Amyloidosis is a relatively uncommon disease caused by an accumulation of amyloid in a person’s organs, usually the nervous system, heart, liver and kidneys. As well as sometimes leading to gastrointestinal, lung, spleen and bleeding problems. Amyloid is an irregular protein structure that is produced within a person’s bone marrow. Alzheimer’s disease is the single most common form of amyloidosis and is a progressive disease that alters one’s memory, as well as other significant functions of the brain. The hippocampus, which is integral in the formation of new memories is effected in the early stages of Alzheimer’s. Research has found that the volume of the hippocampus is decreased by over twenty percent in the cases of Alzheimer’s patients. Alzheimer’s is also the main cause of dementia, a series of impairments that result in the loss of cognitive abilities. In frontotemporal dementia, a patient’s eating habits are often disrupted, due to the a deterioration in the hypothalamus. According to an article published in the Lancet on 30 April 2011, entitled “The three stages of Alzheimer’s disease”, at the turn of this century, there was reportedly 24 million people living with dementia across the globe, the majority of which are believed to have Alzheimer’s disease. This number is expected to increase to over 80 million by the year 2040. Symptoms of the Early Stages of Alzheimer’s Disease: Patients experience trouble remembering names and events, or with recognizing faces – Forgetting the names of familiar places or objects more often -Calling things by the incorrect name or getting stuck for words frequently -Placing items in unusual locations. For example, when unpacking the shopping, a person may place toothpaste in the fridge. -Repetition, for example, asking the same question over and over, due to the person forgetting that it’s already been asked. – Confusion, increased anxiety, loss of self-confidence and fearfulness – Exercising poor judgement skills and finding it difficult to make decisions in all aspects of life. The neurophysiological damage to the frontal lobe, and area involved In reasoning and planning has a role in these symptoms. – Wandering around aimlessly or getting lost in familiar settings – Mood and personality changes -degeneration of the amygdala plays a role in this -Taking considerably longer to perform routine everyday tasks. Often in Alzheimer’s, once relatively easy tasks to the patient, like for example running errands or doing mental arithmetic, become increasingly laborious. – Forgetting or confusing dates, times and appointments on quite a regular basis and not recalling them until some time after, or perhaps not remembering them at all The Second Stage of Alzheimer’s Disease Aphasia- Patients encounter significant difficulties when speaking and also greater challenges in understanding language, both aurally and whilst reading. Difficulty with writing can also occur and agraphia is among one of the early signs of Alzheimer’s Disease, as well as misspellings, written and oral grammatical errors and a general decline in one’s ability to articulate themselves. The examination of writing skills has been shown through studies to be a suitable means to assess what stage of dementia a patient may be at. Sleep disturbances – The pathophysiological effects of Alzheimer’s on the brain is believed to alter the sleep/wake cycle. In the first stage of the disease, people with Alzheimer’s may sleep excessively and often awake confused. In the later stages of the disease, people with Alzheimer’s sleep much less and at irregular intervals, often dozing in and out of sleep during the day and throughout the night. Hallucinations- events characterized by the apparent perception of someone or something that’s not actually there. They often increase in severity as the patient’s condition declines. Patients, according to the Alzheimer’s Society UK, often encounter visuospatial difficulties such as finding it difficult to negotiate steps and when maneuvering objects. At this middle stage, patients also have a decline in their ability to focus on a series of tasks, or concentrate on a book or the storyline of a television programme for example. Patients also often feel increasingly anxious, and may experience depression, as are also symptoms of the early stages of Alzheimer’s. The Later Stages of Alzheimer’s Disease In the third stage of the disease, the symptoms experienced by the patient greaten in severity and hence, become increasingly distressing for the person to cope with on a daily basis. Delusions, as well as hallucinations may occur more frequently and the patient may also become increasingly agitated and disorientated in once familiar surroundings. They may also act in a violent manner during episodes of hallucinations, in which they hear or see things which are not actually present. Delusions, when people begin to believe things that are not true, are more common than hallucinations. Other prominent symptoms classified by the NHS as part of the later stage of the disease are aphasia, dysphagia, substantial unintended weight loss, urinary incontinence and a drastic decline in both short and long term memory. Sadness, apathy and frustration are also experienced by the patient. Alzheimer’s patients at this stage also become very feeble, and often struggle to stand up, walk and dress themselves. According to the Alzheimer’s Society in the UK, people diagnosed with Alzheimer’s disease live approximately 8-10 years after the early stages of the disease present itself. The Risk Factors of Alzheimer’s Disease Age is the principle risk factor for developing Alzheimer’s Disease. The risk of Alzheimer’s increases substantially after the age of 65 and a person’s chance of developing dementia increases twofold every ten years after the age of 60.Over 10% of patients are over the age of 65 while over 30% of patients are over the age of 85. Early onset Alzheimer’s can also occur in a person’s 40s and 50s. Furthermore, a medical research finding published by the Feinberg School of Medicine in Northwestern University, Chicago, found an accumulation of protein amyloid deposits in the brains of some deceased young adults, of 20 years old. Such a finding is highly indicative of the early, or preclinical stages of Alzheimer’s Disease. Smoking is related to a broad spectrum of illnesses particularly many forms of cancer and heart disease, as well as Type 2 diabetes. Studies have also concluded that smokers are placed at over a 40% greater risk of developing Alzheimer’s disease, when compared with non-smokers and ex-smokers. Additionally, research has shown that ex-smokers can lower their risk of Alzheimer’s by quitting smoking. Gender- Some evidence suggests that women may be more at risk of developing Alzheimer’s than men, which could possibly be due to their longer life expectancy, but the evidence on this factor is not yet conclusive. Nonetheless, the Alzheimer’s Society in the UK reports that there are at present approximately two times as many females as males diagnosed with Alzheimer’s, over the age of 65. A possible explanation for this could lie in the fact that a correlation may exist between this disease in women and reduced oestrogen levels in post-menopausal years. A study published in the Current Opinion in Society Journal found compelling evidence suggesting a distinction between cognitive function and cognitive reserve among men and women. Diabetes- Multiple medical studies have also established a very strong correlation between patients with Type 2 diabetes, and the risk of developing Alzheimer’s disease later in life. Further research suggests that Type 2 diabetes patients are at two times a greater risk of developing Alzheimer’s, compared with those without diabetes. Hypercholesterolemia and hypertension have both been established as risks for the development of Alzheimer’s disease, particularly vascular dementia, due to the damage to the blood vasculature. The Alzheimer’s Asscociation reports that multiple studies have established the strength of the heart-head connection, given that the heart is the principle organ supplying blood to our brains. Hence, any pathology of the heart, or indeed the circulatory system in general, can also cause damage to the brain and it’s cognitive function. Such research has shown that tangles and plaques are more likely to trigger the development of Alzheimer’s, if damage to the brain’s blood vasculature has also occurred. Obesity and lack of exercise has also been linked to the development of Alzheimer’s disease, and thus healthcare professionals recommend daily exercise and a balanced healthy diet, with the inclusion of fruits and vegetables, to help ward of dementia. A study carried out by Rush University Medical Centre in Chicago found that a daily serving of green leafy vegetables prevents cognitive decline with age and facilitates memory preservation. Vegetables such as kale and spinach are particularly beneficial to brain function due to their high Vitamin K content. Another study carried out by the University of Macncherster, UK, found that eating purple coloured fruits such as blueberries, may prevent Alzheimer’s Disease. This is due to the fact that it absorbs detrimental iron compounds within the body, by a method of detoxification. Additionally, a correlation has also been established between excessive alcohol consumption and dementia. Low levels of education, less than secondary school graduation has also been found to be a risk factor for dementia. A correlation has also been established between depression and dementia, although the research currently is quite conflicting about whether depression is a risk factor for dementia, or rather a symptom of the early stages of this progressive disease. Patients, especially during the first and second stages of Alzheimer’s disease may feel isolated and anxious. They often withdraw socially, find it difficult to maintain focus and their thought process and rationalization skills may be altered. Finally, people who have sustained either a severe head injury, or repeated head injuries are also at greater risk of developing dementia later on in life, particularly if the trauma occurs on more than one occasion, or if loss of consciousness occurs. Medical investigations suggest this may be due to the deposits, which accumulate in the brain as a result of a head injury, perhaps playing a role in causing dementia. Finally, mild cognitive impairment is also listed among the risk factors for Alzheimer’s disease. People with mild cognitive impairment, who’s memory and cognitive abilities may be worse than expected for their age,but not severe enough to be diagnosed as Alzheimer’s, have an increased risk of developing dementia later in life, according to the Mayo Clinic in the US. However, it is not definitive that a person with a Mild Cognitive Impairment diagnosis will inevitably develop dementia. In fact, in some cases, a patient’s cognitive abilities return to within normal parameters and, in other cases their cognitive capacities remains at a stable, manageable level.
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