Date Psychiatric Diagnosis

DatePsychiatric Diagnosis

Alzheimer`sdisease (AD) is a disease that progressively destroys memory and ofthe crucial mental functions. AD is the most common source dementia(a group of disorders in the brain that leads to loss of social andintellectual skills). These changes are very intense and interferewith daily life. AD causes the brain cells to degenerate and die,leading to a steady memory decline that affects mental functions. Adinterferes with the ability to perform simple tasks. In most cases,AD symptoms appear at the age of six. Current strategies formedication and management of AD can improve symptoms. Thesestrategies help people with Ad to improve mental functions andindependence. The severity of AD varies from mild, moderate andsevere (Perry 3).



Inthe initial stages of AD, the patients have the problem ofremembering some things, even immediately after learning them. Thepatients also lose their direction and end up in new places. Somehave problems with complex tasks such as planned a party or payingbills. Sometimes, the patients have difficulties in coming up withthe correct words in the given contexts. Also, the patients tend tofeel moody and do not like interacting with other people. It isimportant to report early warning signs whenever they are observed.When such symptoms are noticed from friends or family members, it isadvisable to report to the doctor for help before the disease getsinto a more complicated stage (Perry S3).


Thislevel of the AD lasts for many years. It varies from one person toanother. The memory gets worse as the AD evolves. The patient hasmore problems with thinking and language. The patients have a problemidentifying friends and family members. They may fail to trace thecurrent day of the week and forget important details about them suchas phone numbers, addresses, and their former high schools orcollege. The patients have problems dressing in the right order andare unable to pick the right clothes. They also have problems inusing the toilet and bathing. They exhibit jumble words and may hearor see things are not there. They have a poor judgment about health,safety, and finances. Their personality may be altered during thisstage and may begin to experience depression and anxiety and becomeangry and violent. They begin to suspect people of cheating, lyingand stealing from them (Perry S3).


Inthe late stage of AD, the patients may no longer remember their lifehistory. They may not tell where they are. Their physical abilitiesare affected and are unable to carry out simple tasks. The patientscannot speak many words at the same time. At this stage, AD patientsare helped to walk and later in this stage, they may fail to sit,hold their heads up and cannot smile. They experience problems incontrolling their bladder and bowels (Sudhaet al 476).They wander from one place to another and get lost. They canrecognize familiar faces, but they fail to recognize their names.Several personality changes may take place in them, and they developweird habits such as shredding tissues and wringing their hands. Inthe most severe situations, the patient’s brain fails to coordinatewith the body. The patient may sit in the toilet and eventuallyforget what they were there to do or hold food in their mouth andforget how to swallow (Perry S3).

TheCauses of AD

Thereis a lack of full understanding of what causes AD, but it isapparently becoming clear that AD develops as a result of thecomplicated sequence of events happening in the brain for a prolongedperiod. Most likely, AD originates from a mixture of environmental,genetic and lifestyle factors. People differ in both lifestyles,environmental and genetic factors. Thus, the importance of one ormore of these factors to a person determines the level of the risk ofdeveloping AD. Researchers are carrying out studies for moreknowledge concerning tangles and plaques, and other characteristicsof AD.

Throughimaging the brain of living individuals, the scientists have beenable to visualize beta-myeloid, which is associated with plaques.Also, they have been able to explore the earliest steps in thedevelopment of the disease. These attempts will certainly lead themto complete understanding of the disease. However, the disease isusually known to affect people in old age. The research linking agewith brain changes has shed light on this development. For instance,it has been proved that changes in the brain as a result of agingcauses damage to neurons, which contributes to AD. Age-related brainproblems include brain atrophy, inflammation and production of freeradicals (unstable molecules) and mitochondrial dysfunction (Sudhaet al 478).


Early–onset Alzheimer’s affects the people of the age between 30 and60. However, it is a rare form of AD. IT occurs in only 5 percent ofthe people with AD. Early-onset Alzheimer’s has symptoms related tothe familiar AD and is caused by one among genes from a parent. Manypeople who have AD developed ‘late-onset Alzheimer’s,’ itusually begins from the age of 60. Many studies associateapolipoprotein E (APOE) gene with the late-onset Alzheimer’s. APOEgene has several forms, including APOEe4, which appears to alleviatea person’s risk of developing AD. However, having APOEe4 is not aqualification for developing AD. Researchers have indicated that thedevelopment of late-onset Alzheimer`s may be influenced by theemergence of additional genes. Other genes apart from APOEe4 havebeen found to manipulate the emergence of late-onset Alzheimer’s(Alzheimer`sAssociation 2).

Environmentaland Lifestyle Factors

Severalfactors apart from genetics can play an important role in thedevelopment of AD. Several studies have associated cognitive declinewith several vascular conditions such as stroke coronary heartdiseases, high blood pressure, obesity, and diabetes. When theserelationships are clearly examined through clinical processes, theycan help to determine whether combating the vascular conditions canreduce the risk factors in developing AD. There are several practicesthat can help the older individuals remain healthy. For example, gooddiet and physical activity can add much health to the agingindividuals. Also, social engagements and pursuits that are mentallystimulating are a good source of physical and mental health for theaged. These and other related practices can help reduce the risks ofdeveloping cognitive decline and AD (Sudhaet al 481).

TheDiagnosis of AD

Initially,AD could only be diagnosed after the patient’s death throughlinkage of clinical tests with brain tissue examination and pathologyin an autopsy. Today, there are several ways and methods as well asthe tools that can lead to an accurate and fair determination. Theycan show if a person who is faced with memory troubles has either‘probable Alzheimer’s dementia (no other found cause of dementia)or ‘possible Alzheimer’s dementia,’ that is, there could beanother cause for dementia. To diagnose AD, doctors may ask questionsrelated to the overall health of the patient, ability to carrying outdaily tasks, past medical problems and behavior and personalitychanges. Doctors may also conduct memory tests, counting, andlanguage, attention and problem-solving tests. To establishalternative causes of mental problem, doctors may administer standardmedical tests, including urine and blood tests. Brain scans such asmagnetic resonance imaging (MRI) and computed tomography (CT) may beperformed to distinguish AD from other factors that share symptomswith AD such as tumor or stroke. These tests can be repeated to helpthe doctor get information about the changes of symptoms with time(Alzheimer`sAssociation 2).

Earlyand correct diagnosis is important for various reasons. First, ithelps to establish if the symptoms identified are caused by AD orother related causes such as tumor, stroke, and Parkinson`sdisease. Sleep disorders and drug side effects may have similarsymptoms, but these conditions can be treated and possibly bereversed. Early diagnosis can help the patients and their families tomake future plans and make arrangements for better living anddevelopment of support networks as well as taking care of legal andfinancial matters. In addition, early diagnosis may offer biggeropportunities for people’s involvement in clinical trials. During aclinical trial, researchers measure a treatment procedure or drug tofind the effectiveness of the intervention and the people on whom itcan work best (Maceet al 26).

Careand Treatment

Caringfor patients with AD may have high emotional, physical and financialcosts. However, giving close attention to these patients isnecessary. The patients with mild and moderate AD need to live in aresidential care setting with or with the family. They need help withdressing, managing finances and safe, taking of the drugs. Caregiverscan help them go through the suggested corrective changes andmedication procedures suggested by the doctor. When a patient hassevere AD, much help is required in terms of personal care and dailyactivities. Patients may need to live in the AD’s care setting. Inthe final months of the disease, hospice care is important in keepingthe patient comfortable (Maceet al 21).

Thefundamental disease process may not be reversed, but early treatmentfor the disease process is critical in the preservation of functionfor some period. Four main drugs are used to treat AD. Galantamine(Razadyne), rivastigmine (Exelon) and Donepezil (Aricept) are usefulin the treatment of mild and moderate AD. Donepezil is also useful intreating severe AD. Memantine (Namenda) is used in the treatment ofboth severe and moderate AD. These drugs help in the regulation ofneurotransmitters. They help to maintain speech, memory, andthinking. They also help in managing some behavioral problems.Nevertheless, the said drugs may never reverse the underlying diseaseprocess and works only for certain people and on others. Also, theyhelp for a limited period (Alzheimer`s Association 3).


Alzheimer`sdisease mainly affects the elderly population except for theearly-onset Alzheimer`s, which affects people who are less than 60years of age. AD patients need a lot of care of the family andsignificant others. Caregivers can help them meet some daily tasksthat they cannot do without help. Those patients with severe AD mayneed hospice care. Early diagnosis is important because it helpsdifferentiate AD from other conditions and diseases that have similarsymptoms. It is not possible to reverse the fundamental diseaseprocess, but patients are recommended to take medication. Thebenefits of drugs cannot be overlooked, and caregivers should ensurethat patients follow the recommended dosage procedures


Alzheimer`sAssociation. “What Is Alzheimer`s?” Online. Available at:&lt

Hennig,Wilfried, and Daniele Schubert.&nbspAlzheimersDisease.Hamburg, Germany: 3B Scientific, 2003.

Perry,George.&nbspAlzheimer’sDisease: Advances for a New Century.JAD, January 23, (2013): S5-S65. Print.

Mace,Nancy L, and Peter V. Rabins.&nbspThe36-Hour Day: A Family Guide to Caring for Persons with AlzheimerDisease, Related Dementing Illnesses, and Memory Loss in Later Life.Baltimore: Johns Hopkins University Press, (1999): 11-33. Print.

Sudha,Seshadri, Alexa Beiser, Jacob Selhub, Paul, Jacques. P., Irwin,Rosenberg, H., Ralph, D`Agostino, B., Peter, Wilson, W.F. &amp Wolf,Philip. PlasmaHomocysteine as a Risk Factor for Dementia and Alzheimer`s Disease.TheNew England Journal of Medicine.January 14, (2002):346:476-483