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Dementia-Alzheimer Disease
Mental diseases are some of the most difficult to treat. Unfortunately, many people get these diseases as they grow older. Generally, dementia is a group of symptoms that affect the ordinary behavior of the brain such as memory and reasoning. Basically, the disease starts mildly with a person constantly forgetting new and non-repeat tasks. Nevertheless, as the disease progresses, it may have detrimental effects. Notably, a person is said to have dementia when he/she has a severe deterioration of cognitive functions beyond that expected of in an old age (Jack et al., 2011). Given that, the disease affects memory, thinking, orientation, comprehension, calculation, language, and judgment. In addition, it may be preceded or accompanied with deterioration in emotional control, motivation, or social behavior. Consequently, it is a major cause of disability of older people.
Further, dementia normally affects people who are above sixty years. Nonetheless, it actually occurs in people of younger ages. Importantly, the disease is caused by various factors which include degenerative diseases such as Alzheimer, Parkinson’s, and Huntington’s disease (Alzheimer’s Association, 2015). Additionally, infections such as HIV and vascular diseases, stroke, depression, and chronic drug abuse may trigger its occurrence. However, Alzheimer is the major cause of dementia, and it is responsible for 50 to 70 percent of the ailments (Meiner, 2015).
In brief, Alzheimer is a progressive brain disease that inhibits cognitive functions and causes memory impairment. Noteworthy, the damage of the brain starts before the symptoms show up. Generally, abnormal protein deposits on the brain form plaques and tangles on an individual with Alzheimer. Thereafter, these plaques and tangles cause a disconnection in brain cells, leading to their death.
Statistics
Evidently, the world population is aging quickly. Correspondingly, it is expected that the number of people having Dementia-Alzheimer will increase. Unfortunately, mental health and emotional well-being are important to the elderly just as they are to the young (Jack et al, 2011). In brief, statistical information of people suffering from Dementia-Alzheimer enables countries and respective organizations to plan accordingly on how to deal with the disease.
Currently, it is estimated that there are 47.5 million people with dementia worldwide. Worse still, there are 7.7 million new cases annually (Alzheimer’s Association, 2015). Notably, 60-70% of these individuals suffer from Alzheimer. Consequently, of the 47.5 million people with dementia, more than half have Dementia-Alzheimer disease. In addition to this, the population of the world elderly is expected to nearly double by 2050 (Alzheimer’s Association, 2015). Basically, only 12% of the world population was over 60 years in 2015 (Alzheimer’s Association, 2015). Nonetheless, this number is expected to double to 22% by 2050. Further still, it is estimated that this number will increase to 75.6 million in 2030 and 135.5 million in 2050 (Alzheimer’s Association, 2015). Moreover, the majority of these individuals will be from low and middle income countries.
Signs and Symptoms
Basically, the symptoms of Dementia-Alzheimer are mild at the beginning but worsen as the disease progresses. Noteworthy, every individual is unique; as a result, individuals have different symptoms (Meiner, 2015). Nevertheless, there are some common symptoms of Dementia-Alzheimer disease: most people show memory lapse as the earliest symptom. In particular, they have difficulty recalling events or learning new information (Azermai, et al., 2012). Notably, this is caused by the damage of the hippocampus, which is responsible for maintaining day-to-day memory. In addition to memory loss, some individuals may develop problems in thinking, reasoning, and communicating.  In brief, early Dementia-Alzheimer symptoms are the following:

  1. Memory loss
  2. Language impairment
  3. Loss of visuospatial skills
  4. Inability to concentrate, plan, and organize activities
  5. Orientation problem

Generally, in later stages of the disease, the symptoms worsen and an individual may experience hallucinations. In addition, the affected may have unusual behaviors such as aggressiveness, disturbed sleeping patterns, and restlessness (Andrew & Solomon, 2016). Moreover, in the final stage, an individual may become unaware of what is happening around them. Consequently, he/she may be unable to do his/her daily activities such as walking  or eating.
Stages of Dementia-Alzheimer
Essentially, every individual shows unique behavior depending on their personality. Nonetheless, these symptoms are divided into three stages (Pasmore, Ho, & Gallegher, 2012). Notably, they are the early, middle, and late stage.
Early Stage
Basically, the early stage Dementia-Alzheimer is not as pronounced as the later stages. As a result, it is often overlooked.  In essence, the common symptoms at this stage are as follows:

  • Loss of memory
  • Loss of track of events and time
  • Getting lost in familiar areas

Middle Stage
Importantly, at this stage, the symptoms become more pronounced and restricting. In general, these symptoms are the increased severity and occurrence of symptoms in the early stage. Basically, these symptoms include the following:

  • Forgetting events and people’s names
  • Getting lost in familiar areas such as at home
  • Experiencing difficulty in communication
  • Needing assistance in personal care
  • Experiencing abnormal behaviors such as wandering around

Late Stage
Notably, patients at this stage experience near total dependence and inactivity. In particular, they have serious mental and physical incapacitation. Generally, the symptoms include the following:

  • Getting lost and inability to keep track of time
  • Having difficulty recognizing close family members
  • Needing assistance with personal care on almost all activities
  • Having difficulty in walking and feeding
  • Experiencing abnormal behaviors such as wandering and aggressiveness

Risk Factors
Basically, the elderly people are the ones who have the highest risks of getting Dementia-Alzheimer. Notably, old people lose their ability to live independently owing to reduced mobility (Alzheimer’s Association, 2015). In addition to this, older people are more prone to experience painful events such as bereavement, a drop in socioeconomic status, retirement, and disability. Generally, social, psychological, and biological factors determine a person’s mental health.  There are various risk factors for the elderly as follows:

  • Age: Generally, people are at a more risk of getting Dementia-Alzheimer as they get older.
  • Alcohol use: Excessive consumption of alcohol increases an individual’s chance of getting this disease. Nonetheless, a moderate amount is helpful.
  • Diabetes: Uncontrolled diabetes is a major cause of stroke which leads to the occurrence of this disease.
  • Genetics: In essence, a person’s risk of developing Dementia-Alzheimer increases if more than one person suffers from this disease in his/her family.
  • Hypertension: High blood pressure is associated with cognitive decline, stroke, and вementia-Alzheimer. Importantly, stroke is also a major contributor in the occurrence of this disease.
  • Mental illness: Notably, depression is associated with mental illness. In essence, depressive environments are causes of dementia-Alzheimer.
  • Smoking: Smokers are prone to diseases that slow blood flow to the brain. Consequently, this leads to its degeneration and as a result the formation of dementia-Alzheimer.

Diagnosis Criteria
Generally, diagnosis is done to evaluate whether the patient has dementia or effects of diseases that exhibit similar symptoms. Notably, among the diseases with similar symptoms are vitamin B12 deficiency, abnormal thyroid functions, drugs induced encephalopathy, and normal pressure hydrocephalus (Meiner, 2015). Basically, the assessment usually includes the following:

  • Identifying the patient’s history: Generally, patients who have a history of dementia have a higher chance of getting the disease. Additionally, the physician analyzes if the patient is taking medications that may lead to these reactions.
  • Conducting a physical exam: Importantly, the measurements of physical conditions such as blood pressure may enable a physician to identify signs that are symptoms of dementia-Alzheimer or of diseases that cause it.
  • Neurological evaluation: Essentially, this involves assessing balanced sensory functions such as eye movement, reflexes, and vision. In addition to this, doctors may use an electroencephalogram to assess the brain’s electrical activity.
  • Brain scans: Generally, this method is used in rare occasions and includes the use of computer topography (CT) scan and magnetic resonance imaging (MRI).
  • Cognitive and neuropsychological tests: Notably, early symptoms of dementia-Alzheimer are characterized with a slow rate of understanding of simple tasks. Consequently, this method measures the individual’s rate of understanding various tasks.
  • Laboratory tests: Importantly, these tests enable physicians to identify the cause of underlying symptoms. Basically, they are conducted to measure vitamin B12, blood pressure, and blood sugar levels.
  • Pre-symptomatic tests: Generally, some forms of dementia are a result of underlying genetic defects. Consequently, these tests are done on members of the same family to test their likelihood of getting dementia-Alzheimer.
  • Psychiatric evaluation: Generally, these tests determine whether depression or other health conditions are the contributors to an individual having symptoms similar to those of dementia-Alzheimer.

Nursing Intervention
Unfortunately, there is no cure for neurodegenerative forms of dementia such as dementia-Alzheimer. Nonetheless, treatment is available to manage the symptoms of disease. Notably, among the available classes of medicine are cholinesterase inhibitors, which include medicines such as donepezil, rivastigmine, and galantamine. Generally, these drugs are effective in stabilizing a patient’s memory and thinking skills (Andrew & Solomon, 2016). Additionally, memantine class of medication is also effective in treating dementia-Alzheimer. Basically, it works by regulating the activity of neurotransmitter glutamate. Generally, excessive amounts of glutamate cause neurons to die, leading to the development of dementia.
Other Considerations
Essentially, behavioral therapies are beneficial in the treatment of patients suffering from dementia-Alzheimer. Generally, exercise increases blood flow into the body, which improves cardiovascular functions and increases a patient’s flexibility, strength, and balance. Notably, caregivers should be trained on how to facilitate exercise for people with dementia-Alzheimer. Importantly, exercise may lead to improvement in physical health and reduction of behavioral stress (Rubistein, 2011).
Importantly, a person with dementia-Alzheimer needs high care and attention. Notably, as the disease progresses, the patient’s dependency levels increases. Consequently, the collective use of family members to treat the patient is an important method in reducing stress. Additionally, family-care slows the rate of progress of the disease and leads to an overall high quality life of the patient (Rubistein, 2011). Moreover, there is usually an increase in mutual bond, love, and family connection between the patient and the care giver. Nonetheless, caring for a person with dementia-Alzheimer can be challenging and annoying. Basically, these individuals experience abnormal changes in their moods. Consequently, a person should seek training on what to expect if he/she has a family member who has this disease.
Evidence –Based Practice (EBP)
Basically, evidence-based practice refers to the use of current evidence when making decisions on the best approach to treat a patient. Notably, nurses use this method when they carry out assessment, inquiry, and use the available clinical evidence to treat a patient. In the treatment of the dementia-Alzheimer, nurses normally have to conduct a number of tests so as to conclude that a patient has dementia-Alzheimer. In particular, they conduct laboratory tests of vitamin B12, cardiovascular tests, and blood sugar tests. In addition to this, they also carry out psychiatric tests. Consequently, the use of evidence-based practice is paramount in the treatment of patients (Alzheimer’s Association, 2015).
Conclusion
Conclusively, dementia-Alzheimer is a common disease, and doctors and families must be trained on how to handle patients suffering from it. In addition to this, since the disease indiscriminately occurs to anybody, people should all be prepared to cope with it and accept those who fall sick. Consequently, a supportive social infrastructure is necessary to facilitate a conducive and stress free environment for people with this disease.
 
 
 
 
 
 
References
Andrew, B., & Solomon, P. (2016) Memory loss, Alzheimer’s practical guide for clinicians (2nd Ed.). New York: Elsevier.
Alzheimer’s Association.(2015). Alzheimer’s disease facts and figures. Alzheimer’s & dementia 2015. Chicago: Alzheimer’s Association National Office.
Azermai, M. M., Pertovic, M., Elseviers, M., Bourgeois, J., Van Bourtel, M., &, Stichele, H. (2012). Sytematic appraisal of dementia guidelines for the management of behavioral and psychological symptoms. Ageing Research Reviews, 11(1), 78-86. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21856452
Jack, R., Albert, M., Knopman, S., McKhann, M., Sperling, A., Carillo, M., Phelps, H. (2011). Introduction to revised criteria for the diagnosis of Alzheimer’s disease: National Institute on Aging and the Alzheimer Association Workgroups. Alzheimer’s & Dementia : The Journal of the Alzheimer’s Association, 7 (3), 257-262. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096735/
Meiner, S. (2015). Gerontologic nursing. (5th Ed.). St. Louis, Mosby: Elsevier.
Pasmore, J., Ho, A., & Gallagher, R. (2012). Behavioral and psychological symptoms in moderate to severe Alzheimer’s disease: A palliative care approach emphasizing recognition of personhood and preservation of dignity. Journal of Alzheimer’s Disease, 29(1), 1-13. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22207006
Rubistein, N. (2011). Alzheimer’s disease and other dementias: The caregiver’s complete survival guide. Minneapolis, Minnesota: Itsaca Books. https://www.jointcommission.org/assets/1/6/Crosswalk_CLAS_AHC_20141110.pdf