Research so far has shown brain abnormalities to do with Alzheimers these include:
- Plaques- These are microscopic deposits (clumps) of beta-amyloid peptide (a protein). The clumps can block cells signalling to each other through synapses they also cause immune cells to be activated leading to inflammation.
- Tangles- These are coiled strands of the protein Tau.
- Loss of connections between brain cells.
- Inflammation- A result of the brain trying to defend itself against the other changes happening.
- The death of brain cells (and severe shrinkage of the brain tissue).
Treatment at the moment is aiming at:
- Producing a drug that prevents the formation of beta-amyloid. Beta-amyloid breaks off from the larger protein called amyloid precursor protein (APP), and this is caused by 2 enzymes called beta-secretase and gamma-secretase. Drugs are trying to be created the prevent beta-amyloid clumping together, to stop the enzymes from breaking it off and even trying to use antibodies against beta-amyloid so it can be cleared from the brain when people start developing the clumps
- Producing a drug that prevents Tau molecules from collasping and twsting into tangles as it destroys a very important cell transport system.
- Also looking at insulin resistance and seeing how the brain cells use insulin and to see if it would be possible to prevent insulin from feeding changes related to alzheimer’s.
Many studies are also being done on blood testing or testing spinal fluid as well as brain imaging, to try and develop a brain scan that could detect the onset of alzeimer’s earlier.
Firstly, to clarify any confusion, dementia and Alzheimer’s disease aren’t the same, even though they are used interchangeably. Alzheimer’s is a disease that causes dementia.
What is dementia?
- It’s an impairement of a persons memory and thinking
- It can stop them carrying out things they used to be able to do
- It is a symptom
- It’s caused by something like Alzheimer’s for example
- “Dementia simply means the symptom of a deterioration of intellectual abilities resulting from an unspecified disease or disorder of the brain.”
What is Alzheimer’s?
- It’s one of the diseases that causes dementia,
- It’s the most common form of dementia
- It’s a disease that affects the brain (brain disease) and it is progressive
- It affects thinking, memory and behaviours become so severe that work life and social life is affected
- Alzheimer’s damages the brain cells and eventually brain cells are destroyed
- It gets worse over time
- It is fatal
- There is no cure yet
- Common in older people
Alzheimer’s is a disease and dementia is a symptom of Alzheimer’s
On 4th January 2013 I started volunteering at a care home. I go every Tuesday after school for about 1 and a half- 2 hours. I have been given 3 residents that I am allowed one-to-one with, which involves just talking to them or doing an activity if they wanted to. Many of the residents suffer from dementia so patience is one of the key skills you need, especially if you are working with them every day. The phrases that you here most of the time is ‘Can I go home yet?’ or ‘I think it’s time for me to leave’. With this you need to try and settle them back down and get them doing something else (preferably something they enjoy such as embroidery).
What I also found was that many of the residents go back to behaving as if they were a child again and some become very upset as they start remembering their parents and grandparents. At this point to be able to deal with this you need to know the person pretty well on a personal level as some prefer to be left alone, some want to talk about it and others the best thing to do is again taking their mind off of it.
Some of you may be wondering so how does this help with medicine? Firstly, volunteering in a care home gives you that one-to-one patient contact that you will need to be able to do for the rest of your career in medicine. It doesn’t matter what area you end up specialising in you will need to have patient contact at some point. Some areas require more patient contact than others. In the UK especially we have an ageing population and so you are more likely to come into contact with elderly patients so being able to deal with different age related illnesses they may have is essential. Talking to a patient with dementia you will have to have the patience to be able to deal with getting the same answer as you have been getting for the last 5 minutes and trying to find a way in getting the information you need out of them which may mean phrasing your question differently. Also in the care home a few residents suffer from hallucinations, sometimes this can be a symptom of an underlying health problem/disease/illness, but for some it’s just something they have developed. The worst thing to do is be stubborn and say ‘No that’s not true, you are being silly’ because firstly that is rude and you shouldn’t talk to patients like that and secondly, some may become hurt by it, then you have an even bigger problem on your hands in having to make them happier again. So either just partly agree with them and try and move onto a different subject or just try and carry on with the conversation you were having before.
The experience I have gained so far at the care home has been brilliant, being able to see how the same illness can affect different people very differently is fascinating, especially with dementia. It has made me want to study medicine even more because it has shown me how varied patients are, how you have to be the detective in figuring things out and knowing they won’t make it easy for you! But that’s the interesting part! However, it has also made me understand that at this stage of life making sure the patient is as comfortable and as happy as possible is very important, and you will never believe how happy the residents are when the doctor of the home walks in, it’s as if all their troubles and problems have been lifted from them. Most of the time there is nothing you can do, but it seems just the simple trick of actually listening to their problems and taking a real interest in them makes most of the things go away, and this is because they have lifted it off their chest and are they are so much happier for it. I want to be that Doctor that could make one very unhappy resident smile just because I have made them feel I was doing something and really cared about their problem, even if I couldn’t cure them of a a disease like dementia, they would know I was their and would always do the best I could for them.