Other Dementias (Alzheimer’s Association, 2022) Corticobasal syndrome (CBS) Creuzteldt–Jakob disease (CJD) HIV-associated neurocognitive disorder (HAND) Huntington’s disease
Self-Assessment Quiz Question #1 What is dementia? a. Memory loss that is intermittent. b. A combination of behaviors and impairment that are a result of a brain disorder. c. Immediate diminished capacity. d. A loss of sensation.
Normal pressure hydrocephalus (NPH) Progressive supranuclear palsy (PSP)
ALZHEIMER’S DISEASE
Alzheimer’s disease (AD) is a chronic, incurable brain disorder that is a leading cause of death for people over age 65, primarily women. Accounting for 60%–80% of confirmed cases, AD is the most common type of dementia (Zhou et al., 2021). The World Health Organization (WHO) states that globally, there are approximately 50 million people with dementia currently, and that number is increasing (WHO, 2022). AD symptoms can include personality and behavioral changes, which ultimately lead to total decline as the brain loses the ability to communicate with the body. The actual causes of AD vary, and it can be impacted by lifestyle factors such as age, physical fitness, nutrition and diet, genetics, cardiovascular health, alcohol intake, amount of social connection, and sleep. Alzheimer’s disease symptoms present
due to the formation of amyloid plaques and neurofibrillary tau tangles (NFT) on the brain that impede normal cognitive functioning. The plaques and tangles begin developing 15–20 years prior to the manifestation of clinical symptoms; thus, early detection and a healthy lifestyle are important. Self-Assessment Quiz Question #2 Alzheimer’s disease is the result of the formation of: a. Amyloid plaques and tau tangles. b. Plaque and enamel. c. Tangle and tear. d. None of the above.
IMPACT OF ALZHEIMER’S DISEASE ON THE BRAIN
A typical healthy brain has billions of neurons that transfer signals and information from the brain through the body for overall functioning (Flo et al., 2022). Alzheimer’s disease disrupts the brain as neurons lose the ability to communicate. The disruption occurs in stages that present over time. At this time there is no cure for AD, but a healthy lifestyle may help address symptoms.
Evidence-Based Practice! In March 2022, federal funding for the National Institutes for Health’s (NIH) research on Alzheimer’s disease was increased to $3.5 billion. The NIH leads the global effort to address AD and serves as a resource for those seeking information about this disease. Understanding root causes of AD, as well as actual aging, will help scientists address symptoms as they develop, which may prevent them from worsening (Alzheimer’s Association, 2022).
STAGES OF ALZHEIMER’S DISEASE
The Reisberg Alzheimer’s Scale (see Table 2) is used by clinicians and in residential care settings to provide insight into what stage of AD a patient is in. It also provides expectations for caregivers. Understanding the stage of the person with AD can help identify methods of communication for improved quality of life.
The scale divides the disease into seven stages, with two categories. Category 1, predementia, includes Stages 1–3. Category 2, the dementia stages, includes Stages 4–7.
Table 2. Stages of AD Stage Description
Clinical Presentation
Stage 1 No evident dementia
• No identifiable dementia; person is mentally healthy
Stage 2 Subjective memory loss and age-related forgetfulness
• Can last 15 years in healthy people • May have difficulty remembering where they have placed things • May not be able to recall names as they have in the past • Subjective cognitive decline • Memory issues may be noticed by loved ones or coworkers • May repeat statements
Stage 3 Mild cognitive impairment (MCI)
• Job performance may be impaired • Concentration may be impacted • High levels of anxiety
• Patient should visit a physician to understand root cause of MCI • Lifestyle changes can be made to reduce stress, improve diet, and increase physical exercise
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