Identify
Upon diagnosis, United States president Ronald Reagan announced about the Alzheimer condition. On November 5, 1994, he wrote to Americans immediately commence the expedition that will bring me toward the distant horizon of my life. He dedicated the message to them. Reagan said that he and his wife, Nancy, decided to reveal his illness to raise awareness of the disease that slowly but surely robs the brain of its memories. They believe that we may help bring attention to this issue by exposing our hearts. Perhaps it will inspire a better understanding of the people and families affected by it. As recently as 2004, a decade after the incident, Reagan succumbed to the sickness. A long time later, the illness continues to be almost as deadly. In the United States, this disease is among the leading causes of death, ranking at number six. However, there is beliefs that the number of deaths could be higher.
Describe
The cerebrum does not lose neurons or bulk due to solid maturation. Damage in Alzheimer’s disease is far-reaching, as many neurons stop functioning, lose connections with other neurons and die. Correspondence, digestion, and repair are all disrupted by Alzheimer’s, affecting neurons and their groupings. The entorhinal cortex and hippocampus, two parts of the brain involved in memory, are typically obliterated by Alzheimer’s disease from the start. Neurons responsible for language and social behaviour are later affected by this process. Many different parts of the brain get damaged throughout time. Alzheimer’s patients gradually lose their ability to live and work independently over time. The illness is fatal in the long run.
The disease causes major effects among dementia patients, 100 million People will have Alzheimer’s disease (AD) by 2050, according to current projections. In Alzheimer’s disease, brain cells degenerate, eventually leading to their deterioration and eventual death. Memory, behaviour, and social skills decline as a person ages with Alzheimer’s, significantly influencing an individual’s ability to operate independently. The disease is complicated and neurodegenerative in terms of Alzheimer’s disease pathology. The plasma membrane is compromised when an amyloid pathogen cleaves the amyloid processor protein differently. While interfering with synaptic signalling, B tends to oligomerize and diffuse into the synaptic clefts (Caberlotto et al., 2019). Because of this, amyloid fibrils will form, resulting in the formation of plaques. Activation of kinases due to polymerization leads to hyperphorylation of the protein linked with microtubules.
There will be an increase in microglial activity and an inflammatory response in the area surrounding the plaques as they form, which will lead to neurotoxicity. It is possible to witness neuronal misfortune and pathology in the entorhinal cortex, amygdala, hippocampus as well as subcortical cores such as the dorsal serotonergic raphe, noradrenergic locus cerulean, and the basal cholinergic core, in addition to frontal and parietal cortices (McCance & Huether, 2018). The tangle statement affects the trans-entorhinal cortex, the CA1 district of the hippocampus, and then the cortical affiliation areas, where front-facing, parietal, and transient flaps are most impacted. Alzheimer’s disease severity is correlated more strongly with tangle density than with the number of brain amyloid plaques (Mathys et al., 2019). The development of tau proteins is closely linked to mental degeneration and decay, particularly in the hippocampus nucleus. The temporofrontal cortex of Alzheimer’s disease suffers from a deficit of neurons and deterioration, resulting in the accumulation of amyloid plaques and a tangled jumble of protein sections. Thus, there is a rise in the number of monocytes in the cerebral cortex, as well as in the number of macrophages, and this also activates microglial cells.
An amyloid-beta affidavit is responsible for the formation of decaying plaques in Alzheimer’s patients. When the amyloid precursor protein is broken down by -secretase, -secretase, and -secretase, A is released as small dissolvable peptides. Because of the paradoxical relationship between the formation of -amyloid and its subsequent release, several forms of toxic oligomeric, namely protofibrils, fibrils, and plaques, are produced. However, the organization, concentration, and steady states play an important role in explaining A’s growth. Cholinergic dysfunction, amyloid/tau poisoning, and oxidative stress/mitochondrial dysfunctions all play a role in Alzheimer’s disease’s Etiology.
Define
There are various ways in which nitrogen and oxygen reactive species are generated in the human body; they both play a role in cell flagging pathways and vicious cycles that can impair the structure of cells. High oxygen utilization in the cerebrum indicates that the mind is vulnerable to oxidative stress since it consumes 30% more oxygen than mitochondrial respiratory tissues. Many polyunsaturated lipids are found in the brain’s most basic functional unit. Its cooperation with ROS can trigger apoptosis and lipid peroxidation. One of the causes of oxidative pressure damage, which includes neurodegenerative and malignant diseases and tumour growth, is metal dyshomeostasis, which contributes to neurons’ lower glutathione levels (Fantoni et al., 2018). Progress metal homeostasis is modulated by the ionosphere and chelators, used in clinical studies. Metal-restricting mixes aren’t the only drugs capable of influencing metal homeostasis. Copper, iron, and other redox progress metals are shown to have changed harmony in the current proof. When a patient experiences an elevated amount brain toxins, this could be associated with Alzheimer disease.
Asses
Acetylcholinesterase drugs’ beneficial effects in Alzheimer’s disease patients may be affected by apolipoprotein E genotype. Treatment for Alzheimer’s disease involves acetyl-cholinesterase inhibitors, and the APOE genotype is the primary factor associated with the disease. The “Cholinergic Hypothesis” of Alzheimer’s infection, first proposed in 1976, is debunked by recognizing that cholinergic neurons are not the major target of Alzheimer’s illness. Cholinergic receptor restriction is reduced in specific areas of the brain associated with mild to moderate Alzheimer’s disease (AD). Solid, more established adults’ slower handling speed may be linked to their lower receptor restricting. In vivo cholinergic receptor restriction may reveal links to other significant mental changes associated with maturation and Alzheimer’s disease and provide a viable therapy target at the subatomic level. It has been more than two decades since medications like donepezil, which regulate acetylcholine transmitter levels by inhibiting enzymes that break down the cholinergic neurons in the forebrain regions, have served as the foundation for a possible therapy for the disease (Fantoni et al., 2018).
History
Historical Variations
In Germany, Auguste Deter starts having trouble recalling recent events. She also notices a shift in her behavior that she can’t explain, and she has a hard time talking or writing about it. Auguste, who will age 50 in 1900, is still remarkably young considering the symptoms commonly associated with dementia, a disease that is traditionally assumed to affect only the more mature adults. Auguste is sent to a facility since her side effects worsen, and she has no one to turn to for assistance. Doctor Alois Alzheimer learns about Auguste and her startling symptoms, which began remarkably young. Dr. Alzheimer conducts a series of conversations with her over the following year to learn more. The phrase “I have lost myself, to put it another way” is Auguste’s go-to response to questions she cannot answer. Similarly, Dr. Alzheimer observes this, and he is also perplexed. Auguste has a habit of referring to things by a different term. He also noted a decline in her abilities in the late evening. Auguste’s mental ability has deteriorated over the last five years at the institution, where she has received no therapy for her symptoms.
In April, she passed away. Dr. Alzheimer wants Auguste’s brain and medical records to be examined. When he examines her brain, he sees that it has shrunk in particular places, and he also notices a variety of unusual shops. Dr. Alzheimer believes that Auguste had a rare kind of dementia that affects people under 60. Furthermore, he believes the brain abnormalities he discovered in Auguste’s cerebrum are linked to her illness. His thoughts are geared toward further studies on the disease that will soon be named after him.
Psychological Stressors
This sort of dementia has been dubbed an interesting one because of Dr. Alzheimer’s discoveries. Fewer than 150 logical papers on Alzheimer’s were published between the end of the 1960s and the middle of the 1970s. But all that changes when a landmark paper is published in a scientific journal and the entire outlook on the condition is altered. An American nervous system expert, Robert Katzman, describes Alzheimer’s disease as the sixth most cause of mortality in the United States after coronary artery disease, malignant growth, and stroke and a huge global health concern. Because to Katzman’s work, Alzheimer’s is no longer seen as a rare disease that only affects a small number of people.
Because of Katzman’s book, organizations have been formed worldwide to generate funds for Alzheimer’s research and increase awareness of those affected by Alzheimer’s disease and their parents. More than 50,000 publications on Alzheimer’s have been published since then, exploring the disease’s causes, effects, and potential treatments. Alzheimer’s and other dementias have not been cured, but four drugs that can delay mental degeneration have been tested and recommended, and additional research is ongoing. In addition, more effort is being made to improve the personal well-being of Alzheimer’s patients.
Psychological Mechanisms
In Canada, there are steps to improve our medical care system so that people with Alzheimer’s disease, their caregivers, and their families may rely on it more easily. Auguste and many others were placed in harsh conditions with no possible regard or support, as was done with Auguste and many others. This hurts their happiness and the stigma associated with dementia. Instead of relying on organizations, we provide long-term care for Alzheimer’s patients in the latter stages of the disease so that they can live peacefully. If Auguste had seen a specialist today, she would have been diagnosed with young-onset Alzheimer’s and would have access to resources and support that might help her fight against mental decline. Researchers, donors, and supporters worldwide are working tirelessly to find a cure for the disease.
People with the disease have difficulty recalling recent events and discussions. Repeating comments and inquiries, forgetting appointments, and reciting the same things over and over again are all signs of a mental illness. The patient frequently misplaces items and places them in irrational locations. Forgetting family members’ names and items and finding the correct phrases are some of the difficulties they are experiencing (Belonwu et al., 2022). The patient has trouble focusing and can’t do more than one thing at a time.
Historical Impacts
Alzheimer’s patients are more likely to experience personality changes such as apathy, sadness, and social disengagement. An Alzheimer’s disease diagnosis includes numerous procedures, including magnetic resonance imaging (MRI) that uses radio and magnets waves to obtain an image of the brain. Plaques in the brain damaged by Alzheimer’s disease can be seen using positron emission tomography (Vargas et al., 2018). Medications slow its progression, but no cure has been found, in the early disease stages. Because there is no approved treatment for the illness, the choice would be to wait and see and examine the use of acetylcholinesterase inhibitors as an off-label treatment.
Planning Care
Goal Statement
As part of the nursing admission examination, nurses are tasked with looking for signs of dementia in senior patients. The goal of dementia treatment is to keep people as functional and self-sufficient as possible for the longest time possible. The patient’s safety, self-care independence, decreasing anxiety and agitation, improving communication, providing closeness and intimacy with others, correct nutrition, and assisting and teaching family caregivers are critical goals. The patient’s psychological and emotional health will be preserved for as long as possible, and any undesirable behaviour will be reversed. Family members will demonstrate an understanding of the care required, appropriate coping techniques, and the utilization of community resources.
The patient’s functional capacity will be raised to its optimal level if necessary adjustments are made to his environment to make up for any shortcomings. Analyse the patient’s overall mental abilities, including concentrating and recalling information. Cognitive evaluation techniques can determine a patient’s level of cognitive function.
Nursing Concerns
Results from the evaluation are used for further investigation and as a basis for therapy. For example, the patient may be suffering from sensory deprivation, the concomitant use of CNS medicines, or other concurrent health issues. Disorientation and a change in mental state may occur due to taking this drug. Complete person-centred evaluations regularly and timely interim assessments. At the absolute least, assessments should be conducted every four months to reveal issues that will help the person with dementia live a complete life (Arranz & De Strooper, 2019).
Short-term memory is presumed to be intact. As necessary, help the patient become familiar with their surroundings. Various media, such as calendars and television, are permissible. Only those suffering from delirium or depression-induced disorientation can benefit from reality orientation techniques, which help them become more aware of their surroundings and themselves. According to the stage of the illness, it may be reassuring to patients in the early stages of Alzheimer’s who are concerned about losing their sense of reality. Nevertheless, when dementia is irreversible, patients cannot grasp the reality around them. The actuality of television and radio broadcasts can be overstimulating, irritating, and unsettling for those unable to distinguish between reality and fiction or what they see on TV. Using a calendar or creating a to-do list is a good idea. In some cases, patients may benefit from receiving written reminders to help them remember certain tasks. Encourage non-conventional treatments, including massage, guided meditation, and physical activity. Stress can exacerbate memory loss, so these activities can help alleviate it. Set up a medicine cabinet for the customer. Having a medication box on hand might make it easier to remember to take their prescriptions on time and restock the box.
For those with Alzheimer’s disease who are eligible for treatment with aducanumab, it may not be the best option for everyone (Barupal et al., 2019). Dementia-related agitation, aggressiveness, depression, and psychosis are the most prevalent causes of assisted living or nursing facility placement. In addition to lowering the cost of caring for these people, early identification and treatment can significantly improve the quality of life for both the patient and the caregiver. Effective treatment for patients with Alzheimer’s disease should include regular evaluations to ensure they are progressing as expected. Regular visits allow treatment choices to be customized to the present demands because dementia’s behavioral and cognitive symptoms alter as the disease progresses. To ensure that your history is as accurate as possible, you should attend all visits with someone, not a family member, friend, or caregiver who is not suffering from dementia.
Patient care Technologies
A patients may be using memory booster supplements, alternative treatments, or preventative food and vitamins. The use of these medications instead of or in addition to those recommended by a doctor is fraught with danger. Doctor-prescribed therapy is preferred; however, there are severe concerns about using these drugs instead of or in addition to that treatment. Supplements’ purity and efficacy are both under question, as are their safety and efficacy. There is no systematic tracking of adverse reactions or interactions between prescription medications and dietary supplements.
Dementia symptoms can be alleviated by using the following drugs. Cholinesterase inhibitors. A chemical messenger critical to memory and judgment is elevated by these medications, including rivastigmine, donepezil, and galantamine (Vargas et al., 2018). In addition to treating Alzheimer’s disease, these medications may also be used to treat vascular dementia, Lewy-bodies degenerative dementia, and Parkinson’s disease dementia. Side effects include vomiting, diarrhoea, and nausea. Reduced heart rate, dizziness, and sleep disturbances are other possible side effects. Memantine. Glutamate is another key chemical messenger in brain processes such as learning and memory, and memantine controls glutamate activity. A cholinesterase inhibitor may be used in conjunction with memantine. Memantine is known to cause dizziness as a side effect.
Intervention
Appropriate Nursing Interventions
Scientists have learned a great deal about the pathophysiology of Alzheimer’s disease. There has never been an FDA-approved medication that addresses the illness as Aducanumab will in June 2021, which has been awarded expedited approval and is expected to be widely available. “Breakthrough Therapy” designations have been given to donanemab and lecanemab as anti-amyloid medicines for the disease (Rossini et al., 2020). This stage aims to expedite the review and development of new drugs for life-threatening illnesses. According to a preliminary study, the drug “may exhibit considerable improvement over conventional therapy.” Even though the FDA has not approved these additional drugs, this categorization underscores the scientific justification of exploring this treatment option further.
Common Medication Classes
Technology plays an important role in nursing education and practice in today’s changing healthcare systems. According to this piece, masters-level nurses require a better understanding of Alzheimer’s disease and the best ways to reduce its mortality rate and its negative impacts on patients’ quality of life (Arranz & De Strooper, 2019). The facts presented in this essay are quite insightful about the need for fundamental changes in the US healthcare system. Nurses’ education will also have to adapt before and after receiving their licenses.
Patient Care Technologies
Treatment objectives remain the same; nevertheless, nurses should be prepared to address the diverse demands of patients, serve as leaders and promote the research that will benefit clients and the capacity of healthcare professionals in delivering safer, better care services. To make matters worse, some of the article’s misinformation suggests that moderate cognitive deficits can be a precursor to early-onset dementia. The definition of MCI appears to be rather variable since people with the illness have a better probability of being stable despite the higher risk of dementia (Wan et al., 2020). Patients with Alzheimer’s disease should take extra precautions to keep themselves secure at home, as well. This includes checking for possible dangers in healthcare facilities and making notes on what improvements are needed. In contrast to modifying the client’s behaviour, making the environment more accommodating and less hazardous for the patients is crucial. As dementia advances, a detailed safety plan must be in place for everyone’s sake. Improving safety will reduce the number of fatalities and give Alzheimer’s patients a sense of calm and security and help them maintain their independence.
Evaluation
Determining Success Measures
Evaluation determines whether or not the limitations of the previous care planning system have been addressed by the Nursing Care Plan system and its effectiveness and adequacy. The evaluation includes user feedback, care standards, nurse order sets, and computer objectives. There are various ways to collect data, including focus groups with super users, surveys for all Nursing Care Plan users, and interviews with staff by their managers. Focus groups will evaluate the Nursing Care Plan system’s components.
Potential of Success
The Nursing Care Plan system is evaluated using the rating scales in the paper and pencil questionnaire. Unit managers will conduct interviews with potential new hires using the same worklists to deliver customer support. This new care planning system will use structured staff questionnaires to determine whether or not the existing worklist constraints have been eliminated. Several data-gathering waves will commence following the go-live date. To sum up, the care strategy detailed here is highly likely to be tremendously successful. This is due to extensive medical research and case studies providing important background information for Alzheimer’s disease management. Further research is expected, though.
References
Arranz, A. M., & De Strooper, B. (2019). The role of astroglia in Alzheimer’s disease: pathophysiology and clinical implications. The Lancet Neurology, 18(4), 406-414. https://doi.org/10.1016/S1474-4422(18)30490-3
Barupal, D. K., Baillie, R., Fan, S., Saykin, A. J., Meikle, P. J., Arnold, M., … & Alzheimer
Disease Metabolomics Consortium. (2019). Sets of coregulated serum lipids are associated with Alzheimer’s disease pathophysiology. Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring, 11, 619-627. https://doi.org/10.1016/j.dadm.2019.07.002
Belonwu, S. A., Li, Y., Bunis, D., Rao, A. A., Solsberg, C. W., Tang, A., … & Sirota, M. (2022). Sex-stratified single-cell rna-seq analysis identifies sex-specific and cell type-specific transcriptional responses in Alzheimer’s disease across two brain regions. Molecular neurobiology, 59(1), 276-293. https://doi.org/10.1007/s12035-021-02591-8
Caberlotto, L., Nguyen, T., Lauria, M., Priami, C., Rimondini, R., Maioli, S., … & Carboni, L.(2019). Cross-disease analysis of Alzheimer’s disease and type-2 Diabetes highlights the role of autophagy in the pathophysiology of two highly comorbid diseases. Scientific reports, 9(1), 1-13. https://doi.org/10.1038/s41598-019-39828-5
Fantoni, E. R., Chalkidou, A., O’Brien, J. T., Farrar, G., & Hammers, A. (2018). A systematic review and aggregated analysis on the impact of amyloid PET brain imaging on the diagnosis, diagnostic confidence, and management of patients being evaluated for Alzheimer’s disease. Journal of Alzheimer’s Disease, 63(2), 783-796. 10.3233/JAD-171093
Mathys, H., Davila-Velderrain, J., Peng, Z., Gao, F., Mohammadi, S., Young, J. Z., … & Tsai, L.H. (2019). Single-cell transcriptomic analysis of Alzheimer’s disease. Nature, 570(7761), 332-337. https://doi.org/10.1038/s41586-019-1195-2
McCance, K. L., & Huether, S. E. (2018). Pathophysiology-E-book: the biologic basis for disease in adults and children. Elsevier Health Sciences.
Rossini, P. M., Di Iorio, R., Vecchio, F., Anfossi, M., Babiloni, C., Bozzali, M., … & Dubois, B. (2020). Early diagnosis of Alzheimer’s disease: the role of biomarkers including advanced EEG signal analysis. Report from the IFCN-sponsored panel of experts. Clinical Neurophysiology, 131(6), 1287-1310. https://doi.org/10.1016/j.clinph.2020.03.003
Vargas, D. M. D., De Bastiani, M. A., Zimmer, E. R., & Klamt, F. (2018). Alzheimer’s disease master regulators analysis: search for potential molecular targets and drug repositioning candidates. Alzheimer’s research & therapy, 10(1), 1-12. https://doi.org/10.1186/s13195-018-0394-7
Wan, Y. W., Al-Ouran, R., Mangleburg, C. G., Perumal, T. M., Lee, T. V., Allison, K., … &
Logsdon, B. A. (2020). Meta-analysis of the Alzheimer’s disease human brain transcriptome and functional dissection in mouse models. Cell reports, 32(2), 107908. https://doi.org/10.1016/j.celrep.2020.107908
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