Alzheimer’s Disease and Other Dementias: Symptoms, Stages, and Communication Strategies Expanded ____
• The microglia and astrocytes release chemicals that cause inflammation, resulting in increased brain damage.
bodily trauma.
CAUSE AND EFFECT: MILD COGNITIVE IMPAIRMENT (MCI)
Self-Assessment Quiz Question
People with a lifetime of mild cognitive impairment (MCI) or Down’s syndrome are more vulnerable to AD and other demen- tias (National Institute on Aging, n.d.). MCI may include memory loss, confusion, poor focus, and impaired critical thinking, spatial and visual perception, and decision-making capabilities. These can result in progressive dementia-like symptoms. It is important for people with MCI to maintain a healthy lifestyle MCI presents in the earlier stages of AD; however, not all MCI is AD. Upon presentation of symptoms, a person should visit their physician to ensure proper diagnosis, pharmacological support, identification of lifestyle modifications, and develop- ment of a plan of action and care. CAUSE AND EFFECT: CARDIOVASCULAR HEALTH The vascular system significantly impacts cardiac and brain function, metabolism, and cell migration (Govindpani et al., 2019). Vascular changes are noted in the preclinical stage of AD, as amyloid plaques may contribute to constrictions that impact blood supply. The changes in arterial functioning will impact the transfer and communication of neurons as well as metabolic function, resulting in worsening of the disease over time. Destructive stages of AD progression may be due to vascular issues and brain inflammation. Behaviors that promote heart health are correlated to brain health. Smoking; high stress; poor diet; and unmanageable chronic conditions such as diabetes, high blood pressure, and heart disease can lead to AD and other dementias. Limited blood and oxygen supply to the brain can impair overall func- tion and memory. A heart healthy lifestyle is also good for brain health. Modify- ing diet, increasing movement, and engaging in preventative health care can improve vascular health outcomes. CAUSE AND EFFECT: SLEEP Exhaustion and sleepiness during the day can contribute to dementia (Carroll & Macauley, 2019). Obstructive sleep apnea (OSA) in the elderly may lead to dementia, cognitive impair- ment, and AD symptoms. Sleep deprivation increases tau levels and over time can cause increased plaques and tangles. Sleep disorders can be a part of AD pathology, but the exact role is unknown at this time. Sleep has two stages: Rapid eye movement (REM) and nonr- apid eye movement (NREM), and their respective restorative powers impact neuronal functioning and recovery. When these stages are interrupted, amyloid and tau levels increase, potentially impacting cognition. Additionally, restricted sleep directly correlates to a reduction in glucose tolerance as well as insulin sensitivity. These risks are present in the early stages of AD. It is thought that this can be the outcome of impaired
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
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. 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. Microbiome/Gut Health The “Western diet,” which includes high levels of saturated fats and added sugars, is a risk factor for AD (Askarova et al., 2020). Early studies show a correlation between a notable increase in AD and a high-fat diet that changes the gut microbiota and causes inflammation and metabolic changes. CAUSE AND EFFECT: PHYSICAL EXERCISE/ MOVEMENT Physical activity improves memory and can potentially reduce the risk of AD (Lourenco et al., 2019). This is potentially due to irisin, a hormone that circulates when exercising. It is thought to promote the growth of neurons in the hippocampus. CAUSE AND EFFECT: TRAUMATIC BRAIN INJURY/ HEAD TRAUMA Head trauma is a leading environmental factor that causes AD and other dementias (Shively et al., 2012). Head trauma can cause chronic inflammation, resulting in permanent damage to the brain. When the skull receives a harsh jolt, it disrupts brain function, disabling protective abilities and perpetuating more trauma. Ongoing damage can result in brain dysfunction that can disrupt thought patterns, clarity, problem solving, and executive functioning. Balance and core strength can prevent brain and head injuries. Strength-building exercises help with balance, as do vision and hearing tests, which confirm if there is a need for assis- tive devices, respectively. Falls are a leading concern of older adults. They can lead to broken bones, concussions, and other
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