Carol

Alzheimer’s Disease Submitted in Partial Fulfillment Of the requirements in English IV

Ms. Gypsie Valencia

Caroline L. Panlilio IV – 25 January 26, 2007

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Introduction What do you think will happen if all of a sudden you’ll forget everything about yourself, family and friends? What if you don’t remember anything about your past, your experiences and your childhood? But worst, what if you forget your name; you forget who were your parents, your brothers and sisters and friends? Memory is a very significant to are lives. Forgetting everything about oneself is like a living from scratch, from nothing, we’ll be like child lost on this very huge world. This is why I become so interested to study and research a disease that will deteriorate this very what part of our life, “our memory” the disease. I’m referring to is the “Alzheimer’s” disease.

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Acknowledgement This is my chance to give my sincerest thanks to the people behind the scenes that make this research possible.

First of all to my parents for their moral and financial support. Also to my sister and my cousin Game for using their computer.

To all my friends and classmate for the help. Especially to my true friends, Lacel, Joana, Kath, Alet, and Jona, without whom this research could not be possible.

Of course to our generous English teacher, Ms. Gypsie Valencia. For her patience, kindness and consideration.

And most especially to God our Father who is the reason of this entire thing. Thanks for the guidance and knowledge. Thanks for giving me the chance to live in this wonderful land. Without him, so would I be, and this research will not be possible. A billion thanks!!

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Outline I. Introduction II. Acknowledgment III. Outline IV. Alzheimer’s disease V. Symptoms of Alzheimer’s disease a. Disorientation b. Forgetfulness c. Language Difficulties d. Confusion VI. Causes of Alzheimer’s disease a. Brain damage b. Estrogen c. Smoking d. Environment VII. Effects of Alzheimer’s disease a. Depression b. Effects on the family VIII. Diagnosis of Alzheimer’s disease

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a. Medical History b. Brain Scans c. Basic Mental test d. Neuropsychological testing or examination IX. Treatments of Alzheimer’s disease a. Exelon b. Cognex X. Medication of Alzheimer’s disease a. Namenda XI. How does Alzheimer’s disease affect one’s brain?

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IV. Alzheimer’s disease

The most common cause of the progressive loss of intellectual abilities is known as dementia. Alzheimer ’s disease is a devastating and incurable disease that chiefly afflicts old people. It was first described in 1906 by Alois Alzheimer; a German neurologist. Alzheimer’s disease is estimated to affect 5% to 10% of people older than 65 as well as significant number of younger individuals. Already a major public-health problem, it will become an even greater problem as the number and proportion of old people in the population increase.

V. Symptoms of Alzheimer’s disease

A. Disorientation

Disorientation in one or more of these spheres frequently occurs, both in toxic-organic diseases and in psychogenic disorders. Thus, a person may know where he is and what time of the day it is, but may insist he is Napoleon Bonaparte; or he may say he is Napoleon Bonaparte and insist he is in France and marshalling his troops for a dawn attach and insist you get up and march with him.

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B. Forgetfulness C. Language Difficulties

Since the earliest symptoms of Alzheimer’s disease develop gradually, the exact onset of the disease may be difficult to identify. Often, the earliest sign is forgetfulness, which may be accompanied by subtle changes in personality. As the disease progresses, other impairments develop, including difficulties with language, perception, and complex motor skills. The patient gradually declines over a period of 5 – 10 yrs and may reach a point of loosing control of body functions and becoming unresponsive to those around him. D. Confusion

Confusion is the disturbance of consciousness in which the powers of recognition and interpretation are impaired. The patient is perplexed, bewildered, and disoriented; he has difficulty in associating ideas. Confusion frequently occurs in toxic or infectious states, high bodily fevers, brain injuries, and often after an epileptic seizure; sometimes it accompanies hysteria. E. Personality Changes

It is well recognize that disorders affecting the brain can produce changes in personality. The specific alteration and personality brought about by brain disease depend on the number of factors. In wide-spread disease (dementia or delirium), impairment of intellect and memory or flo0rid psychosis, are the foremost characteristics. Depressive, manic, paranoid, or catatonic states may

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occur in previously well adjusted individuals; ability of emotional expression may be seen; altered states of awareness are common in acute toxic states; loss of social inhibition is a frequent occurrence in both acute and chronic disturbances. An ancient dictum states that the personality traits seen in organic brain disease are exaggerations of pre-existing traits. With brain disease, a quiet, cautious individual may become garrulous, grandiose, and free-spending, an apparent reversal of previous personal habits.

VI. Causes of Alzheimer’s disease A.Brain damage

The control of breathing, heart rate, and bodily temperature; vision, hearing, and speech; as well as movement and sensation of all parts of body is regulated by nerve cell in relatively small areas of brain. Injury in these areas gives rise to impaired sensation, to defects in the field of vision, or to a partial or complete paralysis, of the face, arm, and leg on the side on the body opposite to the injury. These defects are apparent in persons after a “stroke” or after certain, birth injuries resulting in “cerebral palsy”. However the highest level of brain function man’s mental and emotional capabilities that involves almost the whole of the cerebral hemi-spheres of his brain are often not impaired by the injuries associated with “stroke” or “cerebral palsy” since these highest function are not to localized to particular parts of the hemispheres. The highest integrative function includes not only orientation (knowing where you are in time and place),

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Memory and judgment, but also the ability to initiate and modulate strong emotional reaction, to deal effectively with new ideas and design. Brain damage therefore is not to be thought in solely in terms of loss of motion, speech, or sensation, but also as impairment of the highest integrative function.

B. Estrogen

Estrogen is a compound that promotes the development of the egg producing follicles in the ovaries and controls secondary sex characteristics in female animals. In humans these characteristics include body contour, skeletal development, distribution of body hair, and the pitch of the voice. During pregnancy, estrogens stimulate the development of the mammary glands. Estrogens also affect the metabolism of water, salt, and calcium. C. Smoking

Is the drawing of tobacco smoke from a cigarette, a cigar- and puffing it out. The term usually refers to the inhalation of cigarette smoke, the most common form of smoking. Medical studies show that smoking is a great health hazard. These studies show that the average life expecting of a smoker is three to four years less than that of a smoker.

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One of the least appreciated influences on disease is environment. Where a man lives and how he lives may have a greater effect on his health-often in unsuspected ways than microbes he encounters on the genes he inherits. A laborer in a rock quarry is likely to contract silicosis, respiratory ailment caused by the dust he inhales. People who live in the tropics are scourged by malaria, a disease seldom encountered in temperature zones. City dwellers almost never get hook worn, a parasitic disease are usually enters the body through the bare feet. Nevertheless, a civilized environment is not always the healthiest one. The Australian aborigines, living in relative isolation in a societies that begins to approximate the good health the worlds least civilized people enjoy as a birthright.

VII. Effects of Alzheimer’s disease A. Depression

Depression is a feeling-tone of sadness that may vary from a mild downheartedness to complete stupor. In the milder depression, the patient is usually quiet, restrained, pessimistic, discourages, has a feeling of inadequacy and hopelessness, and loses interest in his usual activities. Some depressed persons are irritable and distrustful. In deeper depression the patient is dejected, fearful, and deeply hopeless. His initiative is lost, decision-making becomes very painful, and he feels rejected and uninvolved. Attention, concentration, and memory may become impaired. Ideas of quit, unworthiness, and self-accusation are common. Suicidal thoughts are often entertained. Fear is frequently expressed.

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B. Effects on the family

Alzheimer’s disease causes tremendous psychological strain on the patient and his family. Legal and financial issues often become comp heated when an individual is no longer competent to manage his own affairs socially, the family may find it hard to maintain the same life-style when a patient is unable to act responsibly. The family faces many difficult decisions as the disease progresses. Often the most difficult decision is whether or when to place the patient in a nursing home during the later stages of illness.

VIII. Diagnosis of Alzheimer’s disease A. Medical History

There are many reasons to taking the history of the present illness before beginning questions about the past history which are untreated to the present chief complaints. The patient should have an opportunity to talk about what he considers important before these questions are asked. Furthermore, one may better direct (data) the inquiry into the past history, family history and functional data once one is acquainted with the present situation. (General) Careful evaluation and recording of fast events are important. A common error is to accept the patient’s use of a diagnosing a past illness. It is wise to make some inquiry into the symptoms and situations which caused a certain diagnosis to be made. Each past illness should be carefully evaluated from this point of view. For example, patients often cite a diagnosis (to be made. Each past illness should

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be) of poliomyelitis in childhood to explain some old trouble with an extremity. Such a statement may not fit with the present findings, and further inquiry about such an illness may be enlightening. B. Brain scans

The Brain scan usually becomes positive seven to ten days after thrombosis or embolus, and is usually positive earlier in hemorrhage. It is negative in lacunar strokes and may not always be positive in thrombotic and embolic strokes. Like a computerized axial tomography (CAT) scan-an x-ray of the head showing both bones and brain tissue

may be use to look for sign of

stroke or brain tumors. An electroencephalogram (EEG) is used to measure the electrical activity of the brain; which is abnormal in many kids of dementia. C. Basic Mental test

Blood test may be done to help doctors rule out of her potential causes of Alzheimer’s disease, such as thyroid disorders or vital deficiencies.

D. Neuropsychological testing and examination Working in the field called neuropsycology, a clinical and experimental psychologist try to discover the way damage to the nervous system affect behavior. They have use itelligence test like the Wechsler, and have developed many specialized procedures. The following are the Neurologic Examinations:

General examination: 1. It there evidence of liver, kidney, lung, heart or thyroid disease?

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2. Check for pathologic reflexes (e.g., Babinski, suck, snout, grasp). 3. Are this focal signs such as field defect or aphasia? 4. Test for smell. Make certain the patient can hear.

E. Mental Status evaluation 1. Check the state of consciousness. If the patient is not fully awake, one should suspect a metabolic disorder or space occupying lesion. 2. Check for orientation to place, person, and time. 3. Is the patient aphastic can be read a newspaper and write to dictation? If so, does he make errors? 4. Old Memory: Can he give correct information about events which occurred some years ago. 5. New Memory: Can the patient can call three or four unrelated objects after five minutes? Can he remember money place under his pillow, in his pajama pocket? What is hi knowledge of recent current events? 6. Calculation: give a simple problem e.g., six rolls cost 60 each: if you give the baker $ 1.00, how much change would you receive? 7. Abstractions: How are a ball and orange a like? What do a bath tub and the ocean have in common? 8. Judgment: What would he do if he spotted a fire in a theater; if he found a spotted? Addressed enveloped in the street? 9. Picture: How well can the patient interpret a picture in a magazine? Does he focus on the tiny part; is he unable to integrate it (visual agnosia)? Can the patient draw or copy designs?

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10. What is the patient’s mood and mental content? Is he sad or inappropriately cheerful? Is he fearful or paranoid? Is he active or apathetic, personality neat or sloppy?

IX. Treatments of Alzheimer’s disease A cure to Alzheimer’s disease has not yet to be identified. However, different types of treatments are available to address changes in memory, mood and behavior that can occur Alzheimer’s disease. Much can be done to maintain the quality of life and improve the care of those with Alzheimer’s throughout the course of the disease. Currently, these ear two types of drugs that may help in treating mild to moderate symptoms of memory loss: . Tacrine (cognex) . Rivastigmine (exelon) Researchers are testing drugs which slow the progression of the disease. They are also exploring new teaching methods for people who care for Alzheimer’s patients in how to address changes in a person’s behavior.

X. Medication for Alzheimer’s disease A.Namenda

Specific medication can be use to treat the depression and other psychological problems that may accompany the disease.

XI. How does Alzheimer’s disease affects one’s Brain? Alzheimer’s disease is defined by specific changes in the brain. The disease involves shrinkage of the brain together with loss of nerve cells in

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several areas of the brain through to be important for intellectual activity. Under the microscope, two abnormalities are usually found. Clusters of damaged nerve endings, called neurotics plagues, are widespread. Malformations called neurofibrillary tangles are present within diseased neurons and may interfere with normal functioning of these cells. In association with these changes in nerve cells are alterations in neutransmitters, the chemical messengers is particularly important, since many of the drug treatments for neurological and psychiatric diseases work by way of neurotransmitter systems.

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Bibliography Books 1. Asa, Benedicto L. Clinical examination in Neurology. By W.B Saunders Company, 1956, p. 4 2. Benson, Frank, M.D, Dietrich Blumer, M.D. Phychiatric Aspects of Neurologic Disease. Grune and Stratton, Inc. 1975, p. 151 3. Dubos, Rene, Maya Pines. Health and Disease. Tim Inc. 1965 Revised 1969, p. 16 4. Weiner, Howard L. M.D, Lawrence P. Levitt M.D. Neurology for the house officer. 2nd Edition. The Williams & Willkins Company. 1978, p. 21, 53-54 5. Samuels, Martin A. Manual of Neurologic Therapeutics. 1986, p. 30-31, 189 6. Sundberg, Norman D. Assessment of Persons. 1965, p. 135 Encyclopedia 1. “Alzheimer’s disease” The World Book Encyclopedia, 1989, I, p. 403 2.”Brain Damage” Colliers Encyclopedia, 1982, IV, p. 468 3.”Estrogen” Encyclopedia Americana, 1829, X, p. 606 4.”Smoking” The World Book, 1997, XVII, p. 501 Internet Yahoo.com.phhttp:// www. Michigan. gov/ itc/

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