Term Paper: Alzheimer's Disease and Aging at What Age

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Alzheimer's Disease And Aging

At what age do people start to get Alzheimer's?

Alzheimer disease (AD) usually does not start until around 65 years of age or older. It is characterized by gradually worsening dementia (forgetfulness) caused by cerebral atrophy (deterioration). It is the most common form of dementia. Fewer than 2% of families with AD have early-onset familial AD (EOFAD), in which symptoms occur before the age of 65 years. EOFAD only refers to families in which multiple cases of AD occur. Early onset may happen in the 40s or early 50s, although early onset in the 30s has been reported. Sixty-one percent of individuals with early-onset AD had a positive family history and thirteen percent affected individuals in three generations. EOFAD is not any different from non-familial AD, except it is based on family history and age of onset. (Bird, 2005)

Genetics usually cause Alzheimer disease, but there are also unknown causes. Vascular dementia, another common form of forgetfulness, results from reduced blood flow to the brain's nerve cells. In some cases, Alzheimer's disease and vascular dementia can occur together in a condition called "mixed dementia." Other causes of dementia include frontotemporal dementia, dementia with Lewy bodies, Creutzfeldt-Jakob disease and Parkinson's disease. The earlier the onset of Alzheimer's Disease, frontotemporal dementia, and other non-Alzheimer dementias, the more likely it is they are inherited (Nee, 219)

Although there is currently no cure for Alzheimer's, new treatments are on the horizon as a result of increased research and discoveries about the biology of the disease. Studies have also shown that effective care and support can improve quality of life for individuals and their caregivers over the course of the disease from diagnosis to the end of life.

All of these questions (What is Alzheimer disease? What are its causes? And Can medication prevent it?) are treated in this paper.

1. Why I picked this topic:

My Grandfather had it.

2. Definition: (how it happens, what is it?)

Alzheimer's disease is a progressive brain disorder that gradually destroys a person's memory and ability to make judgments, learn, communicate, reason and carry out daily activities. As Alzheimer's progresses, individuals also experience changes in personality and behavior, such as anxiety, suspiciousness or agitation, as well as delusions or hallucinations.

Four major types of familial Alzheimer disease have been identified. Types 1, 3, and 4 are classified as early-onset Alzheimer disease because their signs and symptoms appear before age 65. Type 2 is classified as late-onset Alzheimer disease because its signs and symptoms appear after age 65 (Pollen, p. 5). The difference between AD and Early Onset Familial Alzheimer Disease (EOFAD) is becoming less obvious as more research on the disease is done.

Close relatives of an individual with AD have about a 20% lifetime risk of developing AD. Presumably, when several individuals in a family have AD, the risk is increased. EOFAD is often inherited in an "autosomal dominant manner." The risk to children of individuals with EOFAD is 50% if a www.geneclinics.org/servlet/access?qry=139&db=genestar&fcn=term&gtreport2=true&id=8888890&key=MY89iv-vDQpDO&format=framemutation is found. Other causes of dementia are treatable. These are conditions which affect memory decline, such as depression, chronic drug intoxication, chronic CNS infection, thyroid disease, vitamin deficiencies (especially B12 and thiamine), CNS angitis, and normal pressure hydrocephalus (Chan, p. 1121).

Alzheimer disease is characterized by adult-onset slowly progressive dementia associated with diffuse cerebral atrophy on neuroimaging studies. It is the most common form of dementia." (Bird, 2005).

3. Causes

The exact cause of the disease is unknown. A common view among doctors is that non-familial AD has many factors that cause it and that it results from a combination of aging, www.geneclinics.org/servlet/access?qry=72&db=genestar&fcn=term&gtreport2=true&id=8888890&key=MY89iv-vDQpDO&format=framegenetic tendencies, and possibly one or more environmental events, such as head trauma, viruses or contaminants, although no environmental agents have been proven to be directly involved in the cause of AD. Molecular genetics have been studied to find at least three subtypes of EOFAD based on the causative www.geneclinics.org/servlet/access?qry=66&db=genestar&fcn=term&gtreport2=true&id=8888890&key=MY89iv-vDQpDO&format=framegene. It is likely that other www.geneclinics.org/servlet/access?qry=66&db=genestar&fcn=term&gtreport2=true&id=8888890&key=MY89iv-vDQpDO&format=framegenes will be identified as a cause of EOFAD because people www.geneclinics.org/servlet/access?qry=112&db=genestar&fcn=term&gtreport2=true&id=8888890&key=MY89iv-vDQpDO&format=framekin to those having the disease, with no known www.geneclinics.org/servlet/access?qry=139&db=genestar&fcn=term&gtreport2=true&id=8888890&key=MY89iv-vDQpDO&format=framemutations in PSEN1, PSEN2, or APP, have been found. (Tanzi, p. 35)

Health Issues

Symptoms of early-onset Alzheimer's disease are similar to those of late-onset Alzheimer's disease, except that the younger person often is still active with work, family and social activities when the symptoms begin. Younger people who develop Alzheimer's disease tend to have more of the negative changes found in the brains of those with late-onset Alzheimer's disease. These changes include twisted nerve cell fibers, known as neurofibrillary tangles, and a sticky protein called beta amyloid, which forms structures called plaques. Plaques and nerve twists damage healthy brain cells that surround them, causing cells in the brain to wither and die. Some believe that younger brains need to suffer more damage than older brains before the patient begins to show symptoms, so the nature of the disease may not be that much different (Chan, p. 1121).

Symptoms

The main symptom of Alzheimer disease (AD) is dementia that typically begins with subtle and a not very well recognized failure of memory which slowly becomes more severe and, eventually, incapacitating. Other common symptoms include confusion, poor judgment, language disturbance, agitation, withdrawal, and hallucinations. Occasionally there are seizures, Parkinson's disease-like features, increased muscle tone. Myoclonus, incontinence, and mutism sometime occur. "Death usually results from general inanition, malnutrition, and pneumonia. Death usually results from pneumonia, malnutrition, or general body wasting. The duration of the disease is eight to ten years, with outside ranges of one to 25 years. (Tanzi, p. 59)

Early Warning Signs

Memory loss is the most common sign of Alzheimer disease. Memory worsens over time and interferes with most aspects of daily living. A person with Alzheimer disease may get lost or become confused even at home. The patient is challenged to do even routine tasks such as preparing meals, doing laundry, and performing other household chores. It may become difficult for the patient to recognize people and name objects. They may gradually require more help with dressing, eating, and personal care.

Hereditary

About 75% of Alzheimer disease cases are classified as sporadic, which means that, even with no history of the disorder in a family, they happen. While the cause is unknown, gene changes may play a role. Virtually all sporadic Alzheimer disease begins after age 65. The remaining cases of Alzheimer disease are found in multiple members of a family. Hereditary Alzheimer disease can be divided into early-onset disease (symptoms beginning before age 65) and late-onset disease (symptoms beginning after age 65) (Chan, p. 1121).

The Stages of Alzheimer disease

As the disease progresses, some with Alzheimer disease experience personality and behavioral changes and have difficulty in social setting. Other symptoms include irritability, restlessness, withdrawal, and problems with speaking. The advanced stage usually requires comprehensive care. After the symptoms first appear, affected individuals usually survive 8 to 10 years, but the disease can last from 1 to 25 years. "Death usually results from general inanition, malnutrition, and pneumonia." (Bird, 2005).

Drugs for Alzheimer Disease

Medication can improve the quality of life for people with Alzheimer's and their caregivers. It may even delay placement in a nursing home.

A. Names of Drugs

The U.S. Food and Drug Administration (FDA) has approved two classes of drugs to treat cognitive symptoms of Alzheimer's disease. The first Alzheimer medications approved were cholinesterase inhibitors. About half of the people who take these experience a little improvement in brain-related symptoms.

Three of these drugs are commonly prescribed:

Donepezil (Aricept®), approved for all stages of Alzheimer's disease

Rivastigmine (Exelon®), approved for mild to moderate Alzheimer's disease

And galantamine (approved in 2001 under the trade name Reminyl® and renamed Razadyne® in 2005), also approved for mild to moderate stages (Genetics, 2006)

Treatment trials evaluating use of anti-inflammatory agents (NSAIDs), estrogens, nerve growth factors, and antioxidants are underway. Vitamins and other over-the-counter medications have been used in the treatment of AD. Some, but not all, reports suggest that www.geneclinics.org/servlet/access?qry=252&db=genestar&fcn=term&gtreport2=true&id=8888890&key=MY89iv-vDQpDO&format=frameaffected individuals taking HMG-coenzyme A reductase inhibitors for hypercholesteralemia have a reduced incidence of dementia. Immunization of an AD mouse model has stimulated the search for a possible vaccination approach to the treatment of human AD. A human trial of this approach was halted because of encephalitis in a few subjects (Genetics, 2006).

Memantine (Namenda®) is a drug approved in October 2003 by the FDA for treatment of moderate to severe Alzheimer's disease. Memantine may protect cells against excess glutamate by partially blocking NMDA receptors (Genetics, 2006).

B. Side Effects of Pills

Tacrine (Cognex®), the first cholinesterase inhibitor, was approved in 1993 but is rarely prescribed today because of associated side effects, including possible liver damage.

Research has shown that taking vitamin E supplements may offer some benefit to people with Alzheimer disease, but A person taking "blood-thinners," may not be able to take Vitamin E or will need to be monitored closely by a physician.

Alternative Treatment

Frustration with the progression of symptoms of Alzheimer disease may cause some people… [END OF PREVIEW]

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