Friday, June 20, 2014

Transmission,Treatment and Prevention--the WHO, WHERE, HOW AND WHAT



WHO is at risk and WHERE?
    Statistics show that as one ages, their likelihood of getting Alzheimer’s increases (Imtiaz, Tolppanen, Kivipelto & Soininen 2014). Women are said to be more at risk than men but this is likely due to the fact that women have a longer life expectancy (Alzheimer's Association). New numbers from the Alzheimer's Association show that blacks and hispanics are more likely to develop Alzheimer's than other ethnicities. Freidmen (2010) states that it is still unsure why this is happening but statistics show that blacks are twice as likely to develop the disease while hispanics are 1.5 times more likely to develop the disease. The Alzheimer's Association states that these numbers could be affected by the medical care of blacks and hispanics. Fridmen (2010) writes that these groups are less likely to know they have the disease and are also less likely to receive treatment due to lack of resources. 

HOW is Alzheimer's Spread?
Alzheimer's is not a communicable disease and it cannot be transferred from person to person. In terms of spreading, once the disease develops, it spreads in the brain. The progression of Alzheimer's disease once diagnosed, varies on the patient, it can be rapid and detrimental or the onset could continuously progress in a slower manner. Fridmen (2010) The Alzheimer's Association claims that one may have the disease for 20 years before diagnosis occurs and after that, mild years of the disease could last up to 10 years before severe stages of Alzheimer's occur (Vos et al 2013)

Alzheimer's disease can be thought of as spreading through genetics rather than directly from person to person contact. The disease is highly heritable and people with immediate family members who have or had the disease should prepare and take precautions for themselves (Wimo, Brayne, Gauthier, Handels & Jones 2014).

What about treatments?
As of now, there is not a cure for Alzheimer's disease but there are "treatments" for symptoms of Alzheimer's disease that can potentially delay progression of the disease. The best methods of "treatment" are measures that help one catch the disease before it becomes detrimental. In many cases, patients do not know they have the disease until their condition is moderate or severe and thus their condition continues to worsen (Imtiaz, Tolppanen, Kivipelto & Soininen 2014. By brain scanning, CSF checking and testing memory and cognition, one can attempt to catch Alzheimer's before it creeps up on a patient (Vos et al 2013). While one cannot get rid of the disease, one can try to reduce the severity of the side effects of Alzheimer's through measures such as cognitive exercises, and person to person recalling of memories.

MY Opinion
From my experience, Alzheimer's is a painful disease that is draining for family members and friends of the patient. I think it is crucial for people who are at higher risk to take precautions and take measures seriously. While I know that there is no medical treatment or cause of the disease, I truly believe that brain scans and cognitive exercises can help one identify the disease early. Studies have shown that early catches of the disease could ultimately help keep the patient "mentally there" for longer (Vos et al 2013).  The hardest part of Alzheimer's, for me, is losing the person you once knew even though they're still physically there. Therefore, I think it is extremely important to take precautions and do as much as we can to catch this disease as early as possible. As for future research and methods for treatment, I have the hopes that with the technology and education of our century, a cure can be developed. Ideally, this cure would be able to decrease severity of symptoms dramatically or erase the disease all together. I know that the brain is a fragile yet complex part of our body and finding a cure will be extremely difficult or maybe it really is impossible. One cannot lose hope that one day there will be a cure to this awful disease that effects people other than the patients. 


References:
Imtiaz, B., Tolppanen, A., Kivipelto, M., & Soininen, H. (2014). Future directions in Alzheimer's disease from risk factors to prevention. Biochemical Pharmacology88(4), 661-670. doi:10.1016/j.bcp.2014.01.003

Vos, S., Xiong, C., Visser, P., Jasielec, M., Hassenstab, J., Grant, E., & ... Fagan, A. (2013). Preclinical Alzheimer's disease and its outcome: a longitudinal cohort study. Lancet Neurology12(10), 957-965. doi:10.1016/S1474-4422(13)70194-7

Richarz, U., Gaudig, M., Rettig, K., & Schauble, B. (2014). Galantamine treatment in outpatients with mild Alzheimer's disease. Acta Neurologica Scandinavica, 129(6), 382-392. doi:10.1111/ane.12195

Wimo, A., Ballard, C., Brayne, C., Gauthier, S., Handels, R., Jones, R., & ... Kramberger, M. (2014). Health economic evaluation of treatments for Alzheimer's disease: impact of new diagnostic criteria. Journal Of Internal Medicine, 275(3), 304-316. doi:10.1111/joim.12167





What is Alzheimer's?




Background:


(Photo from Leading Age)
Alzheimer’s is a disease associated with the loss of brain functions, which result in memory, thinking and behavior complications (Liu, Yao, Jiany & Chen 2014). In the early 1900s Alzheimer’s disease was first identified by a brain autopsy of a women who had signs of memory loss and relationship changes with family members (Richarz, Gaudig, Rettig & Schauble 2014). Years later, the disease was named and researched more by a fellow doctor of Alois Alzheimer. As time progressed, technology and education allowed further research to be done on the disease. In the late 1900s, Alzheimer’s was named the most common form of dementia and various doctors and researchers attempted treatment plans (Vos, Xiong, Visser, Jasielelc et al. 2013)
.

Facts (WebMD; Alzheimer’s Association):
  1. “Estimated that 5.1 million Americans may have Alzheimer's disease
  2. “The National Institute on Aging indicates that the prevalence of Alzheimer's disease doubles every five years beyond age 65”
  3.  “It is estimated that about a half million Americans younger than age 65 have some form of dementia”
  4. “It is estimated that one to four family members act as caregivers for each individual with Alzheimer's disease.”

Factors Associated with Development:

  1. Aging is a factor for getting Alzheimer’
    1.  Statistics show that as one ages, their likelihood of getting Alzheimer’s increases (Imtiaz, Tolppanen, Kivipelto & Soininen 2014).
  2. Genetics
    1.  As for many diseases, if a direct family member has or had Alzheimer’s, the chance of you getting the disease is higher than the average person (Wimo, Brayne, Gauthier, Handels & Jones 2014).
  3. Sex
    1. Women are more at risk than men (Johansson 2014).


Symptoms:
  1. Short-term memory loss (Vos, Xiong, Visser, Jasielelc et al. 2013).
  2. Aphasia (Vos, Xiong, Visser, Jasielelc et al. 2013).
    1.  Aphasia is the inability to communicate with others
  3. Apraxia (Vos, Xiong, Visser, Jasielelc et al. 2013).
    1. Apraxia occurs when one loses the ability to do daily tasks that came naturally to them at once
  4. Agnosia (Vos, Xiong, Visser, Jasielelc et al. 2013).
    1.  Agnosia is when a person cannot get information from their environment by using their senses
  5. Personality alterations (NIH 2011).
  6. Hallucinations
  7. Delusions


  Detection Methods:
  1.      .  Genotyping (NIH 2011).
  2.         Tests measuring memory and cognitive abilities (Vos, Xiong, Visser, Jasielelc et al. 2013).
  3.         Insulin Resistance examinations (NIH 2011).
  4.         Measuring cerebrospinal fluid (CSF) (NIH 2011).
  5.         Brain Imaging (Vos, Xiong, Visser, Jasielelc et al. 2013).
  References:

Liu, G., Yao, L., Liu, J., Jiang, Y., Ma, G., Chen, Z., & ... Li, K. (2014). Cardiovascular disease contributes to Alzheimer's disease: Evidence from large-scale genome-wide association studies. Neurobiology Of Aging35(4), 786-792. doi:10.1016/j.neurobiolaging.2013.10.084

Imtiaz, B., Tolppanen, A., Kivipelto, M., & Soininen, H. (2014). Future directions in Alzheimer's disease from risk factors to prevention. Biochemical Pharmacology88(4), 661-670. doi:10.1016/j.bcp.2014.01.003

Wimo, A., Ballard, C., Brayne, C., Gauthier, S., Handels, R., Jones, R., & ... Kramberger, M. (2014). Health economic evaluation of treatments for Alzheimer's disease: impact of new diagnostic criteria. Journal Of Internal Medicine275(3), 304-316. doi:10.1111/joim.12167

Johansson, L. (2014). Can stress increase Alzheimer's disease risk in women?. Expert Review Of Neurotherapeutics14(2), 123-125. doi:10.1586/14737175.2014.878651

Vos, S., Xiong, C., Visser, P., Jasielec, M., Hassenstab, J., Grant, E., & ... Fagan, A. (2013). Preclinical Alzheimer's disease and its outcome: a longitudinal cohort study. Lancet Neurology12(10), 957-965. doi:10.1016/S1474-4422(13)70194-7

Wu, J., Wang, Y., Zhang, Z., & Yu, B. (2014). Herbal medicine in the treatment of Alzheimer's disease. Chinese Journal Of Integrative Medicine,

Richarz, U., Gaudig, M., Rettig, K., & Schauble, B. (2014). Galantamine treatment in outpatients with mild Alzheimer's disease. Acta Neurologica Scandinavica129(6), 382-392. doi:10.1111/ane.12195