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Niels 1 Sarah Niels Prof. Presnell Engl 1103 12 Nov.

2012 Alzheimers Disease At first, I didnt have a clue about what to write about. I considered a few possible topics; the disappearing bumble bees, lives of songwriters and even community services impact on our generation. But none of them had personal meaning until I contemplated my family history. My great aunt Ruth was diagnosed with Alzheimers disease when I was very young. At the time, I didnt understand why she couldnt remember anything and it angered me when she didnt know my name. Over the years, she progressively grew worse. Kimberly, her granddaughter, placed Ruth in a nursing home because she didnt want to tend to her anymore. I would accompany my grandmother and mother at least once a month to visit Greataunt Ruth. She was sad all the time. The smell of the nursing home was sickening, old mothballs and denture cream filled the halls. There were wrinkly people barely managing to walk about while a few skittish cats roamed from room to room. But no one laughed; no one uttered a word outside of his or her rooms. I couldnt fathom how she lived in a place like that. Sometimes I wonder if we could prevent this disease from occurring to our loved ones or us. I saw my Great-aunt Ruth die with no memories; she had nobody to love or had the mental ability to express herself. I want to be well educated because this is a life changing disease and I currently know

Niels 2 nothing about Alzheimers. So here I am to investigate more about Alzheimers disease. At first, I wanted to know how this disease was discovered. I came across a scientific journal, Auguste D and Alzheimers Disease, which explained the history of Alzheimers. Born on June 14, 1864 in Germany, Alois Alzheimer studied medicine, becoming a physician in his later years. According to Maurer, Konrad, Stephan Volk, and Hector Gerbaldo, he had a variety of interests such as psychoses, forensic psychiatry, epilepsy, birth control, and dementia of degenerative and vascular origin. Alzheimer had a patient Auguste D- admitted on November 25, 1901 whom he examined until her death on April 8, 1903. According to the documents, She had a striking cluster of symptoms that included reduced comprehension and memory, as well as aphasia, disorientation, unpredictable behavior, auditory hallucinations, and pronounced psychosocial impairment. Alzheimer conducted tests relative to her ability to recall information or recent events as well as tests for processing or producing information. Auguste D would lose herself in the middle of writing her name or she would repeat a line she already read in a book. This is similar to what my great aunt Ruth would do; while reading a book, she would thoughtlessly read the same line over again. After Auguste Ds death, Alzheimer had the patients brain sent to Munich, where he examined it. Alzheimer was the first to discover the abnormal neurofibrils in the brain. Logged in his reports, Alzheimer said, In the center of an otherwise almost normal cell there stands out one or several fibrils due to their characteristic thickness and peculiar impregnability.

Niels 3 After 90 years of these case records being lost, they were recovered on December 19,1995 and reinvestigated by scientists today. From the US Department of Health and Human Resources, I pulled an article that dove into the scientific aspect of Alzheimers disease. This government document provides factual information to the public, undergoing numerous verifications to pass the federal regulations to be published nationwide. I found in the Alzheimers Disease Fact Sheet that this is a progressive brain disease considered to be a version of dementia. Once it begins, you cannot reverse the loss of cognitive functioning or behavioral abilities. It is not apparent as to why this disease occurs in only certain people but scientists believe the process of damage begins ten years before Alzheimers becomes apparent. Toxic changes occur in the brain in this period; thus, the symptoms are not recognizable in this stage. Within time, proteins in the brain are built up, forming amyloid plaques. This build up interferes with the transfer of information between neurons in the brain. Another abnormal occurrence forms tau tangles; this is an irregular amount of tau, which holds up microtubule structures (they allow for transportation of nutrients in the brain). In the early stages of Alzheimers disease, the patient will experience memory problems. This is usually the first warning sign for a decline of thinking, remembering, and reasoning (all part of cognitive loss). Sometimes, people will be diagnosed with MIC (amnestic Mild Cognitive Impairment) and later develop Alzheimers disease. The disease may cause the person to have trouble with word finding, their vision, spatial aspects may be affected, and their judgment is questionable.

Niels 4 The disease will worsen to a mild Alzheimers, meaning their memory will continue to decline alone with other cognitive abilities. The patient may easily become lost, they may repeat themselves, or normal tasks would take more time than necessary to complete. Paying bills would be extremely difficult, money handling may be an obstacle, and their judgment would be impaired. With time, Alzheimers disease will reach to its moderate state and spread to damage the ability to control language, reasoning, sensory processing, and conscious thought, according to the Alzheimers Disease Fact Sheet. The patients ability to remember grows even less; eventually, they wont be able to recognize their family members or friends. Carrying out day-to-day activities may be impossible; whereas, they lack the ability to learn new tasks. The final stage of Alzheimers disease is when it reaches severe stage and the brain is taken over by the plaques and tangles. There is a significant amount of brain tissue diminished and the person with Alzheimers is completely dependent on the help of others. There are a few beliefs as to why Alzheimers happens to only certain people. Again, from the US Department of Health and Human Resources, some scientists have found a gene called apolipoprotein E (APOE) and linked it to late-onset Alzheimers disease after the age of 60. Most cases have revealed this gene present; yet, people have developed Alzheimers and they didnt carry the APOE gene. Using a different source, Whats the Connection between Nitrogen Fertilizers an Alzheimers Disease, I found some interesting information regarding my topic. The author, Anne Hart, has published a large amount of articles and books about

Niels 5 nutrition, health, and culture. Scientists have undergone an investigation regarding how we farm our food sources; they believe a connection may be made linking the nitrogen fertilizers and Alzheimers disease. In previous years, carbon dioxide levels have been rising, harming the quality of food and the plants ability to create protein from nitrate. Nitrogen is a key element plants need to survive and grow; with a 50 percent increase in carbon dioxide in the atmosphere, there is a decline of nitrogen status in plants. These scientists believe the increase of nitrates in our food and environment may be associated with deaths due to Alzheimers. Our generation has been exposed to a high amount of nitrogen, and an increase of people suffering from Alzheimers disease has followed. The preservation of foods also contains a high amount of nitrogen, which adds to our health risk. Meats and fish contain sodium nitrates used to preserve, color, and flavor meats. The article explains that a simple reduction of nitrate levels in fertilizer and water, and also detoxifying tap water and food from common environmental toxins should help lower our risks of developing Alzheimers. This does not cause Alzheimers disease; it is only a trend between an increase of nitrogen use and amount of Alzheimers patients. Determining whether or not a patient has Alzheimers disease is no easy task due to the lack of technology we currently have. We can only be sure after the patient has died by preforming an autopsy on the brain, confirming the existence of tangles and plaques. Testing memory and ruling out other problems the patient may have are the first steps the doctor should do. If the patient experiences

Niels 6 difficulty with communicating, remembering dates, or doing everyday tasks, take them to be examined. Even though we have made huge strides researching Alzheimers, there are currently no cures for this progressive disease. According to a resource I found using the Atkins Library ESCO host link, Consumer Reports on Health, doctors have developed a few options for the treatment of patients. First, the patient should avoid places they are unaware of; the unfamiliar setting would cause excessive stress. Avoid situations where the patient may become embarrassed or over excited. Also, keep the patient away from illnesses or infections that may be contracted. There are anti-anxiety drugs or antidepressants for those patients who display behavioral problems. Unless it is extremely necessary for the patient to take drugs for antipsychotic needs, avoid them at all costs. They are known to increase the risk of death for those with dementia and Alzheimers. The final option for a person with Alzheimers is to take generic donepezil or generic galantamine (both are Alzheimers drugs). These two drugs are relatively inexpensive and are proven to have less side affects than other drugs. If there is no improvement within three months of taking the drugs, it is very unlikely the person will show any progress. Most patients will stop taking the drug at this point. Overall, drugs dont delay the onset of Alzheimers disease or improve the patients mental condition; they merely slow the degeneration process down. There are many concerns as to whether or not a family should place the Alzheimers patient into a nursing home, if they should allow them to live on their

Niels 7 own, or if they should tend to them personally. I found an interesting article written by Bercedis Peterson, Gerda Fillenbaum, Carl Pieper, and Albert Heyman that determines the affects of nursing homes and lifespan of an Alzheimers patient. They even lead their own study conducted over nine years and incorporated their findings in the conclusion of the article. After conducting a study for the longevity of patients with Alzheimers disease living in a nursing home against those who stay at home, the experimenters concluded there is no variance. As long as the nursing home has appropriate living conditions, it significantly does not make a difference. As long as you consider the services provided, administration and staff, the medication policies, and health ratings of the nursing home, the patient should live just as long as they would at home. Hiring a private nurse can be very helpful but also extremely expensive. Most people will keep their family member at home for as long as possible. As a family member, keep a positive attitude while around the Alzheimers patient. They do not need negativity, which may lead to depression. Approach the patient at the same level, they want to be considered equal and may be easily frightened. Speak calmly and dont keep pressuring them to remember something. They cannot remember because their brain has shrunk and it only frustrates the patient when they cannot recall an event or person. When I began this research, I lacked knowledge about Alzheimers disease and I didnt know what I would find. Having a family member with Alzheimers disease affects the family responsibilities, ultimately leading to the decision of nursing home placement or not. It merely depends on how comfortable the family is and whether

Niels 8 or not they are qualified to tend to the Alzheimers patient. I realize there are many obligations to fulfill once deciding to tend for an Alzheimers family member; be prepared to face these duties and have a plan of action. I believe people should take precautions concerning their food consumption and they should continually exercise their mind. In hindsight, I wish my family knew more about the disease before my aunt was diagnosed with Alzheimers. Anything that could have helped Aunt Ruth would have been greatly accepted to help improve her mental stability and comfort.

Niels 9 Work Cited "Consumer Reports on Health." Consumer Reports on Health. 24.11 (2012): 8-8. Web. 1 Nov. 2012. Maurer, Konrad, Stephan Volk, and Hector Gerbaldo. "Auguste D and Alzheimers Disease. Lancet. 349. (1997):1546-1549. Web. 5 Nov. 2012. Petrson, Bercedis, Gerda Fillenbaum, Carl Pieper, and Albert Heyman. "Home or Nursing Home: Does Place of Residence Affect Longevity in Patients With Alzheimers Disease? The Experience of CERAD Patients." Home or Nursing Home: Does Place of Residence Affect Longevity in Patients With Alzheimers Disease? The Experience of CERAD Patients. 25.5 (2008): 490-497. Web. 1 Nov. 2012. United States. US Department of Health and Human Resources. Alzheimer's Disease Fact Sheet. 2012. Web. "What's the Connection Between Nitrogen Fertilizers and Alzheimer's Disease?." Examiner (2011): n.pag. News Bank. Web. 1 Nov 2012.

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