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Alzheimer’s Initiative  1   21 October 2013

Research, Advocacy, Results

Alzheimer’s Initiative Chung Science Museum G110 Tompkins Hall Dear Ms. Chung,

I. Statement of Problem Alzheimer’s disease is becoming much more prevalent in society. People, with or without the disease, need to become aware and involved in the prevention and treatment of this growing problem. The specific issue to address is the effect of Alzheimer’s disease on patients and how it progresses. The increasing amount of research performed on the topic is especially important because of the baby boomers. Because the people in society considered Baby Boomers are currently reaching the age where Alzheimer’s is common, more attention is focused on the disease. II. Purpose of Study The goal of our study is to raise awareness for the increasing number of people affected by Alzheimer’s disease. We also want to specifically address how the disease is diagnosed and the effect this terminal disease has on the patients and families. Every individual case of Alzheimer’s disease is unique. These characteristics per case include how rapidly the disease progresses and the projected life expectancy of the patient. Studying the disease could lead to discoveries about prevention and treatment. We will be using personal interviews and articles written by people who have a loved one with Alzheimer’s Disease to examine the effect on the family and the patients’ behaviors after being diagnosed. 5432 Any  Street  West   Townsville,  State  54321  USA     (543)  555-­‐0150    (800)  555-­‐0150   (543)  555-­‐0151  fax   www.adatum.com  


Alzheimer’s Initiative  2   III. Research Questions / Hypothesis For the purpose of this study, the following questions were addressed: i.

Based on previous Alzheimer’s cases, how has research progressed regarding the disease?

ii.

How does Alzheimer’s disease affect the patient/family/loved ones?

As part of this study, investigation included one research hypothesis: iii.

Scientists are currently researching Alzheimer’s disease by examining deceased patients.

Each diagnosis per patient is different. As more patients are examined, a greater variety of research can be obtained, furthering progress in possible treatment plans for Alzheimer’s patients. This disease affects more families every year because of the increasing amount of Alzheimer’s cases. IV. Conclusion (Impacts, Benefits) Alzheimer’s disease is becoming a widely studied disease. A spot in the museum would increase awareness, inspire research, and promote change. The time is now for people to be knowledgeable about this problem. There is no known cure for this disease, but nothing is preventing further investigation. Informing the public about Alzheimer’s can raise money to sponsor research about this growing phenomenon. Enclosed please find the literature review, body copy, and reference list for the study, “The Alzheimer’s Initiative” Sincerely,

Elizabeth Folk Peyton Holmquist Maggie Irvin Jessica Kraus The Alzheimer’s  Initiative  


Alzheimer’s Initiative  3  

The Alzheimer’s Initiative Elizabeth Folk, Peyton Holmquist, Jess Kraus, Maggie Irvin North Carolina State University English 101 (Section 21) May Chung October 21, 2013


Alzheimer’s Initiative  4   Literature Review Prevalence in society Alzheimer’s disease has exponentially increased its prevalence in society over the past few years. The prevalence doubles every five years, and by the age of 90, 35-40% of people are affected by Alzheimer’s disease (Dalvi, 2012). The baby boomers era has aged into the stage where Alzheimer’s disease is acquired. Because so many people were once in this era, the number of cases has greatly increased, causing the disease to be considered a “major public health concern” (Ballard, et al., 2011). According to ABC News (2011) “almost 10 million baby boomers [are] expected to die with or from Alzheimer’s disease.” The number of fatalities has never been predicted this high in history. Symptoms/Risks Alzheimer’s is a deadly disease that does not have a cure, and no clear cause. Although there is no one distinct reason for a person to develop Alzheimer’s, there are many risks. Age is the number one risk for the disease with 1% of the population developing Alzheimer’s by the age of 65 and nearly 40% developing the disease by age 90 (Dalvi, 2012). Almost 70% of Alzheimer’s cases have a family history of the disease (Gauthier, Corbett, Ballard, Brayne, Aarsland, and Jones, 2011) and this family history increases the risk of developing Alzheimer’s (Dalvi, 2012). Alzheimer’s is more prevalent in females than males. Any previous accidents that included head trauma can also increase a person’s risk of developing Alzheimer’s. Another trend is Down Syndrome patients are more likely to develop Alzheimer’s than others (Dalvi, 2012). Through lots of research, only one genetic idea has been discovered about what could cause Alzheimer’s. Some genes are thought to be a greater risk than others, but the gene,


Alzheimer’s Initiative  5   apolipoprotein E-e4 (APOE-e4), is thought to “pose a risk to developing Alzheimer’s” (Ballard et al., 2011). Symptoms of Alzheimer’s include having a “hard time remembering, hard time learning new things, irritability, depression, and apathy” (Dalvi, 2012). Alzheimer’s is “relentlessly progressive” no matter what treatment (Castellani, Rolston, and Smith) so, as the disease progresses, patients have a harder and harder time remembering things. As the disease worsens, it leads to “disorientation, personality and judgement dysfunction, and speech abnormalities (Rudy et al.) The rate at which the disease progresses varies between patients, so these symptoms will be independent to each patient (Dalvi 2012). Diagnosis One of the astonishing aspects of Alzheimer’s disease is it is very difficult to diagnose. While many symptoms, such as loss of memory and increased depression, are easily detected, ʺAlzheimer's disease can only be definitively diagnosed post mortem,” (Ballard, et al., 2011). Even then, extremely detailed medical records are needed to confirm that the patient had Alzheimer’s disease (Ballard et al. 2011). This makes it very difficult to diagnose and, therefore, treat. However, there are tests that help distinguish Alzheimer’s from other forms of dementia. The neuropsychological testing is one such test that is used to determine the extent of the disease. This process of testing “helps distinguish depression from dementia,” (Dalvi, 2012).

Treatment There is no current cure for Alzheimer's disease, a frustration that everyone, both patients and their families, have with the disease. To most effectively deal with Alzheimer’s disease, families should be involved as soon as the diagnosis is made. Doctors treat Alzheimer’s patients based on certain symptoms of the disease with “drugs, antidepressants, immunotherapy,


Alzheimer’s Initiative  6   chemical inhibitors, natural products and vitamins” (Dalvi 2012). Dalvi (2012) also claims that each treatment “depends on each individual case because every person is so different.” For example, patients suffering from depression can be treated with antidepressants to try to make them feel better. While the antidepressants will not cure the actual disease, they can treat a part of it. Mild cases of Alzheimer’s are best treated by a nonpharmacologic approach by the use of cholinesterase inhibitors. They have a small role in reducing the behavioral problems of the patients (Ballard et al., 2011). Patients can use glutamate antagonists to, “enhance the function in the surviving neurons of the hippocampus” (Ballard et al., 2011). Conclusion Overall, Alzheimer’s disease is a medical phenomenon that needs to be brought to people’s attention. There is no cure yet, but there is hope for a change. With the increasing amount of cases every year, more research is being put into finding a cure for the disease. Some research being done now is determining if any specific genes carry Alzheimer’s or if specific gene mutations cause the disease. With an answer to these questions, scientists could potentially find a way to correct or prevent the rogue gene, creating a cure.


Alzheimer’s Initiative  7   Body Copy A deadly disease with no cure is spreading across the country at alarming rates. People are becoming more aware of a disease that even medical professionals still do not completely understand. A terrifying figure of 10,000 people a day are being diagnosed with Alzheimer’s Disease (Bartzokis 2011), a type of dementia that results in memory loss, impaired movement, and even personality changes (Dalvi, 2012). The worst part: there is no way to stop this disease and it constantly affects patients and families by it’s wrath. The number of disease cases continues to increase, but there is no telling when a cure will come around. So, what are the symptoms? How is it diagnosed? How does it affect the families of the patients? What are our next steps to solve this climaxing issue? There are endless questions to this disease, and we have only started to try and answer them. Prevalence in society Common knowledge circulating in society today might be the uproar about health care, the recent government shut-down, or global warming. The first thing that comes to mind when you think of something that is prevalent in society is most likely not Alzheimer’s disease. Alzheimer’s disease is on the back burner, not receiving the attention necessary for change. Unfortunately, the number of disease cases is quickly rising as the population continues to age. People are either not aware that anyone can be affected by the disease, or in denial that they could be a victim. People frequently think, “Oh that could never happen to me,” but in reality, it could. By the age of 65, 1% of the entire world’s population will suffer from Alzheimer’s. The prevalence of Alzheimer’s disease in society doubles every 5 years. This means by the age of 90, nearly 40% of the population will potentially become victims of the disease (Dalvi, 2012). The


Alzheimer’s Initiative  8   following graphs display the percentage increase in patients diagnosed at the age of 65 compared to the patients diagnosed at the age of 90.

The time span of the 1940s to 1960s was considered the Baby Boomers era. The people who were born during this period were unique, because they were a part of the mass number babies born at the same time. The people who are considered Baby Boomers are now reaching the age at which Alzheimer’s takes its course. Since there were so many babies, now there are many new Alzheimer’s patients. The numbers are continuously increasing as the baby boomers age, and there is no stopping this relentless disease. Symptoms/Risks The main cause for any one person to develop Alzheimer’s is simply age, a heartbreaking fact because there is nothing anybody can do to avoid the aging process. Statistical research (previously addressed) has shown that by the age of 65, 1% of the population will be diagnosed with Alzheimer’s, and by the age of 90, about 40% of the population will be diagnosed with the deadly disease (Dalvi, 2012). The baby boomer generation contributes to this percentage, with a projected 10 million baby boomers to die with or from Alzheimer’s (Bartzokis, 2011).


Alzheimer’s Initiative  9   Family history increases the risk of any one person to develop Alzheimer’s Disease. While it’s upsetting at the time to see a parent or grandparent suffering from Alzheimer’s, people should also be aware that the same thing could happen to them. Roughly 70% of all Alzheimer cases have a family history of the disease (Gauthier, Corbett, Ballard, Brayne, Aarsland, and Jones, 2011), an alarming fact for anyone because there’s nothing anyone can do to prevent the disease from affecting them. Alzheimer’s is also more prevalent in females than males (Dalvi 2012), but this is perhaps because there are more females than males in the world. While most other risks are thought to have already been “programmed” into us, the only risk factor that can be prevented is head trauma. Cases of severe head trauma earlier in life have led to Alzheimer’s Disease later in life. A risk factor that is currently being researched is the idea of a genetic factor being a cause of the disease. A mutation in the gene, APOE-e4, is thought to “pose the [greatest] risk in developing Alzheimer’s Disease” (Ballard et al, 2011). While some other genes are thought to also be a cause for Alzheimer’s, APOE-e4 is the main gene associated with the disease. Symptoms of Alzheimer’s are similar in every case, but the progressiveness is different in all cases. The first thing people with developing Alzheimer’s notice is memory problems. They will have a hard time recalling memories or learning new things. As the disease progresses, the memory problem becomes worse, and they will even have a hard time remembering who are the important people in their life. Other symptoms of Alzheimer’s are depression and irritability, mainly due to their memory loss. They become depressed because the disease starts taking over their life and they have to start relying on other people to take care of them. Irritability coincides with this depression because the patients feel helpless or confused, and in turn become irritated (Dalvi 2012).


Alzheimer’s Initiative  10   Diagnosis Many people claim that the key to treatment is diagnosis. But what happens when it is impossible to confirm a diagnosis until after the patient is dead? This is the problem with Alzheimer’s Disease. Doctors claim that ʺAlzheimer's disease can only be definitively diagnosed post mortem,” meaning an individual person with Alzheimer’s cannot officially know whether he possesses the disease until after death (Gauthier, Corbett, Brayne, Aarsland, Jones, 2011). Symptoms and side-effects of the disease can give way to an assumption that a patient is a victim, but nothing can be actually diagnosed. Tests, such as the neuropsychological test, can be used to help differentiate Alzheimer’s disease from other forms of dementia and depression. Alzheimer’s Disease has three subcategories that distinguish the extent of the disease. These subcategories are Mild AD, Moderate AD, and Severe AD. Mild AD is characterized by forgetfulness, irritability, and depression. Moderate AD includes the same symptoms as Mild Ad but the patient also experiences agitation, aggression, and needs assistance with getting around without getting lost. Severe AD occurs when the patient requires supervision to keep them safe. They also begin to have a hard time communicating and daily activities become extremely difficult (Dalvi, 2013). The truth is that Alzheimer’s Disease mimics many other memory loss diseases. For example, vascular dementia has the same symptoms as Alzheimer’s except the memory is affected less (Dalvi, 2013). It is very difficult for a doctor to tell to what extent a memory is affected without analyzing the brain after the patient has passed. This leads to the inability of doctors to guarantee an accurate diagnosis while the patient is alive. The use of MRI’s, or magnetic resonance imaging, is helpful for physicians to determine the loss of activity in certain areas of the brain. However, MRI’s cannot be used to definitively diagnose Alzheimer’s (Dalvi,


Alzheimer’s Initiative  11   2013). The important thing to remember about diagnosis is that Alzheimer’s is impossible to definitively diagnose. This leads to many difficulties with treatment and the process of finding a cure.

Treatment Treatment for Alzheimer’s is easily one of the most frustrating aspects of the disease. As of now, there is no cure for the disease as a whole. There are specific drugs and methods that help the symptoms and side effects of Alzheimer’s, but nothing can completely cure the disease. For example, depression is common among Alzheimer’s patients so their doctors will prescribe them antidepressants to help. Although this doesn’t cure the disease as a whole, it helps with part of it. A basic understanding of brain functions is helpful when learning about Alzheimer’s disease. At any given point in time, tiny chemicals, known as neurotransmitters, carry information from one cell to another, connecting at synapses. “Alzheimer's disrupts this necessary process, and eventually destroys synapses and kills neurons,” (Alzheimer’s Association 2013) a crucial necessity in any human being. These neurotransmitters are needed for normal brain function. Additionally, knowledge of brain functions that are altered by Alzheimer’s helps lead scientists to discover treatment methods. One drug that Alzheimer's patients can use is cholinesterase inhibitors. This drug slows down the degradation process caused by Alzheimer's. Memantine is another drug that regulates any excess glutamate, which slows down the memory loss aspect of Alzheimer’s disease (Alzheimer’s Association, 2013). The primary negative aspect regarding these drugs is their life span. For half of the individuals that take them, they last less than a year and then start to wear off because the patients’ bodies


Alzheimer’s Initiative  12   become immune to the drugs (Alzheimer’s Association, 2013). There are researchers who have created several hopeful drugs that are currently being tested. Another problem slowing down the testing for the disease is the availability of volunteers. As these drugs are being developed, more and more volunteers are needed, and not many are willing to help.This poses a challenge to the continued effort to cure the disease. Conclusion There are currently scientists researching and trying to find new ways to treat and deal with Alzheimer’s disease. The drugs that people use nowadays help stop some of the symptoms and slow down the process for the patients, but they do not help cure the disease. However, there is still hope for finding a solution to the disease. Awareness about the problem is the first step to finding an ultimate solution. The time is now for Alzheimer’s to be extinguished from society.

   


Alzheimer’s Initiative  13   Works Cited Ager, Susan (1996). Effects of alzheimer’s disease unpredictable. The Tampa Tribune. Retrieved September 30, 2013, from http://www.lexisnexis.com/lnacui2api/deliv ery/PrintDoc.d o?fromCartFullDoc=false&fileS Ballard, C., Gauthier, S., Corbett, A., Brayne , C., Aarsland, D., & Jones, E. (2011). Alzheimer’s disease. The Lancet , 377(9770), 1019-1031. Retrieved September 30, 2013. Bartzokis, G. (2011, July 18). Baby boomers and alzheimer's disease. ABC News , Retrieved from http://abcnews.go.com/Health/Alzheimers/baby-boomers-alzheimersdisease/story?id=14084404 Castellani, R., Rolston, R., & Smith, M. (n.d.). Alzheimer disease. Disease-a-Month. Retrieved September 30, 2013, from http://www.sciencedirect.com.prox.lib.ncsu.edu Dalvi, A. (2012). Alzheimer's disease. Disease-a-Month, 58(12), 666-677. Retrieved September 30, 2013. Hendrie, H. (2001, June). Exploration of environmental and genetic risk factors for alzheimer’s diesease: the value of cross-cultural studies. Current Directions in Psychological Science, 10(3), 98-101. Retrieved from http://www.jstor.org/stable/pdfplus/20182709.pdf?acce ptTC=true&acceptTC=true&jpdConfirm=true. Stanton, S. (2001, April). Alzheimer's disease: A family affair and a growing social problem. ProQuest. Retrieved from http://www.csa.com/discoveryguides/alzsa/overview.php   What we know today about Alzheimer’s disease. Current Alzheimer's Treatments. Retrieved October 10, 2013, from, http://www.alz.org/research/science/alzheimers_disease_ treatments.asp  

Alzheimer's initiative  

Elizabeth Folk Peyton Holmquist Jess Kraus Maggie Irvin

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