Learning and Memory Disorder, Alzheimer’s Disease
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Learning and Memory Disorder-Alzheimer’s Disease (AD)
Memory is defined as the recording, retaining and the ability to recover the information that has been earned from experience, ranging from facts, occasions that can easily be traced and skills that can be put into practice. Learning refers to a reasonably irreversible transformation in behaviour due to diverse experience. Memory Loss occurs as a result of injury to neuroanatomical structures that deters its normal way of functioning, how is stores, remembers and recall of memories. Learning and memory disorders can be progressive or instant. Alzheimer’s disease is one of the memory and learning disorder that has Impacted several people around the world.
Alzheimer’s Disease
This is a neurological disorder that is progressive, deteriorating and lethal to the brain cells. This disorder can cause memory loss and decline in cognitive response. It slowly destroys the brain cells, which in turn ruin and impair the memory, ability to think as well as the capability to handle and complete simple assignments (Kessels, Remmerswaal, & Wilson, 2011).
It is named after medical personnel called Dr Alois Alzheimer, who first recognized and identified its symptoms from one of the patients who succumb to mental illness, he observed alterations in her brain tissue followed by poor memory, difficulty in speaking and questionable behaviour. The patient was later examined, and they discover abnormal masses referred to as amyloid plaques with neurofibrillary.
This disorder results when the plaque is comprising of beta-amyloid form in the brain, as symptoms persist, the persons affected will be experiencing difficulty in remembering current occurrences, poor reasoning ability and they cannot identify people they usually know. The development of Alzheimer’s disorder can be categorized into three stages; preclinical, when symptoms have not been noticed, mild cognitive damage, the symptoms are minor, dementia; the last stages when symptoms are noticeable. This disease is a common form of dementia.
Symptoms of Alzheimer’s Disease
First, amongst the early symptoms of Alzheimer’s is having a problem in remembering recently learned information like the dialogue, people’s identity and occasions. Secondly, some people may develop an observable change in their character, inability to see any problems in expressing themselves well. Thirdly, Alzheimer’s people tend to get lost in places well known to them, and they cannot figure around the direction. Fourth, they are also unable to identify the correct words to name objects, expressing how they are feeling or engaging in a conversation. Lastly, these patients are unable to accomplish a certain simple task like cooking or washing.
Diagnosis
To diagnose Alzheimer’s disease, specialists carry out tests to evaluate memory impairment that encompasses cognitive skills, ability to think, check out of functional potentials, and ascertain any change in behaviour, evaluate the immediate results of poor thinking concerning day to day life, check whether the person displays any noticeable change in personality or character. Medical personnel can also examine the major causes of the symptoms depicted by a person with Alzheimer disorder. Brain imaging can also be conducted to know any internal complication, and this enables the doctor to subtract other conditions that might possess similar symptoms. This method of diagnosis is useful in ruling out other causes like haemorrhages, tumours in the brain and strokes, the ability to differentiate the diverse kinds of degenerative brain ailments ( Perry, 2012).
In blood tests method, a blood sample is collected from a patient, and further laboratory test is done to rule out any other underlying condition. Lumbar puncture is done by inserting a tiny needle at the lumbar spine, and the fluid collected s then taken for further analysis. In the urinalysis method, Urine samples are taken to the laboratory to analyze the presence of several cells and chemicals like the excess proteins and white blood cells. Electroencephalogram (EEG) is a method that typically monitors the progressive electrical activity by the use of electrodes found on the surface of the scalp. The most commonly used technologies in brain imaging include the following; Magnetic resonance imaging (MRI); This method employs the use of powerful radio waves combined with magnets to establish a wide and fine view of the brain. The other method is Computerized tomography (CT) that maximizes the use of X-ray to achieve cross-sectional imageries of the brain. Finally, positron emission tomography (PET) scans and exploits the use of radioactive material called a tracer to identify elements. The early signs and symptoms of this disorders vary from mild to severe, and they include, memory loss, experiencing difficulty in focusing, planning coupled with poor management skills, unable to complete assigned tasks on time, problems when it comes to expressing oneself, sudden variation in moods like depression.
Review of the Research
In the year 2008, Alzheimer’s disorder was declared as a significant condition that has greatly affected a larger population of the older people by the World Health Organization (WHO). This disorder accounts for 60 -80% among the older generation, globally, 10% of the population with the age of 65years and below have been diagnosed with this condition. This disorder is more prevalent amongst women men due to extensive life expectancy. In 2018, the number of people with this disorder was estimated to be around 35.6 million and is likely to double up after every ten years. According to Goldsmith (2018), the overall number of people with this disorder yearly stands at 7.7 million worldwide, indicating that in every five seconds, there is one new case. The number of people with this disorder will tend to rise as the population tends to increase if we are still unable to get its cure or drug of prevention. According to Bucciarelli (2015), students with Alzheimer’s disorder have not gone past secondary education; this resulted from them having poor memory hence difficulty in grasping the content being taught in school.
Significantly,70% of people with down syndrome have a higher chance of developing this disorder, and this is because they have three copies of chromosome 21 that will generate beta-amyloid when combined with the three genes of proteins that they have. Scientists have found that this disorder is passing on from one generation to the next, meaning it is inherited. Considering the above data; there is a greater need for taking appropriate and urgent actions before the condition worsens. This disorder is threatening a larger population and the health sector. According to the World Health Organization, the cost of treating and taking of people with Alzheimer’s condition is significantly higher. It has roughly cost the world around S$ 604 billion yearly.
Causes and Risk Factors
Alzheimer’s disease is activated by a couple of factors including genetics, existing environmental conditions and our way of living (lifestyle) that gradually affects how a brain functions. Ageing is among the risk factors as the early signs of Alzheimer’s disease are easily notice when a person is approaching 60 years and above. Family history, if parents have Alzheimer’s disease, children are at higher risk of developing the same condition. Heredity, there is a higher chance of inheriting the gene responsible for transmitting this condition. Mild cognitive impairment, this is associated with severe problems that don’t merge their normal age though it does not affect their daily living. Head injury, there is a likelihood of developing Alzheimer’s disease when there is a damage or injury in any part of the head.
The Physiological Basis
There are different types of memory, depending on the stage of Alzheimer’s disease. The long term memory describes the infinite memory collection of information and can be retained over a long period. In Alzheimer’s disease, this memory is well retained during its initial stages of the disease, and any change indicates the commencement of the ageing journey. On the other hand, declarative memory is the deliberate storage and remembrance of facts. This memory is encoded at the hippocampus, entorhinal cortex as well as the perirhinal cortex and later combined and stored by the temporal cortex.
Additionally, semantic memory is responsible for processing thoughts and notions that add up to our knowledge, and it entails items that we learn from the environment. The human brain is made up of billions of specialized neurons that process and communicate a message through the use of chemical and electrical signals. They transmit messages from one part of the body to the other organs for smooth and normal functioning. Alzheimer’s disease interrupts this usual communication in neurons hence making the cells non-functional.
In Alzheimer’s disease, the first identified histopathological icon being the extracellular amyloid plaques with the intracellular neurofibrillary tangles responsible for synaptic disintegration and aneuploidy. When beta-amyloid is coupled up with neurofibrillary tangles, results to the loss of synapses and neurons that transmits information to the whole body organs, this will lead to gross atrophy in sections of the brain affected emanating from the mesial temporal lobe. The numerous numbers of plaques, considered as protein deposits that accumulate in between the nerves cells leads to the development of Alzheimer’s disease. On the other hand, Tau proteins can accumulate inside a nerve cell coupled with the numerous sums of plagues can interfere with the transmission of messages from one nerve cell to the next. This great destruction mainly occurs at the hippocampus, fragment of the brain liable for creating memories. As the significant number of neurons continues to die, and a larger section of the brain is negatively influenced. There are theories explaining mechanisms of the Alzheimer’s disease; the amyloid hypothesis suggests that continuous buildup of beta-amyloid in the brain that activates a sequence of events that cell death in neural, failure in neural synapses, continuous neurotransmitter shortfalls that fully contributes to Alzheimer’s condition. Another one is prion mechanisms, on the surface of the brain, there is a protein called prion protein that is responsible for causing similar prion proteins to entangle leading to an unwanted increase in the number of abnormal proteins resulting to brain damage. In Alzheimer’s disease, they have been discovered that they have the same prion protein with self-replicating characteristics.
Anatomical Correlates of Memory Changes in Alzheimer’s Disease
Atrophy of Cortical Structures
In Alzheimer’s disease, the brain is greatly damaged by the widely spread of neurofibrillary tangles as well as neuritic plagues. The most affected part being areas of temporal, frontal lobes and parietal, whereas the motor with somatic sensory is not adversely affected. The specific parts that harbour neurofibrillary tangles are the supra and the upper layer called infragranular mainly in layer three, and four. The existing tangles are organized in cluster forms, whereas those in supra and infragranular are in the form of a register. The neuritic plaques are found in all the layers and severely affect layer 2 and 3 and don’t display clustering patterns.
The subcortical neuron damaged that happens at the nucleus basalis in meynert as well as locus ceruleus leads to weakening of cholinergic with noradrenergic source structures in the neocortex. The adverse effects of neurons myelinization, the greatly myelinated neurons are largely affected at their last phases. In contrast, the scarcely myelinated neurons are largely affected at the initial phases of Alzheimer’s disease. When these structures reduced incapacity, that is amygdala and hippocampus can forecast the development of Alzheimer’s disease amongst the cognitively strong healthy population of an older generation. Alzheimer’s patients characterized by numerous neuropsychiatric exhibitions reveal more actualities on GM atrophy on the left superior temporal gyrus plus insula when matched with healthy controls. On the other hand, patients with a small number of neuropsychiatric portray more of GM atrophy in prefrontal regions and dorsal anterior.
Behaviours Associated
Patients with Alzheimer’s disease tend to be aggressive, and they are being angered easily. They shout or call out other people loudly, anger which might cause physical harm to the immediate environment; anxiety and agitation, which are often triggered by pain from the external environment. Patients tend to be anxious as a result of injury, types of medications or uncomfortable surroundings. Alzheimer’s patients are characterized with forgetfulness and confusion; they are unable to identify familiar people, environment or things. They might also forget their names, home locations. It presents repetitive actions where they end up repeating something for a long time, like a word or an activity. These patients can also start to destroy what has been build and restart again from scratch. Wandering and getting lost, persons with this disorder tend getting lost as results of memory loss (Goldsmith, 2018). They also experienced sleeping problems due to influence on the brain.
Neurological Elements
This refers to any disorder that affects how the nervous systems work. The human brain contains several neurons that transmit information from one part of the brain to different organs of the body. Neurons have three main parts that accomplish communication, metabolism and do the reparation, re-establishment as well as regeneration. Alzheimer’s disease disrupts all the normal functioning of the neurons with its widespread connections.
At the initial stage, Alzheimer’s disorder kills neurons, entorhinal along with hippocampus and their vital role they play in the brain, including the memory. It then proceeds to destroy some parts of the cerebral cortex that plays a vital role in language, general social behaviour and ability to reason. Ultimately, a larger part of the brain is greatly impaired. At this point, a patient with Alzheimer’s disease slowly losses the potential to live as well as function normally and might need a caregiver to help him or she accomplish his or her daily activities.
Summary of Related Processes
People with Alzheimer’s disease have a varying degree of experiences depending on how the disease progresses from one stage the next. Stages of this disease start with early and unnoticeable signs to another stage with evident symptoms. The following summarizes the stages of this Alzheimer’s disease. In the first stage, there is no impairment, at this phase, Alzheimer’s has no visible symptoms, and I still undetectable. For the second stage, Alzheimer’s patient experienced a very mild decline; people who are old enough start experiencing a slight change in memory; they start losing items in their immediate environment. However, this problem cannot be noticed earlier.
On the other hand, the third stage has a mild decline; at this level, close people can easily notice a change in behaviour and how they respond to the external environment. People with Alzheimer will start having difficulty in communication, failure to remember the names of familiar people. In the fourth stage, there is a moderate decline; at this stage, affected people start having short-term memory, poor management skills of their finances and they can easily forget fine and important details about themselves.
In the fifth stage, Alzheimer’s disease patients have moderately Severe decline, at this phase, people with Alzheimer’s require great help to run their daily activities well because they are likely to experience difficulty in dressing coupled with intense confusion. During the sixth stage there is severe decline, people at this stage needs continuous supervision and also a professional caregiver as they are not able to manage some of the symptoms including uncontrollable bladder, wandering, confusion and severe social behaviours. Finally, patients have a very severe decline, this is the last stage, and the patients are nearing death as this is term as a terminal illness. The patients cannot communicate, not in touch with the immediate surroundings, and they are likely to have difficulty in swallowing food. Therefore, the subsequent loss of networks in the nerve cells will latter destroyed them, and this will negatively affect sections of the brain leading to loss of memory and sudden death of the nerve cells. When the nerve cells die, fragments of the brain that is responsible for language skills, the ability to reason as well as thinking skills are affected, and this marks the shrinking of the brain tissue.
Possible Treatments
Since time immemorial, a cure has not been found; once the brain cells have fully died, its original functions cannot be reversed. Imperatively, therapeutic interventions that enable the affected persons to learn to live healthy with the disease. A person with dementia can be actively involved in various groups that would challenge their existence, enables the person with dementia to learn how to open up, reconnect with their inner feelings and self hence be able to know what is going on in the external environment and respond accordingly ( Goldsmith, (2018). They should ensure effective management of any disorder that might erupt as results of Alzheimer’s. This will help in proper control of the existing condition and help the patient in their recovery journey.
They should engage Alzheimer’s disease patients in various physical activities and daycare platforms. Body exercises make ones healthy, and the body will functions well as the blood will be circulating throughout the body. Engaging an Alzheimer’s patient in daycare platforms would position him or her in an arena with people with the same condition, they would all share what they are going through in their day to day living, and this will entirely boost their morale and develop positive attitudes towards life. According to Zach 2018, The use of drug therapy, scientist and researchers are still working hard to establish a specific drug that would prevent or cure this conditions, there continuous hard work has not yielded fruits. Alternatively, we have options that usually helps in alleviating the daily pain that the patients are being subjected to and also boost the value of life. The main drug used by symptomatic Alzheimer’s persons are Donezepil, tacrine and Rivastigmine; they are cholinesterase inhibitors. People with Alzheimer’s disorder are encouraged to be eating food rich in omega -3 fatty acids and have fewer salts. They should be drinking alcohol in little amount so that they won’t be straining the nerve cells in the body.
References
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