Alzheimer’s fact that Alzheimer’s disease can progress and lead

Alzheimer’s Disease -underlying
biology, and behavioral symptoms

Alzheimer’s disease or dementia caused by Alzheimer’s disease is a
progressive degeneration of the brain tissue, which, above all, occurs in
people older than 65 years (Brookmeyer, R., et al., 1998). This is the most
common cause of dementia, in which there is a decrease in mental abilities. For
instance, memory impairment, a violation of the ability of conscious perception
and speech. Attention becomes distracted, the patient is unable to conduct
simple operations with numbers, to conduct routine daily activities becomes
increasingly difficult, disorientation and frustration are observed. Symptoms
tend to worsen at night. Characterized by a fast change of mood – outbursts of
anger, periods of fear, as well as periods of deep apathy. The patient is
poorly oriented, can go wander and get lost. There are also physical disorders,
such as unstable gait or deterioration and loss of coordination, which progress
gradually. Over time, as the disease progresses, the patient may become
physically helpless, develop urinary incontinence or feces and inability to
communicate (Brookmeyer, R., et al., 1998).

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This topic is highly important because of the fact that Alzheimer’s
disease can progress and lead to death in a short period of time in just a few
years, and for a long time – 20 years. But in most cases, people with
Alzheimer’s disease live about 9 years. To date, this disease ranks 6th among
other diseases leading to death. One person in eight at the age of 65 has
Alzheimer’s disease. Women are more prone to this disease than men (Brookmeyer,
R., et al., 1998).

Progressive
decline in memory and agnosia in Alzheimer’s disease sooner or later lead to
confirmation of the diagnosis. The disease affects the different sides of
memory in different ways. Old memories of their own lives (episodic memory),
long-learned facts, implicit memory (unconscious “body memory”, how
to use cutlery) are prone to personal frustration compared to new facts or
memories. Aphasia is mainly characterized by the impoverishment of the
vocabulary and reduced fluency of speech, which generally weakens the ability
to verbal and written expression of thoughts (Philippe H. Robert, et al. 2005).
The presence of psychotic and behavioral symptoms in a patient with Alzheimer’s
disease is extremely negative and costly for those who care for the sick, and
for society as a whole. The appearance of behavioral symptoms in dementia is
associated with emotional distress among carers and is a significant predictor
in reducing the functional activity of patients and placing them in psychiatric
hospitals. specific groups of symptoms were identified. Behavioral symptoms are
usually detected by observing the patient and include physical aggression,
cries, anxiety, agitation, wandering, violation of generally accepted norms of
behavior, sexual disinhibition, curses, etc. Mental symptoms are usually
assessed on the basis of a conversation with the patient and his relatives and
are manifested by anxiety, depression, hallucinations and delusional disorders
(Philippe H. Robert, et al. 2005). Depressive symptoms develop before the
diagnosis of Alzheimer’s disease for more than two years, while psychotic
symptoms are detected during the diagnosis of dementia and moreover,
apparently, are the reason for a primary appeal to specialists. Behavioral
symptoms, such as aggression, agitation, irritability, developed within the
first year after diagnosis. In patients with Alzheimer’s disease, the severity
of most behavioral disorders is associated with the severity of dementia, in
turn, the appearance of psychotic disorders predicts a deterioration in the
cognitive and functional state of the patient (Philippe H. Robert, et al.
2005).

The presence of psychotic and behavioral symptoms in a patient with
Alzheimer disease is extremely negative and costly for those who care for the
sick, and for society as a whole. The appearance of behavioral symptoms in
dementia is associated with emotional distress among carers and is a
significant predictor in reducing the functional activity of patients and
placing them in psychiatric hospitals (Philippe H. Robert, et al. 2005).
Behavioral symptoms are usually detected by observing the patient and include
physical aggression, cries, anxiety, agitation, wandering, violation of
generally accepted norms of behavior, sexual disinhibition, curses, etc. Mental
symptoms are usually assessed on the basis of a conversation with the patient
and his relatives and are manifested by anxiety, depression, hallucinations and
delusional disorders (Philippe H. Robert, et al. 2005). Depressive symptoms
develop before the diagnosis of Alzheimer’s disease for more than two years,
while psychotic symptoms are diagnosed during the diagnosis of dementia and,
moreover, seem to be the lead for a primary referral to specialists. Behavioral
symptoms, such as aggression, agitation, irritability, developed within the
first year after diagnosis. In patients with Alzheimer’s disease, the severity
of most behavioral disorders is associated with the severity of dementia, in
turn, the appearance of psychotic disorders predicts deterioration in the
cognitive and functional state of the patient (Philippe H. Robert, et al.
2005).

For detection
of Alzheimer’s disease, such diagnostic methods are used: MRI of the brain,
which can detect atrophy of the medial parts of the temporal lobe, amygdala,
hippocampus, posterior cingulate gyrus, positron emission tomography (PET),
which allows to detect a decrease in glucose metabolism in these departments
(Stéphane P. Poulin, et al., 2011).

Progressive decline in memory and agnosia in Alzheimer’s disease sooner
or later lead to confirmation of the diagnosis. The disease affects the
different sides of memory in different ways. Old memories of their own lives
(episodic memory), long-learned facts, implicit memory (unconscious “body
memory”, how to use cutlery) are prone to personal frustration compared to
new facts or memories. Aphasia is mainly characterized by the impoverishment of
the vocabulary and reduced fluency of speech, which generally weakens the
ability to verbal and written expression of thoughts. At this stage of the
disease, a person usually helps to operate adequately with simple concepts in
speech communication (Philippe H. Robert, et al. 2005).

There are plenty of articles that describe the effect of established
biomarkers on cognitive performance. These biomarkers include cerebrospinal
fluid tau and amyloid-beta42, positron emission tomography Pittsburgh
compound-B, and apolipoprotein E genotype. Some modern Ab markers or the course
of neurodegenerative processes are presented (Aschenbrenner, A.J., et al.,
2015). According to one of the hypotheses of the development of Alzheimer’s
disease, this disease is based on factors that lead to the accumulation of
b-amyloid (Ab) in the brain (Ganesh M. Shankar, et al., 2008). The latter
deposits lead to synaptic dysfunction, the formation of neurofibrillary tangles
and neuronal death, which is accompanied by a decrease in cognitive abilities.
Ab accumulation markers include the low concentration of Ab42 in the cerebrospinal
fluid and the presence of amyloid plaques on positron emission tomograms
(Ganesh M. Shankar, et al., 2008). The markers of neurodegenerative processes
are an increase in the concentration of both general and hyperphosphorylated
tau protein in the cerebrospinal fluid, a decrease in metabolic processes in
the temporal and occipital lobes of the brain from positron emission tomograms
with 18FDG, the presence of MRI signs of atrophy in the temporal and medial
parietal cortex. In clinical practice, it is customary to classify markers
according to methods of their preparation (structural MRI, positron emission
tomograms, investigation of cerebrospinal fluid). Since the accumulation of
amyloid occurs long before the onset of clinical manifestations of the disease,
its early detection will allow to diagnose the pathology and begin treatment of
patients with Alzheimer’s disease before the appearance of clinical symptoms,
once the effectiveness of the disease-modifying therapy is proved
(Aschenbrenner, A.J., et al., 2015). The purpose of this research was to
provide an examination of the combined influence of semantic retrieval and
attentional control in discriminating cognitively healthy aging from
symptomatic Alzheimer’s disease, and more importantly to examine if this
measure is sensitive to accumulating Alzheimer’s disease-related biomarkers in
healthy control individuals. The standard markers of Alzheimer’s disease in CSF
are the concentration of Ab42, the total content of tau protein and its
hyperphosphorylated form (Ganesh M. Shankar, et al., 2008). The specificity and
sensitivity of the diagnosis of Alzheimer’s disease in the analysis of all
three biomarkers are very high and is 85-90%. However, despite the fact that
this diagnostic method is already available in the form of commercial kits and
some specialists rely on its results when making a diagnosis, it seems
promising, but not completely applicable to routine clinical practice
(Aschenbrenner, A.J., et al., 2015).   

There are a plenty of researchers all over the world that investigate
different aspects of Alzheimer disease. One of the research areas is the study
of the course of the disease in patients belonging to different races. A group
of scientists led by Lisa Barnes organized a study in which 122 people took
part, of which 81 people belonged to the European race and 41 to the Negroid
race. Scientists have studied the brain tissue of patients. In 71% of patients
of the Negroid race, signs of other pathologies other than Alzheimer’s disease
were found. In the representatives of the Caucasoid race, this indicator was
51%. In addition, African Americans were more likely to have blood vessel
disease. The drugs that are currently used to treat Alzheimer’s disease affect
only a certain type of pathology. The data obtained on the mixed picture of the
disease in representatives of the African Americans will help in creating new
methods of treatment for this group of patients (Hohman, T.J., et al., 2016).