Alzheimer’s; the Zombie of Diseases
Alzheimer’s: The Zombie of Diseases In an estimation made by the Alzheimer’s Association, the leading provider of Alzheimer’s care and research, it is predicted that by the year 2050, 16 million Americans will be diagnosed and suffering with Alzheimer’s disease (“The Coming”, 2014). “Alzheimer’s is a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. Alzheimer’s disease accounts for 60 to 80 percent of dementia cases” (“What”, 2015) according to Alzheimer’s Association. Alzheimer’s is most commonly diagnosed inpeople older than the age of 65, but those younger have been known to be diagnosed. With the wide-range of people who are vulnerable to becoming infected with the disease, and the high statistic estimated to soon overcome the country, what is being done or what will be done soon to prevent the destined future is questioned by many suffering patients and their affected families. Scientists and researchers have been working to develop treatments that would rid patients of symptoms and are even more fixated on discovering and developing a cure that could rid the Alzheimer’s disease from a patient in its entirety.
In order to understand a cure or treatment of the disease, it is necessary to obtain knowledge of the constituents of Alzheimer’s. For Alzheimer’s, one of the contributing factors to the disease is genetics. Dr. Rudolph Tanzi, a Professor of Neurology at Harvard University, and the Director of the Genetics and Aging Research Unit at Massachusetts General Hospital, is one of the most successful scientists at this point in the race to cure Alzheimer’s.
He created a tool he calls “Alzheimer’s in a dish” that allows the recreation of the disease with human brain cells. This allows scientists to better understand the development of the disease, along with testing pharmaceutical treatments on human brain cells without harming actual people. Based on research and experiments performed in both recent and earlier years, the development of pharmaceutical, environmental, and surgical treatments for curing, treating, and diagnosing Alzheimer’s have arisen, along with the recognition of the effect genetics have on the increased likelihood of being affected with the disease. Alzheimer’s is defined as a disease that causes progressive mental deterioration that can occur in middle or old age due to generalized degeneration of the brain (Alzheimer’s Association, 20). One significant characteristic of those who have the disease is that the brain loses mass in the frontal and temporal lobes (Ponier, A. C.
,2014). The frontal lobe of the brain controls one’s reasoning, planning ability, motor cortex (speech and movement), emotions, and problem solving. The temporal lobe has the role of perception and recognition of sound, and more importantly, controls memory (Dishman & Carrillo, 2007). Most people have a slight understanding of the general idea of Alzheimer’s, yet what they know would be insufficient if they, or someone they must take care of, fell victim to the disease, which is certainly possible at this point of time. In fact the disease is in a state of crisis at the moment.
In 2016, over five-million American’s face are facing the Alzheimer’s epidemic, making it place as the sixth leading cause of death, subduing breast and cervical cancer combined and falling shortly behind strokes and accidental deaths (Alzheimer’s Association, 2016). The disease is also quite costly to treat. By the end of the year 2016 Americans will have spent around two-hundred thirty-six billion dollars mainly on Alzheimer’s treatments, care facilities, and other necessities of the disease (Alzheimer’s Association, 2016). A separate portion of that large sum of money goes towards researchers and programs such as Alzheimer’s Association, the world’s leading voluntary health organization in Alzheimer’s care, support and research, in order to grasp a better understanding of the disease. In order to obtain funding for the development of a cure, Alzheimer’s Association provides grants and performs worldwide fundraisers in order to collect money. Alzheimer’s Association’s International Research Grant Program “funds investigations that advance our understanding of Alzheimer’s disease, help identify new treatment strategies, provide information to improve care for people with dementia, and further our knowledge of brain health and disease prevention” (“The Genetics”, 2016).
The program offers grants to professionals of all backgrounds. The grantsy allow people who may have ideas and might otherwise not get the funding to receive the funding and publish their ideas in order to further the development of a cure. There are many possible factors that increase the likelihood of developing the disease. However, it is not definite that having any of those factors will lead to the disease. One example of a factor that falls into this category is genetics, the study of genes, inheritance, genetic variation, and hereditary.
Depending on which type of Alzheimer’s, either early-onset or onset at the standard age, it can be determined whether a genetic mutation was the causeinvolved. Early-onset Alzheimer’s is the only genetically caused type that is developed because of a mutation. Less than 5% of all Alzheimer’s patients have early onset caused. This mutation would be caused in one person and only has a 50/50 chance of passing it on to their children (Goldstein, M. K., Gwyther, L.
P., Lazaroff, A. E., & Thal, L. J.).
All other genetically induced Alzheimer’s are hereditary instead of resulting from a mutation. This early onset Alzheimer’s mutation occurs on either chromosome 21, 14, and 1, varying individually. As one may notice, chromosome 21 is also the chromosome that people with Down Syndrome have two of. Because of this, it is commonly found that people with Down Syndrome also develop Alzheimer’s later in life. The mutation of chromosome 21, 14, and 1 causes abnormal proteins to be made during the protein synthesis process. These mutant proteins then break down amyloid precursor proteins, whose role is not fully understood yet, which leads to the generation of harmful forms of amyloid plaques, the material that physically deteriorates and destroys the brain matter.
However, these mutations can only account for the early onset diagnosis. For later onset Alzheimer’s, genetics play a factor, yet mutation does not cause the disease at this state. Heredity does not guarantee the development of Alzheimer’s;, however, it does raise the probability that one will be diagnosed with it. Scientists are unsure of many lifestyle and environmental risk factors of Alzheimer’s, yet they do have a few ideas and prevention strategies. One risk factor of Alzheimer’s is age, the extensive use of the brain throughout one’s life leads it to shutting down and deteriorating.
Because of different symptoms that accompany come with aging, the Alzheimer’s symptoms in its beginning stages are often overlooked by the person possessing the disease along with those around them. Another risk factor is having a head injury or some type of brain trauma, such as a concussion, in one’s life Smith, G. E., & Lunde, A. M.
, 2014). These injuries would have to be on a larger scale, a small bump to the head by a basketball would not put someone at a higher risk, only extensive injuries would cause a higher risk. Other general risk factors including lack of exercise, obesity, smoking or exposure to secondhand smoke, high blood pressure, high blood cholesterol, poorly controlled type 2 diabetes, and a diet lacking in fruits and vegetables (Ames, Burns, O’Brien, 2010). These factors are what cause the brain to lack necessary nutrients, which consequently makes it more vulnerable to the disease. Through one’s life, one could also make lifestyle choices to lessen the probability of being affected. One of these prevention strategies is obtaining as much education as possible.
As Dr. Tanzi said:, It’s kind of like having money in the bank, the more you make the more can be reserved. The more you’re packing into your knowledge, the more you can be resilient to Alzheimer’s pathology, as much as you accumulate in your brain. You know, all of us can prevent Alzheimer’s pathology in our brains, but we just have to learn more things (Tanzi, personal communication, 2016). Some subjects help more than others in the preservation.
These include foreign language, art, and some sort of a musical class (choir, band, or orchestra). Knowledge of the risk factors and prevention strategies of Alzheimer’s could lead to a significant decrease in people who have the disease whose own actions and lifestyle choices determine whether or not they suffer through Alzheimer’s. In order to formulate any treatment plans or take action in preventing the continuation of the deterioration, one must first be diagnosed. To do this, there are many tests that doctors implement in order to determine the level and severity of the patient’s symptoms. Understanding the importance of a medical diagnosis and plan can help families remain together for a longer period of time. In 1985, Roswell Gilbert personally diagnosed his then seventy-three year old wife, Emily Gilbert with the disease.
Unfortunately, he did not take her to get medical attention which may have alleviated her symptoms and helped her to live a healthier life. After years of brain deterioration, Emily’s symptoms became so bad that her quality and his quality of life became so difficult that he ended up euthanizing her, getting arrested and spending his elder years in prison (Landau, 2005). There are many tests available to determine the level of treatment and care that is needed for the patient. It also determines where they will be living, the kind of professional care that they will need, as well as to what extent the family will be able to be engaged. These tests are given to patients who believe they might have Alzheimer’s or whose caretakers/family/friends believe they might have Alzheimer’s, or to people who believe they may one day be diagnosed with Alzheimer’s and would like to begin treatment as soon as they can. The tests determine whether a person is either a probable Alzheimer’s patient, a possible Alzheimer’s patient, or a definite Alzheimer’s patient (McKhann, G.
, Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E.
M., 2011). According to The Official Journal of the American Academy of Neurology, to be diagnosed as a probable Alzheimer’s patient, the criteria includes dementia, as documented by the Blessed Dementia Scale; deficits in multiple areas of cognition; progressive worsening of memory and other cognitive functions; maintaining of consciousness; appearance of symptoms between of the ages forty to ninety; no other brain diseases that could possibly be causing the symptoms; a impaired daily life; a family history of Alzheimer’s; deterioration of language (aphasia), motor skills (apraxia), and perception (agnosia). These symptoms are only cause for probable diagnosis because all brain scans such as an MRI or CT scan are normal for people of their age group who are not experiencing any symptoms. In order to be diagnosed as a possible Alzheimer’s patient, the criteria includes having noticed dementia without being confirmed by a test; negatively testing for any other disease that could cause dementia; in the case in which a second brain disease is evident but is determined not to be the cause of the dementia; when there is an evident gradual deficit in a patient’s performance on diagnosing exams and it has been determined that there is no other brain disease generating the same effects.
In order to be diagnosed as a probable Alzheimer’s patient,the following needs to be evident; deterioration in two or more parts of the brain; obvious deterioration of memory; obvious deterioration of aphasia, apraxia, and agnosia; and normal laboratory results. In order to be diagnosed as a definite Alzheimer’s patient, the criteria includes meeting all previously stated criteria along with histopathologic evidence obtained from a biopsy or autopsy. Again, once someone is diagnosed, even with possible Alzheimer’s, efforts can be made to doing everything possible to prevent further development or to pursue creating a treatment plan. Once the diagnosis has been made, the next step is to formulate a treatment plan formatted to the victim’s type of Alzheimer’s and to them (and somewhat their family as well) specifically. There are different kinds of treatments that help to ease the progression, development, symptoms, and pain of Alzheimer’s. These treatments are environmental, pharmaceutical , and surgical treatments.
Environmental treatments are not known to be as drastic in helping to delay the progression, yet they do tend to ease the anxiety of not only the patient, but also the family and friends (The Norwegian Centre for Ageing and Health & The Research Council of Norway, 2000). Pharmaceutical treatments have recently made and are continuously making drastic developments, and it is possible that soon in the future, the cure for Alzheimer’s could be a medication (Baxalta US Inc). Surgical treatments have also assisted in easing symptoms, yet there are only few surgeries that have been attempted and were successful in the process (BEC Crew, ). According to Richard Senelic, “There are treatments that can make a difference. Some therapies ease the symptoms and help people do better for longer.
Because the disease’s effects change over time, people often need to have their treatments adjusted by the doctor, or they need to start new ones as different problems emerge”. Environmental treatments mainly ensure that nursing homes and staff are properly trained in order to correctly treat and take proper action in certain situations. In a research study performed by the Norwegian Centre for Ageing and Health along with collaborator, the Research Council of Norway, different types of treatments were administered in different nursing homes and caretaking facilities. The study confirmed that Dementia Care Mapping was the best and most effective type of environmental treatment. Dementia Care Mapping is “an observational tool that has been used in formal dementia-care settings over the past 13 years, both as an instrument for developing person- centered care practice and as a tool in quality-of-life research” (Brooker). Pharmaceutical treatments help to abolish symptoms and ease pain and increase comfort.
They are more likely to be the future of a cure rather than any other type of treatment. This is because medication only needs to be modified as there is already a basic drug and additions need to be made. On the other hand, with environmental and surgical treatments, entirely new ideas need to be created from nothing. As of 2014 it has been easier for medications to be tested than ever before. According to Gina Kolata of the New York Times, “For the first time, and to the astonishment of many of their colleagues, researchers created what they call Alzheimer’s in a Dish — a petri dish with human brain cells that develop the telltale structures of Alzheimer’s disease). Through this creation, scientists are now able to test new medicines on an exact replica of the human brain and get results quicker than ever before.
According to a co-creator of Alzheimer’s in a Dish, Dr. Tanzi, “Previously we had to test each drug individually and that took over a year to even affect the plaque methodology, and we don’t even get the tangles. And with this system we can test thousands of drugs at a time. And each tray is a plate of cells, each one has a mini brain in it, so each plate has hundreds of cells with strings in them that we can test hundreds and even thousands of drugs at a time. And we can get to the plaques and the tangles.” (R.
Tanzi, personal communication 2016). These treatments have been somewhat useful so far, yet they have not been able to cease the deterioration of the brain entirely that leads to consistent death of a patient. However, this may not be for long. In recent years, scientists have been focusing on Alzheimer’s seemingly more than ever before because of the motivation of the belief that the cure is only a few short steps away (Morris, M. & Lundell, J.
2003). From treatments, cures are developed. In 2012, scientists discovered a mutation in, “a gene that produces amyloid-? precursor protein (APP), which has an unknown role in the brain and has long been suspected to be at the heart of Alzheimer’s” (Callaway, 2012). The mutation has been commonly found in Icelanders, Swedes, Norwegians, and Finns for unknown reasons. Since discovery, scientists have been attempting to discover what amino acid sequence was replaced that caused the prevention of Alzheimer’s. So far, there has been no success, yet they are still ceaselessly searching.
A more recent discovery of a cure was revealed in March of 2015. A surgical experiment was performed that showed a seventy-five percent success rate when treating mice with Alzheimer-like symptoms. In the article that documented the experiment, it was stated that:, The team reports fully restoring the memory function of 75 percent of the mice they tested it on, with zero damage to the surrounding brain tissue. They found that the treated mice displayed improved performance in three memory tasks – a maze, a test to get them to recognise new objects, and one to get them to remember the places they should avoid (BEC Crew). Though the physical deterioration of the brain was not resolved, which has never been proven in any experiment to be able to return to full capacity, was not returned to normal, the surgical cure enabled the mice to use a different part of their brain to fulfill the same function as the part of the brain that had been deteriorated.
However, though the experiment worked on mice, nobody is sure how it will work on humans or even if there may be a negative side effect. The scientists are planning on beginning on larger animals in 2017 and progressing to humans. In research, it was found numerous times that there is only an estimated five5 years until a cure for this devastating disease is to be found. Using tactics such as Alzheimer’s in a Dish, and the surgical restoration of memory, or even ideas combined, using environmental, pharmaceutical, and surgical means, one day a cure will be found. Many ideas have been formulating and many trials are being experimented upon as to how treatments of Alzheimer’s can be revised and upgraded. Though there still is the factor that symptoms are not evident early in the disease, which prevents successful action from occurring, this could be preventable through annual brain scans.
There is something individuals can partake in in order to secure their health safety in future years to come. However if these precautions are taken and do not help, as Dr. Tanzi of the Genetics and Aging Research Unit at Massachusetts General Hospital, declares, “We hope that in the next five years there is a successful drug” (R. Tanzi, personal communication, January 14, 2016). With this, even those who do everything to prevent the disease, along with those who do not, will be able to live their wholesome lives. With continued support from scientists and the pharmaceutical, environmental, surgical treatments that have been developed upon over time, along with the increased understanding of how genetics affect the likelihood of obtaining Alzheimer’s when the hereditary gene is present, the hypothesized 16 million Americans who will be diagnosed and suffer with the disease in 2050, likely will not become a reality.
References Alzheimer disease. (2015, October 19). Retrieved October 22, 2015, from Genetics Home Reference website: http://ghr.nlm.nih.
gov/condition/alzheimer-disease Alzheimer’s disease – causes, symptoms, treatment, prevention. (2014, May 14). Retrieved December 4, 2015, from Southern Cross Medical Library website: https://www.southerncross.co.nz/AboutTheGroup/HealthResources/MedicalLibrary/tabid/178/vw/1/ItemID/90/Alzheimers-disease-causes-symptoms-treatment-prevention.
aspx BEC Crew. (2015, March 18). New Alzheimer’s Treatment Fully Restores Memory Function. Retrieved June 9, 2016, from Science Alert website: http://www.sciencealert.com/new-alzheimer-s-treatment-fully-restores-memory-function Brooker, D.
(2005). Dementia Care Mapping: A Review of the Research Literature. Retrieved December 10, 2015, from https://www.alz.org/national/documents/grnt_011_018.
pdf Callaway, E. (2012, July 11). Gene mutation defends against alzheimer’s disease. Retrieved December 10, 2015, from Nature website: http://www.nature.com/news/gene-mutation-defends-against-alzheimer-s-disease-1.
10984 Dishman, E., & Carillo, M. C. (2007). Perspective on everyday technologies for alzheimer’s care: Research findings, directions, and challenges. Retrieved October 29, 2015, from Alzheimer’s and Dementia website: https://www.
alz.org/national/documents/etac_proceedings.pdf Gene Mutation May Prevent Alzheimer’s. (2015, July 2). Retrieved January 7, 2016, from Dementia website: https://www.dementia.
org/gene-protects-against-alzheimers The genetics of alzheimer’s disease. (2012, January 1). Retrieved October 22, 2015, from National Institute on Aging website: https://www.nia.nih.
gov/alzheimers/publication/2011-2012-alzheimers-disease-progress-report/genetics-alzheimers-disease Goldstein, M. K., Gwyther, L. P., Lazaroff, A.
E., & Thal, L. J. (n.d.).
Managing early alzheimer’s disease. Student Resources in Context, 44. Kolata, G. (n.d.).
Breakthrough Replicates Human Brain Cells for Use in Alzheimer’s Research. Retrieved from New York Times website: http://www.nytimes.com/2014/10/13/science/researchers-replicate-alzheimers-brain-cells-in-a-petri-dish.html?_r=0 Landau, E.
(2005). Alzheimer’s disease: A forgotten life. Canada: SLP. Morris, M., & Lundell, J. (2003).
Ubiquitous computing for cognitive decline: Findings from intel’s proactive health research. Retrieved November 5, 2015, from Alzheimer’s Association website: http://www.alz.org/national/documents/Intel_UbiquitousComputing.pdf Ponier, A.
C. (2014, November 14). Areas of the brain affected by alzheimer’s and other dementias. Retrieved November 18, 2015, from WebMD website: http://www.webmd.com/alzheimers/areas-of-the-brain-affected-by-alzheimers-and-other-dementias Smith, G. E., & Lunde, A. M. (n.d.
). Alzheimer’s genes: Are you at risk? Retrieved October 22, 2015, from Mayo Clinic website: http://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers-gTreatments for alzheimer’s disease. (2014, August 5).
Retrieved December 10, 2015, from WebMD website: http://www.webmd.com/alzheimers/guide/treatment-overview