivastigrine, 2-galantine,3-donepezil,4-tacrine,and the fifth on is NMDA receptor antagonist asmemmatine. But the advantage from their use is low. Their is no recentmedication has been obviously shown a decrease in the advancement of AD. Thedecreasing in the activity of the cholinergic neurons is good knowncharacteristic of AD.

Using acetylcholine esterase inhibitors to decrease therole that acetylcholine is broken, so increasing the concentration ofacetylcholine in brain and battling the decrease of Ach happen by the death ofcholinergic neurons. Some evidence is found on the effectiveness of themedication on mild to moderate AD. The only medication which is approved to beused in advanced stage is donepezil. The most muted adverse effect is vomitingand nausea, these adverse effects emerge in 10-20% of patients using thismedication.Lifestyle:People whoaltrated in mental activities as reading, writing, playing musical instruments,finishing, puzzles or sociable interactive shows a decrease in risk of AD,Education decrease the start of AD without changing the times of AD. Alsopeople who learn a second language decrease the risk of getting AD. Physicalactivity can reduce the starting and delay AD.Diet:Eatinghealthy food like Japanese or Mediterranean diet could decrease the risk of AD.

The Mediterranean food could mend the results to people having AD. The peopleeating food rich in fats and carbohydrates have high risk of developing AD.Their is some studies assumed that small to high consuming of red wine maylowers the risk of AD. Other studies assumes that caffeine is protectiveagainst AD and some with flavonoids as coca may reduce the risk of AD.    Epidemiology:It has ahigh propagation to be as high as 24 million patient globally andprognosticated to be doubled every 20 years. There are two measures are used inAD, which is prevalence and incidence.Hope forthe future:Scientistsare working to progress or understanding about AD.

But without clinical trialsand the help volunteers we can’t do anything. Every clinical trial done donatesvery important and valuable knowledge for treatment or prevention of anydisease.    


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