This happens throughout the expansive brain neuron network, comprising the communications system of almost 7,000 potential synaptic connections between neurons. Neurons evolve over time to support the needs of a functioning brain. Their process includes perpetual maintenance and repair as they adjust the synaptic connections needed for message conduction and stimulation received from other neurons. This process happens throughout life for the brain to effectively function, since neurons can break down connections and build new connections throughout the life span. Neurogenesis, the process of generating and developing new neurons, continues through adulthood, allowing the brain to remodel synaptic connections and perform functions such as learning, memory, and brain repair. Other cells, glial cells, are also necessary for healthy brain function. Glial cells work with blood vessels to protect and clear debris from the brain and to regulate brain balance. These cell types exceed the number of neurons in the brain almost 10 to 1. There are three types of glial cells.
The brain is dependent on the fine-tuning and efficiency of neurons, cells, and the bloodstream. As a person ages, the brain decreases in size; however, there is very limited loss of neurons. For the person with AD or other type of dementia, neurons stop working and interneuron communication is disrupted, causing the neurons to be dysfunctional and ultimately die. Over time this lack of brain function impairs parts of the brain, including the cerebral cortex, which is responsible for behavior, emotional regulation, memory, critical thinking, and reasoning. As the brain becomes more impaired, the stages of AD become more evident. Evidence-Based Practice! In March 2022, federal funding for the National Institute of Health’s research on Alzheimer’s disease was increased to approximately $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. There is a time crunch to get this work done as society ages, people work longer, and longevity increases. The increased funding is the federal government’s recognition that AD is a public health challenge.
• Microglia • Astrocytes • Oligodendrocytes
ALZHEIMER’S DISEASE AND OTHER DEMENTIAS: CAUSE AND EFFECT
Cause and effect: Age Scientists are researching age-related brain changes such as chronic inflammation, atrophy, production of free radicals, vascular damage, and changes to cell activity to further comprehend their potential to impact symptoms of AD (Askarova et al., 2020). These changes are a byproduct of aging that can be positively influenced by lifestyle, nutrition, exercise, and social connections. Cause and effect: Gender Women develop AD at greater rates than men (Viña & Lloret, 2010); however, more research must be done to understand the pathogenic mechanism responsible for this reality. At this time research shows that estrogen may be helpful in protecting cells that have some amyloid plaque. Cause and effect: Chronic inflammation A potential cause of chronic inflammation in the brain may be failing glial cells that are unable to clear brain debris, which causes an increase in plaques and tangle. One type of glial cell, the microglia, is directly responsible for brain cleanup, including clearing amyloid plaques. In AD patients the microglia appear to not perform this function. There is a genetic component being researched, gene TREM2 (Kulkarni et al., 2021), which is correlated to the clearing function of the microglia cells in the brain. In AD patients the following occurs, resulting in chronic inflammation that can lead to impaired brain function. • Microglia fail to clear debris in the brain, including amyloid plaque. • The gene TREM2 does not function normally and therefore does not tell the microglia to clean the brain, plaque buildup results.
Depression, memory loss, and lethargy are often attributed to aging. Aging does present normal physical and mental changes, but it is important to visit a physician to set benchmarks and note any changes that may be indicative of an age-related illness. There may be times when confusion or memory loss will present, but it may be situational. Experiencing loss or transition is a part of life that may present confusion or memory loss, as can a UTI or taking medication improperly. Women with the APOE gene are known to experience a higher incidence of brain atrophy, as well as mild cognitive impairment, compared to men. The National Institutes of Health is now requiring all federally funded brain research to include gender information in both preclinical and clinical studies to distinguish and explore potential differences. • Astrocytes, a type of glial cell, also fail to clear up brain debris. • The microglia and astrocytes release chemicals that cause inflammation, resulting in increased brain damage. Self-Assessment Quiz Question #8 When a patient has AD, the microglia do not perform which function in the brain? a. Creating amyloid plaque and debris. b. Clogging coronary arteries. c. Increasing causation. d. Clearing away debris, including amyloid plaque.
Cause and effect: Self-care factors Social Connection/Stimulation
Poor Nutrition A poor diet does not support brain and overall health. High cholesterol and blood pressure can be present, as can diabetes. These conditions can lead to heart attack and stroke, which can impair physical and cognitive abilities as well as memory. They can also worsen chronic conditions and increase morbidity.
An active life leads to better physical and mental wellbeing. Absent of social connection people can become sedentary, higher risk of dementia, heart disease, and stroke. Group activities can be stimulating, engaging, and improve health.
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Book Code: SWUS1525
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