Psychology Degree Guide: Alzheimer’s
For most people, forgetfulness is a normal part of the aging process. Difficulties such as remembering appointments, recalling words and even misplacing car keys are not particularly uncommon. Alzheimer’s disease is not a normal part of the aging process. Forgetfulness classified as “senility” and the symptoms of Alzheimer’s may appear to be similar, but are in fact quite different. Alzheimer’s is a one type of dementia, a disorder affecting memory and brain function. This resource will broadly cover the basic aspects of Alzheimer’s as defined by the psychiatric symptoms outlined in the Diagnostic and Statistical Manual of Mental Disorders, IV (DSM-IV) published by the American Psychiatric Association and provide resources for further research for individuals unfamiliar with Alzheimer’s such as students planning on entering a health profession, patients diagnosed with Alzheimer’s, their loved ones and caregivers.
Overview of Alzheimer’s
Alzheimer’s has been referred to rather casually as “old-timer’s” as if the disorder itself was tantamount to aging. However, the onset of Alzheimer’s does not indicate that a person is merely getting along in years as this would suggest, but is rather facing a debilitating disease that will rob the person of their brain function. The disease is ultimately fatal and causes specific damage to the brain tissue. Evidence of this disease is indicated by the neurofibrillary tangles, and amyloid (neuritic and senile) plaques, which can only be ascertained during an autopsy. Because of this, diagnostic procedure is primarily evaluating behaviors consistent with symptoms in the DSM-IV. Other diagnostic tests are routinely performed to rule out other possible causes of dementia, such as vitamin deficiencies, anemia, thyroid disease, chronic infections, brain tumor or stroke.
Typical early symptoms include lapses in memory that are more significant than forgetting names or losing personal items. Normal forgetfulness may include not remembering an appointment but recalling the appointment at a later time, while a person with Alzheimer’s disease will forget the appointment but not remember it later. A person with Alzheimer’s may put routinely used items in odd places. A person with Alzheimer’s may forget the names of loved ones altogether and may be unable to identify objects or possessions by name. In a person with Alzheimer’s, the symptoms do not abate but become increasingly worse. Other symptoms may include becoming disoriented and confused, difficulty thinking abstractly and participating in conversations. Making decisions may become difficult, and normal everyday events such as cooking meals or running errands become overwhelming. Persons with Alzheimer’s may experience personality changes, depression, and withdraw from normal social interactions.
More General Information
- The American Psychological Association describes Alzheimer’s, offers information about current research and news, tips for self-care, recommended reading and related topics.
- The National Institute of Aging and Alzheimer’s Disease Education & Referral Center provide a Fact Sheet for patients and caregivers.
History
In the early 1900s, German physician Dr. Alois Alzheimer was caring for a patient that exhibited symptoms such as memory loss, bizarre behavior and language deficits. When performing the autopsy after her death in 1906, he found clusters in the brain later identified as neurofibrillary tangles and amyloid plaques, which are the characteristic indicators of Alzheimer’s. Dr. Emil Kraeplin, a German psychiatrist, coined the term Alzheimer’s disease in his book, Handbook of Psychiatry, the precursor to the modern diagnostic manual currently employed by psychiatrists and psychologists, the DSM-IV.
Diagnosis
The Alzheimer’s Association, a non-profit organization dedicated to finding a cure for Alzheimer’s provides a list of ten warning signs of the disease. The diagnostic procedure for Alzheimer’s includes an informal evaluation for typical warning signs to determine if further testing is necessary. Alzheimer’s may be diagnosed by a psychologist, psychiatrist or neurologist, but the primary care physician may also provide a diagnosis and treatment for Alzheimer’s.
Some of the symptoms a health professional will look for in the DSM-IV are aphasia, apraxia and agnosia. Aphasia is difficulty with language and loss of words. Apraxia is disturbance in motor skills, the inability to perform tasks that are understood the person would like to do. Agnosia is the inability to recognize people or objects. A physician will also review medical history, family history, and evaluate if current medications, other disorders or diseases or drug or alcohol abuse are causing symptoms consistent with Alzheimer’s.
Causes
There is no known cause for Alzheimer’s. It is believed to be a genetic disorder, but external factors such as lifestyle choices and environment are also considered as possible contributors. Onset of the disease is typically after age 60, but early-onset Alzheimer’s can have symptoms as early as age 30. Approximately 5% of all cases of Alzheimer’s are early-onset.
Higher risk factors include advanced age, a history of traumatic head injury, and the apolipoprotien E (apoE) gene. Some studies suggest that women are more likely to get Alzheimer’s than men, but research is inconclusive.
Treatment Options
There is no known cure for Alzheimer’s. Treatment options are focused on improving the quality of life of the patient and slowing the progression of the disease. Medications such as antidepressants, anxiolytics (anti-anxiety drugs) and antipsychotics may be used to alleviate symptoms of depression, anxiety and hallucinations associated with the disease. Antipsychotics, however, are connected with an increased death rate in elderly patients with dementia.
Alternative and complementary treatments include non-medicinal therapies such as Vitamin E (which can interact with some medications), sensory therapies such as music and art classes to boost mood, alternative medicine such as diet, dietary supplements, and exercise, and hormone replacement therapy.
Patients with Alzheimer’s may experience behavior difficulties, including wandering off, becoming agitated and changes in temperament. Medications may be prescribed to help minimize some of these issues. The disorientation and confusion commonly experienced by patients may result in agitation. Tests may need to be conducted to identify any other possible causes of agitation.
Caring for Patients with Alzheimer’s (For Patients and Families)
Caregivers will need to organize their homes and schedules to ensure the safety of the patient. Part of this planning may include considering an assisted living facility or nursing home for full-time care.
Caregivers must make certain that they take care of themselves, as well. Caring for an ailing loved one can be particularly exhausting and stressful. Take appropriate measures to get enough rest, seek support from others, and get regular exercise and time away to get refreshed.
Research
Organizations such as American Health Assistance Foundation, Johns Hopkins Alzheimer’s Disease Research Center, and the Alzheimer’s Association are committed to conducting research to slow the progression of Alzheimer’s and find a cure. Free online courses are available to learn more about the disease for non-professionals.
Medications have been developed to improve symptoms of Alzheimer’s, but no medications currently treat underlying issues. Therapies currently being researched are the blockage of amyloid plaques by inhibiting the growth of the protein compound, inhibiting the tangling of the tau protein and anti-inflammatory treatment.
Scientists are researching the possible link between Alzheimer’s and the way insulin is processed in the body. Scientists are also working to find ways to identify Alzheimer’s through brain imaging and biomarkers so that the disease may be diagnosed sooner, providing more options for treatment and the prevention of progression.
More Information and Publications
- Psychology Today provides information about Alzheimer’s, including symptoms, causes and treatment option. Related articles from a psychological perspective, a search option for finding a psychologist in your area and other the latest news is available.
- The Journal of Alzheimer’s Disease is a multi-disciplinary journal dedicated to research and information associated with Alzheimer’s. Reports on research, book reviews, reader letters are the types of material in this journal.
- The article from Science Daily Vitamin D, Curcumin May Clear Amyloid Plaques discusses research from University of California Los Angeles (UCLA) that shows some vitamin D and curcumin (from turmeric) may break up amyloid plaques.
- Alzheimer’s Research & Prevention Foundation (ARPF) is dedicated to the research, prevention and treatment of Alzheimer’s through holistic medicine. Ground-breaking information has been published in medical journals.
