What is Alzheimer’s disease

What is Alzheimer’s disease?

Alzheimer’s disease is a brain disorder that progresses as time elapses. It is the most prevalent cause of dementia, which is a broad term for the loss of memory and thinking capabilities. Alzheimer’s disease’s accounts for about 60 to 80 percent of patients found with dementia (Porsteinsson et al., 2021)

A “Protein Problem”

Physicians refer to it as a proteinopathy. This is a fancy way of saying there is a problem with proteins in the brain. In a normal brain, the cells work with the help of proteins. The proteins in Alzheimer’s disease misfold (take the wrong shape) and accumulate in the brain like rubbish that hasn’t been collected. This garbage later kills the brain cells.

How it affects the Mind

The disease passes through the brain in a specific direction, altering the way in which an individual behaves:

• Recent Memory Loss: The earliest sign is usually this. One may fail to remember having breakfast or even a conversation. This occurs because the illness begins in the part of the brain that forms new memories (the hippocampus).
• Difficulty Planning: It becomes a struggle to accomplish tasks with several steps that are spread out, whether it involves following a recipe or paying the bills. (Srivastava, Ahmad and Khare, 2021)

The “Three A’s”:

• Aphasia: The inability to find the correct words to use or to comprehend what other people are saying.
• Apraxia: The inability to remember how to perform physical activity, such as how to button a shirt or use a fork, although the hands are perfectly aviated.
• Agnosia: the inability to recognize objects or faces of family members.

1. Why Does it Happen? (The Causes)

Scientists assume that Alzheimer’s disease occurs due to a brain chain reaction.

• The Sticky Plaque (Amyloid-Beta).

Amyloid is a protein secreted by the brain. In a normal brain, these are removed. They become sticky, forming clumps that form plaques in Alzheimer’s disease. These plaques are placed between brain cells and prevent them from communicating. An example of this is a tree falling across a busy road the traffic signals cannot pass (Ghosh, Narang and Iyer, 2024)

• The Beginning Of The Drunkard Sadist (Tau Tangles).

Tau is a protein located within the brain cells. Imagine Tau to be the wooden stanchions of a railroad. Food and energy are brought to the cell by these tracks. Tau in Alzheimer’s disease forms tangles. When that occurs, the tracks disintegrate. The lack of the tracks results in the starvation and death of the brain cells.

• Brain Swelling (Neuroinflammation)

Microglia are the brain’s cleanup crew. These are the cells that attempt to devour the plaques and tangles. However, due to the high rate of trash, the cleanup crew is overwhelmed and begins destroying healthy cells in close proximity. This is called inflammation.(Sun, Koyama and Shimada, 2022)

The Family History (Genetics) Role.

• Onset in Early Years (Younger Person): This is uncommon and often occurs in the family. When a parent possesses a known broken gene, there is virtually no doubt the child will develop the disease, and at a relatively early age, in their 40s or 50s.
• Late -Onset (Older People): This is the most prevalent. It is associated with the APOE-4 gene. Getting this gene will not automatically make a person get Alzheimer’s disease, but the possibility of it is much greater since this gene does not do very well at ridding the brain of the so-called sticky plaques.(Gunes and Esteves, 2020)

1. How is it treated? (Medicine and Care)

As much as we cannot prevent the disease entirely, at least you see, we want to help people remain independent and comfortable, unless we cannot.

The Main Medicines

• Memory Helpers (Donepezil): When the brain is compared to a computer, it is equivalent to the message runners (chemicals) that relay information between cells. It is a medicine that inhibits the regular cleaning crew that typically destroys them, allowing the runners to stay around and enabling brain cells to communicate more efficiently.(Andersson and Stone, 2023)
• Brain Shields (Meantime): In cases where brain cells are diseased, the cells leak a chemical that signals the other cells to react too much. This screaming can, in fact, freeze and kill healthy cells. This drug is an earplug, as it shields healthy cells from becoming congested and burning up.
• Plaque Cleaners (Lecanemab): This is another relatively new treatment. It functions as a magnet that enters the brain to remove the so-called sticky trash (plaques) discussed above. It is mainly applicable to individuals at extremely early stages of the disease.

• Lifestyle and Prevention

Physicians have discovered that the heart and the head should be right. Blood pressure management, social life, and even hearing aids can help keep the brain active and delay decline.

1. A Real-Life Example: Mrs. J

The Situation: Mrs. J is 78. She began to lose her way around known avenues. In the evening, she becomes furious and disoriented (so-called sundowning). Even physically, she can move, but she has forgotten how to take a shower (this is referred to as apraxia).

• The 4-Part Care Plan (Bio psychosocial-Spiritual)

Biological (The Body)

• Test Infection: If Mrs. J suddenly worsens significantly, it may not be Alzheimer’s. Even a simple infection of the bladder (UTI) can render an elderly individual extremely disoriented.
• Sunlight and Sleep: The family ensures she gets morning sunlight to avoid being disturbed at night. This helps her brain understand what daytime is and when to go to sleep.

Psychological (The Mind)

• Don’t Argue (Validation): When Mrs. J requests information about her mother (who died many years earlier), the family does not argue and says she is mistaken. They say instead, You must miss her. Tell me a story about her.” This keeps her calm and happy.
• Success Tasks: They do not require her to do anything complicated and provide tasks she cannot go wrong with to avoid frustration.

Social (The Environment)

• Safety First: They install grab bars in the bathroom. They also removed the patterned carpets since she could see that a dark pattern would be mistaken for a hole in the floor.
• Support to the Family: Her daughter is hired to a support group. When the daughter is overwrought or overburdened, she has difficulty looking after Mrs. J.

Spiritual (The Soul)

• Comfort Habits: Mrs. J may not know the name of anyone, but she already knows the lyrics of the old songs or prayers she knows best. When she does these things, she is peaceful.
• Respecting the Person: The family ensures that everyone addresses her with respect. They do not forget that she is a retired librarian, well-informed, not a patient. This makes her dignity alive even when her memory fails.

1. Substance Use Disorder: Alcohol Use Disorder (AUD).

What is it?

Alcohol Use Disorder is not simply drinking in excess. It is a brain disease under which an individual fails to quit drinking even though it is damaging his or her health, his or her job, or his or her family. The addiction is caused by the brain relying on Alcohol only to feel normal.(Kranzler, 2023)

The Alcoholic Effects on the Brain.

The brain is like a see-saw. It attempts to maintain a balance between excitement and calm.

• The “Slow Down” Chemical (GABA): Alcohol causes the calming chemical in the brain to have an overtime working effect. This is the reason why individuals feel calm or sleepy when they consume Alcohol.
• The Speed Up Chemical (Glutamate): To counteract the Alcohol, the brain begins producing additional speed-up chemicals to keep the individual awake.(Koob, 2024)
• The Issue: With time, the brain gets accustomed to Alcohol. When the individual takes a break, the elements of the speed up become uncontrollable since no alcohol is present to restrain them. It is what brings about the shakes, anxiety, and sweating (withdrawal).
• The Reward Centre: Dopamine, the feel-good chemical, is also flooded in the brain due to Alcohol. The brain eventually gets used to forgetting how to be happy with normal things, such as food or hobbies, and it just desires Alcohol.

Ordinary reasons (Why does it happen?)

No one develops a drinking problem for one reason. It is usually a combination of three:

• Family History (Genetics): The risk of addiction is also transferable, as is the case with eye colour. Some people have brains that are naturally more responsive to the feel-good effects of Alcohol.
• Life Stress and Trauma: Alcohol has been used as a way of self-medication by many people. They may take Alcohol to suppress the memory of a sad event or to prevent nervousness.
• The Environment: In case a person is brought up in the environment of excessive drinking, or occupies a stressful job, he or she is inclined to begin to use Alcohol as a soothing agent.

How is it treated? (Medicine and Care)

It aims at assisting the brain become stable without Alcohol.

• Safe Detox: Since the speed-up drugs are themselves hazardous when one quits the habit, the doctor prescribes medicine (such as Valium) to keep the patient calm and prevent withdrawal.(Mannes et al., 2021)
• Anti-Craving Pills (Naltrexone): The medication prevents the high feeling of Alcohol. When the individual takes Alcohol, they do not experience the joyful feeling, and this helps them stop the habit.
• Brain Balancers (Acamprosate): This helps balance the see-saw mentioned above, and the brain is not as paranoid, at least in the initial few months of being sober.
• Vitamins: Prolonged consumption prevents the intake of Vitamin B1 by the body. This is administered by high doses to prevent brain damage permanently, as prescribed by doctors.

Clinical Example: Mr. T

The Case: Mr. T is 45 and was employed in construction. He lost his job after being injured in the back and began drinking 10-12 drinks per day to be numb and forget the pain. He reveals that he wants to quit, but he gets shaky and becomes terrified upon attempts.

The 4-Part Care Plan (Biopsychosocial-Spiritual).

Biological (The Body)

• Medical Detox: Mr. T is admitted to a clinic where he spends 5 days of his life to allow doctors to check his heart momentarily and provide him with medicine to suppress the shakes.
• Vitamin Support: He receives vitamins in the form of B-Complex to support his nerves and brain.

Psychological (The Mind)

• Learning New Skills (CBT): A therapist makes Mr. T understand that he is drinking when he believes that he feels bored or useless. They show him how to deal with those feelings without a bottle. (Knopp et al., 2023)
• Developing Motivation: The doctor asks him what he misses about his life before drinking (being a good dad), rather than telling him he is bad. This helps him want to change.

Social (The Environment)

• A New Group: Mr. T would be motivated to join a group such as Alcoholics Anonymous (AA), as all his friends at the pub attend the drinking joints. This is where he finds individuals who know what he is going through.
• Job Help: A social worker assists him in finding a different kind of work that will not damage his back, and in this way, he becomes productive once again.

Spiritual (The Soul)

• Finding Meaning: Mr. T experiences a lot of shame. The process of spiritual care helps him forgive himself.
• Higher Connexion: It could be religion, or nature, or the simple power of the group, but he gets to know that he does not have to be alone in his burden. This offers him hope in challenging times.
• Reference
• Andersson, M.J. and Stone, J. (2023) ‘Best Medicine for Dementia: The Life-Long Defense of the Brain,’ Journal of Alzheimer S Disease, 94(1), pp. 51–66. https://doi.org/10.3233/jad-230429.
• Ghosh, P., Narang, K. and Iyer, P.K. (2024) ‘Role of amyloid beta in neurodegeneration and therapeutic strategies for neuroprotection,’ Methods in Molecular Biology, 2761, pp. 337–354. https://doi.org/10.1007/978-1-0716-3662-6_25.
• Gunes, S. and Esteves, S.C. (2020) ‘Role of genetics and epigenetics in male infertility,’ Andrologia, 53(1), p. e13586. https://doi.org/10.1111/and.13586.
• Knopp, M. et al. (2023) ‘Affective and cognitive Theory of Mind in patients with alcohol use disorder: Associations with symptoms of depression, anxiety, and somatization,’ Journal of Substance Use and Addiction Treatment, 157, p. 209227. https://doi.org/10.1016/j.josat.2023.209227.
• Koob, G.F. (2024) ‘Alcohol Use Disorder Treatment: Problems and solutions,’ The Annual Review of Pharmacology and Toxicology, 64(1), pp. 255–275. https://doi.org/10.1146/annurev-pharmtox-031323-115847.
• Kranzler, H.R. (2023) ‘Overview of alcohol use disorder,’ American Journal of Psychiatry, 180(8), pp. 565–572. https://doi.org/10.1176/appi.ajp.20230488.
• Mannes, Z.L. et al. (2021) ‘Correlates of mild, moderate, and severe Alcohol Use Disorder among adults with problem substance use: Validity implications for DSM‐5,’ Alcoholism Clinical and Experimental Research, 45(10), pp. 2118–2129. https://doi.org/10.1111/acer.14701.
• Porsteinsson, A.P. et al. (2021) ‘Diagnosis of Early Alzheimer’s Disease: Clinical Practice in 2021,’ The Journal of Prevention of Alzheimer S Disease, 8(3), pp. 371–386. https://doi.org/10.14283/jpad.2021.23.
• Srivastava, S., Ahmad, R. and Khare, S.K. (2021) ‘Alzheimer’s disease and its treatment by different approaches: A review,’ European Journal of Medicinal Chemistry, 216, p. 113320. https://doi.org/10.1016/j.ejmech.2021.113320.
• Sun, Y., Koyama, Y. and Shimada, S. (2022) ‘Inflammation from peripheral organs to the brain: How does systemic inflammation cause neuroinflammation?,’ Frontiers in Aging Neuroscience, 14, p. 903455. https://doi.org/10.3389/fnagi.2022.903455.