Alzheimers Disease

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Degenerative Disease

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Memory Loss

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Impaired Executive Function

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Alzheimer's Disease

 Alzheimer's is an incurable progressive disease which degrades memory, thinking, behavior and other higher functions, usually in people over age 60. As a degenerative or quality-declining disease, Alzheimer's both impedes connections between and destroys neurons. Once known as senile dementia, mistakenly associated only with elderly people, the disease's onset can begin decades earlier but not manifest actual symptoms until much later. Alzheimer's disease acts mainly by triggering protein fragments of beta amyloid to form a "plaque" around neurons. In healthy brain cells, this accumulation is soluble, and purged from the system.

alzheimersAlso present and equally destructive are neurofibrillary "tangles," insoluble threads within the neurons. Made of the tau protein, a vital element in structures known as microtubules which deliver enzymes and nutrients to cell parts, tangles are twisted, collapsed versions of these structures. The microtubules disintegrate, choke off vital feeds, and eventually kill the neuron.

The disease spares no portion of the brain, but particularly affects the hippocampus, its "library" where long-term memory—the literal totality of all we've learned and experienced—is stored. Beyond corroding memory, the resulting damage causes personality changes, loss and misplacement of objects, sudden disorientation in familiar places, and other ills. The effects of Alzheimer's disease can be compared to a city whose transportation routes and communications infrastructure are undergoing slow, but constant, deterioration. Crucial goods aren't regularly delivered, and authorities have no stable means of correspondence.

Accumulating over time, the brain cell damage becomes noticeable to Alzheimer's sufferers as an increasing difficulty in performing daily routines. Once nearly automatic, actions such as climbing from bed, showering, and dressing require a deliberate, focused effort. Especially distressing are moments of "missing time," known in psychiatry as lacunae, or gaps. These can occur during any task, or even while a person is quietly thinking. This chronic unreliability of short-term memory often forces the individual throughout the day to employ visual aids such as sticky notes, color-coded wristbands, and even self-sent voice-mails. Sadly, most of these soon become further mysteries.

Despite these troubles, there are many ways to ease and make safer the life of an Alzheimer's patient. Even though the condition is as yet incurable, the impaired executive function can at least be lessened by a class of drugs called cholinesterase inhibitors, among them donepezil, galantamine, and rivastigmine. These help preserve the neurotransmitter acetylcholine. In the motor neuron, acetylcholine activates synaptic transmission in muscle cells and, much like a key, opens sodium-ion conduits that spark movement.

Placing important items like wallets and purses, keys, and cell phones in one location at home is a good start. Regarding cell phones, it's best to obtain for the person a model with location ability (GPS), so if they become lost or confused others can track their location. Make sure that important numbers are pre-programmed for quick access. And although it may seem obvious, exercise and healthy eating are vital, but often overshadowed by other priorities in the treatment plan.

References:

  1. http://1.bp.blogspot.com/-UYsghggxAr4/VH86oDzjatI/AAAAAAAAIM8/V9f7UrBieag/s1600/Tau%2Bprotein%2Btangles.jpg
  2. http://www.healthline.com/human-body-maps/hippocampus
  3. http://alzonline.phhp.ufl.edu/en/reading/mmi_cholinesterase.php
  4. https://www.psychologytoday.com/blog/resolution-not-conflict/201305/got-anger-disorder-not-according-the-dsm
  5. http://www.mayoclinic.org/diseases-conditions/alzheimers-disease/diagnosis-treatment/treatment/txc-20167132

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