It's the Overall that Matters

From all of the research, the sources, the blogs, the numbers, and the final understanding of what it is that society is to face in the coming future, it is clear that we are not prepared! As much as medical professionals continue to research and hunt for the cause and the cure it is evident that Alzheimer's is one of the most complicated diseases and causes of death known to mankind. It strikes who it wants, when it wants. As the world population grows older the amount of reported cases of Alzheimer's is bound to increase, no doubt about it. All we can do is prepare ourselves for the financial burden the economy will begin to face. We must develop a system in order for these patients to get the support and care that each will need without costing millions or billions of dollars for the economic system let alone the families. The utilization of data and abundunt services and resources available will be the key to preparing mentally and financially for medical costs surrounding the possible occurence to each of us or possibly our loved ones.

It's the Economics

The economic impact of Alzheimer's disease is not a new discussion in the world of medicine or the world in general. "AD is the third most costly disease in the US after cancer and coronary heart disease. Average annual costs of caring for patients with AD have been estimated at $80-100 billion dollars in the US." (Zhu, 2013) The cost of caring for diagnosed AD patients have been studied extensively over the years reaching back to a study conducted by Ernst and Hay in 1994. The Total cost of care combines direct, indirect, and intangible costs for a patient. Direct costs refer to the medical costs including physician visits, hospitalizations, medications, and nursing home care. The indirect costs refer to the "the imputed values of resources lost due to illness, including premature deaths, patient and caregiver lost productivity, and unpaid caregiving time." (Zhu, 2013) The intangible costs take into account the pain and suffering by patients and family members and the deterioration in the quality of life for the patient and caregiver. The intangible costs are rarely taken into account my any scientifical studies or research due to the controversy surrounding the real worth. 

The following link provides almost all possible information and explanation in regards to the economic impact of alzheimer's including links to studies already conducted from which it takes much of its numerical information. 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695165/

Support Services

The most unfortunate part of Alzheimer's disease is it can sneak up on any person at anytime! The disease can start to take over the brain many years before symptoms become evident. It often strikes extremely healthy and active individuals to rob them of their ability to complete even the simplest of tasks.
It takes an extreme amount of time, money, patience, and willingness to care for an alzheimer's patient.
By learning how to make changes in the caring atmosphere it can overall improve the quality of life for both the patient and as a caregiver. The following article provides the "How to Manage": Tips for managing Alzheimer's symptoms and common problems. From wandering to eating it explains many common problems that may arrise that one should be aware of as well as providing what-to-do's in each case.
http://www.helpguide.org/elder/alzheimers_behavior_problems.htm

The Alzheimer's Association is the best source of information for any person; patient, caregiver, family member, any person aware and looking for answers and information about Alzheimer's disease. It provides important information in regards to caregiver support services including Educational seminars aimed for both in-home caregivers as well as workplace seminars. It provides other resource information such as a "Resource Guide for Planning the Care of Aging Loved Ones" and information for caregiver support groups in your area.
Alzheimer's Association also provides what is known as "Respite Care" which allows families in the position of caring for a loved one the chance to relieve them of their responsibilities during major times of need. Whether it be In-home care, which when approved can provide care for up to 20 hours a year free of charge. As well as day programs and overnight programs for which they cover a portion of the charges or will allow patient stay at one of the extensively trained Alzheimer's facilities.

Hindrance on the Economy

What is attached to any and every medical phenomenon or problem? MONEY! It takes money to research, it takes money to treat, and it takes money to care for those suffering. Currently it is "costing the U.S. about $200 billion a year to care for people afflicted with Alzheimer’s." (Wurtzel, 2013) If the number of patients is supposed to increase more and more over the years then it is almost guarenteed that this $200 billion dollars will sky-rocket in coming decades. This number does not by any means take into the account the 17 billion dollars of unpaid care provided by family and friends! In the year 2011 Obama signed the National Alzheimer's Project Act (NAPA) into law. This will establish a crucial plan to address the crisis and increase in Alzheimer's occurences. It will coordinate a response and economical plan on the fronts for research, care, and support services. 
This does not take into account the personal sacrafices of money and time it takes to care for anyone with alzheimer's in any stage. 

No cure No recovery

All of my own research and findings have led me to believe that Alzheimer's may be one of the most complex diseases that could affect the older aged population. It is complex in its entirety; from what causes it, how it works, and any possible ideas on how it could be stopped from affecting so many people. Of the top six causes of death in the US, alzheimer's is the only with no cure or even a chance for recovery. Other examples including AIDS, breast cancer, stroke, and heart disease have seen decreasing numbers over the past many years. "Alzheimer’s-related deaths just keep on rising, making it the greatest threat to the health of our citizens and the future of our economy." (Wurtzel, 2013) 
Numbers are rising and deaths caused by the final stages and decay of the brain continue. 

It's Rising

The following article found as a blog called "Dating Dementia" goes over what is expected of the disease in the coming years! My initial reaction being what the hell!

               "It’s worse than we thought.  Without a cure or an effective way of slowing the          

               progression of Alzheimer’s disease, our nation will face staggering consequences, 

               according to a widely-circulated study published recently by the Rush Institute for 

               Healthy Aging.

               The study followed 10,802 seniors, aged 65 or older, from 1993 to 2011.  Every three
               years the participants were assessed for signs of dementia, and over 400 of the seniors
               developed Alzheimer’s disease during the study.  As a result of the landmark study, and
               taking into account the aging baby boomer population that will probably outlive
               previous generations, there are some new and disturbing Alzheimer’s statistics.

               The most important figure from the study is the estimation that the number of people 
               living with dementia in the U.S. could reach 13.8 million by the year 2050.  That figure 
               is triple the number of affected in 2010, which was 4.7 million."

If the disease is expected to become this bad then what the hell are we doing! Why is it that researchers and scientists have yet to find out what causes the disease? Why is it that there has been nothing formulated to stop the development of the disease? 

Full article:

http://www.datingdementia.com/2013/03/18/what-the-alzheimers-numbers-really-mean/?goback=%2Egde_2230667_member_224011871

Alcohol and Alzheimer's

Is it true that alcohol may be a “protective agent” against the development of Alzheimer’s? There are no absolute links between the use of one and the effect on the other. Many studies have been done in search for a link in 3 of which it was found that drinking led to an increase of AD (Alzheimer’s Disease). Another 7 of them suggested that drinking alcohol led to a decrease in the risk of AD. But there are 9 studies according to an article on aging and mental health that reported alcohol had no impact. Without clear consistency and proof of efficacy there is no way to measure or represent the effect without severe limitations.
With Alzheimer’s being a disease caused by the dysfunction of the brain by the development and addition of abnormal clumps, plaques, and proteins, it is hard to imagine that alcohol will help. Alcohol itself is a depressant that can block some of the messages trying to get to the brain.

Purpose of Knowing

With the options available to anticipate and diagnose Alzheimer’s some may be curious as to the many purposes of knowing the disease is creeping up. The main benefit is to have time, time enough to plan for the future and time enough to get the most out of the treatments available! The more time you have allows an individual to anticipate and be a part of extremely important life decisions; such as living and care options, transportation, and financial and legal obligations. Being a part of these decisions makes the process much better for yourself as well as your loved ones who will now soon be responsible for the care and well-being. Living with Alzheimer’s is by no means easy which is why there are so many care and support services available.

First appointment

When it comes to the first appointment with a doctor that fits your needs and personal welfare there are many questions that should be kept in mind. According to an article I have found through the New York Times database there are 9 basic yet crucial questions to be discussed.

• How can we be sure my symptoms aren’t the result of a stroke, mental illness or another treatable condition?
• What stage of Alzheimer’s disease am I in? What comes next?
• What can I do to preserve my health and mental abilities for as long as possible?
• What physical symptoms should I anticipate?
• Should I undergo brain neuroimaging?
• My children are worried about inheriting this illness. Would it be useful for our family to undergo genetic testing?
• What drugs are currently available for Alzheimer’s disease, and how well do they work?
• My family is afraid to let me drive. Would you refer me for a driving evaluation so we can have an objective opinion of my ability?
• What can I do to make things easier on my family?

            Follow this link to get a small description on why each of these questions are         so important to cover with your doctor. 

http://www.nytimes.com/ref/health/healthguide/esn-alzheimers-ask.html

From there he or she may refer you to as many as four different specialists. The first may be a Neurologist which specializes in diseases of the brain and nervous system. The second a psychiatrist which specializes in disorders that affect the way the mind works and a person’s mood. The third is a psychologist who has special training in testing memory and other mental functions and capabilities. The fourth would be a geriatrician who specializes in care for older adults and Alzheimer’s disease.

Get Checked Early

Nowadays there are many available ways to test an individual for Alzheimer's disease. Not all of which guarantee the existence in your body. According to Mayo Clinic on Alzheimer's disease "Alzheimer's disease can be diagnosed with complete accuracy only after death, when microscopic examination of the brain reveals the characteristic plaques and tangles." As with any other disease or medical examinations the first thin to be checked is a person's physical and neurological symptoms; including but not limited to reflexes, muscle tone/strength, and sense of sight and hearing. From this point on when trying to rule out other possible causes of dementia or memory loss, lab tests may be performed. Mental status testing which may lead to neuropsychological testing in order for a doctor to get a clear idea of the capabilities still within the brain. Brain imaging may be the final per-diagnoses plan for a physician which can be performed using different available technologies. And again along with research on the cause of the disease comes the continued research in look for cure and a definitive way to diagnose. 

The Difference

Alzheimer's is one of those topics that a person will tend to avoid. It's either you know nothing about it, or you know someone suffering from the unfortunate disease. What needs to happen is that the public needs to become more informed; to understand and to recognize when symptoms are coming on. What people need to know is there is a difference between the beginning stages of alzheimer's and normal memory loss or dementia. If the disease isn't diagnosed correctly it could be to late for any doctor intervention to help or delay the progression.

Treatments

To end the last post about breaking the myths of Alzheimer's I finished with the curiosity of whether or not there are treatments available to stop the advancement of the disease. According to the Alzheimer's Association "At this time, there is no treatment to cure, delay or stop the progression of Alzheimer's disease. FDA-approved drugs temporarily slow worsening of symptoms for about 6 to 12 months, on average, for about half of the individuals who take them." 
Researchers continue to look for treatments that can improve the life of those with dementia as well as treatments that will alter the course of the disease. It is very unlikely that one intervention will be found to delay or prevent or even cure the disease. Therefore current treatment and research focus on helping people maintain mental function or managing behavior issues. 

http://www.alz.org/alzheimers_disease_myths_about_alzheimers.asp 

Breaking the myths

What ultimatly got me interested in researching and finding out more information about Alzheimer's disease is my own family experience. With a grandmother now reaching the very late stages of the disease at age 97 I have been curious as to what was expected and normal for people suffering from it. When I first asked someone if they knew what caused the disease I got a very interesting answer; aluminum. Supposedly this person had read somewhere that drinking out of aluminum or cooking with aluminum could be a factor in the unfortunate development of alzheimer's. This specific myth began in the 1960's and 1970's when a single suspicion led to the increased concern about everyday exposure to aluminum.
Other myths have also developed as alzheimer's becomes more prominent. Such as many people believe that memory loss is a normal part of aging. With a new understanding of how the disease affects the brain it is easier to comprehend what kind of changes occur with the disease. Alzheimer's causes brain cells to misfunction and die causing permanent memory loss and damage. Normal memory loss involves short term memory such as forgetting the name of someone just met versus forgetting the name of your children or long term friends or family members.
Other myths:
Alzheimer's is not fatal.
Alzheimer's only occurs in older people. This is not true as proven with early-onset Alzheimer's it can happen as young as 30.
Flu shots increase risk of disease.
Silver Dental fillings increase the risk.
There are treatments available to stop the progression of Alzheimer's.

Risk Factors

Most of my research up to this point has been from websites dedicated to the research and informational websites for Alzheimer’s. Along with using the Auraria library database and research options. For this particular question I used the alzheimer's disease website as well as finding a peer reviewed newspaper article on preventing and reducing the risk of alzheimer's.
Today's question was aimed at finding who is at risk and what other factors can there be.
There are three major risk factors that will never change; family history, heredity, and age. Another risk factor for Alzheimer’s disease is head trauma; especially when or if a person loses consciousness or the trauma occurs repeatedly. From this could it mean that those that constantly participate in full contact sports may be putting themselves at more risk in their older ages for the disease?
Another risk factor links a person’s heart health with brain health, meaning that many heart conditions such as
high blood pressure, heart disease, stroke, diabetes and high cholesterol can increase the risk of developing Alzheimer’s. Latinos and African-Americans are at greater risk for developing Alzheimer’s due to the historical fact of higher rates of such vascular diseases.

http://www.alz.org/alzheimers_disease_causes_risk_factors.asp

Age relation

Today I am looking to find out how young a person can be to be affected by this terrible disease. The initial research and information states that Alzheimer’s is a disease purely for those in the later stages of the aging process. But if it is a disease that starts in the then why couldn’t it develop in younger years? According to the Alzheimer’s association “Alzheimer's is not just a disease of old age. Younger-onset (also known as early-onset) Alzheimer's affects people younger than age 65.  Nearly 4 percent of the more than 5 million Americans with Alzheimer’s have younger-onset.” Alzheimer’s can happen as young as age 30 to anyone. Scientists have found several very rare genes that can directly cause Alzheimer’s in the younger ages. This separate strand of Alzheimer’s is known as “familiar Alzheimer’s disease” which does effect multiple generations in a family.

http://www.alz.org/alzheimers_disease_early_onset.asp

Medications do they differ?

What kinds of medicines are available to help patients? Are they for the disease itself or the effects of the disease?

There are several drugs currently on the market to help alleviate symptoms of the disease. Some of which include cholinesterase inhibitors which are prescribed to those patients suffering from mild to moderate alzheimer’s; rivastigmine or galantamine for the early stages which on the market may be known as Razadyne or Exelon. For the mid to late stages FDA has approved Namenda (memantine) and Donezepil. The main effect of the drugs in prescribed in the later stages of Alzheimer’s is to delay the progression of symptoms. Non of these will prevent or stop the effects of alzheimer’s but such medications are in testing.

There are hundreds of other medications that can be prescribed to control other symptoms such as sleeplessness, agitation, anxiety, depression, wandering, etc.
http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-medications-fact-sheet

Another aspect I would like to research further is are these drugs being prescribed for any other medical problems? Or were they strictly developed for the disease.

Stages for the Body

I wanted to understand what each of the stages on a person's body seem to entail. I will dig deeper into these as my own research continues but on the most basic level...simply put the stages include:

            Early Signs

                     Mild forgetfulness interferes with daily activities
                     Trouble remembering events or activities
                     Trouble remembering names of familiar people and things
                     Loss of ability to solve simple math problems
         Mild to Moderate Stages
                     Loss of ability to do simple tasks like brushing teeth and combing hair
                     Failure to recognize familiar people and places
                     Trouble speaking, understanding, reading and/or writing
                     May become anxious, aggressive, wander away from home
                     Become increasingly unaware of their limitations
         Late Stages
                     Greater confusion and disorientation
                     Complete dependency on others
                     Physical health deteriorates due to inactivity
                     Death is usually due to pneumonia or other infections

http://www.alzdiscovery.org/index.php/alzheimers-disease/learn-more/signs-symptoms-and-prognosis/

How much research?

I was curious as to how much research has been done on Alzheimer's disease itself, and how much in search for a cure.

Today’s research more often target the causes of Alzheimer’s in order to develop disease modifying drugs that will ultimately prevent the disease itself.
NIA- National Institute on Aging (Alzheimer's Disease Education and Referral Center)
The NIA, one of the 27 Institutes and Centers of NIH, leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. The NIA supports and conducts genetic, biological, clinical, behavioral, social, and economic research related to the aging process, diseases and conditions associated with aging, and other special problems and needs of older Americans. The NIA is the primary Federal agency for research on Alzheimer’s disease.

Scientists are making huge advances in identifying potential interventions to diagnose, slow, prevent, treat, and someday cure Alzheimer’s disease. As of today there are more than 90 drugs in clinical trials, and many more waiting for FDA approval to enter into the stage of human testing.

Where in the Brain?

It is unsure how the disease begins, but it is likely that damage to the brain can begin many years before any symptoms become noticeable. The first stage process within the brain is the plaques and tangles appear throughout bringing in abnormal protein deposits. From there the damage spreads to the most essential memory forming portion of the brain known as the hippocampus. Neurons in the brain begin to work less efficiently and/or die off causing the effected portions of the brain to shrink. 

Staged Effects on the brain

From the simple introduction of alzheimer's disease and where the name originated from I was curious as the effect the disease has on the brain. Alzheimer discovered and coined the terms "amyloid plaques" and "neurofibrillary tangles" but what are those? and What do each of them do to the brain as the disease progresses?

Amyloid plaques are abnormal clumps in the brain. These particular plaque deposits are found in spaces between the brain’s nerve cells. The plaques consist of large deposits of a toxic protein called beta-amyloid. Many people develop some plaques as they age, but it is unsure if these plaques are side effects of Alzheimer’s or a major cause of the disease.

“Neurofibrillary tangles are abnormal collections of twisted protein threads found inside nerve cells.” The effect of the major component of the tangles which is a protein called tau causes the microtubules in the brain to disintegrate in turn the “internal transport network will collapse. This collapse stops the ability of neurons to communicate.

Which leads to the third effect of AD, the loss of connections between neurons in the brain. The loss of neuron communication can eventually lead to death of many neurons as well as further shrinking of the affected areas. The shrinking of the brain is known as brain atrophy.

Introduction to Alzheimer's Disease

Did you know that one out of three individuals will be affected by alzheimer's disease by the age of 80?
Alzheimer's is the most common form of dementia seen in many as they age past 65. The first question I asked when beginning my own research on this specific topic was:
Where did the name for the disease originate? 
First discovered in 1906 by German psychiatrist and neuropathologist Alois Alzheimer. After performing an autopsy on a 55 year old female patient at the asylum he worked for. He found that beginning in 1901 the patient’s condition steadily deteriorated beginning with memory loss, speech difficulties, confusion, agitation, wandering, etc. During the autopsy he found her brain had shriveled and neurons has disappeared, at this point also discovering two of the main details of the disease; “neurofibrillary tangles” and “senile plaques”. The first public description of the disease was in 1906 in the presence of a group of psychiatrists.

http://www.alzdiscovery.org/index.php/alzheimers-disease/learn-more/the-discovery-of-alzheimers-disease/