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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
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There is block in the activity of the flow of
nutrients causing twisted nerve fibers in the neurons in the brain.
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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.
Inflammatory Response
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
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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.
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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.
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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.
Symptoms
The remaining life span of an Alzheimer's patient
is generally reduced, though a patient may live anywhere from three
to 20 years after diagnosis. The final phase of the disease may last
from a few months to several years, during which time the patient becomes
immobile and dysfunctional.
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
Alzheimer's patients commonly experience disturbances
in their sleep/waking up cycles.
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.
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