Term Paper on "Alzheimers Disease Alzheimer's Disease in Search"

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Alzheimers Disease

Alzheimer's Disease in search of a cure

The risk for dementia, a major contributor to incapacitation and institutionalization, rises rapidly as we age, doubling every 5 years after age 65. Tens of millions of new Alzheimer's disease (AD) and other dementia cases are projected as elderly populations increase around the world, creating a projected dementia epidemic for which most nations are not prepared. Thus, there is an urgent need for prevention approaches that are safe, effective, and affordable. Much attention has been focused on the abnormal deterioration of the brain called senile dementia of the Alzheimer type (SDAT) which affects five percent of U.S. Adults by age 65 and twenty percent of those over eighty. Diagnosis of SDAT depends on its characteristic symptoms: the victim gradually looses memory and reasoning, the ability to communicate, physical capabilities and eventually life itself; the nerve cells in the brain die, and communication between the cells breakdown. The causes of SDAT continue to elude researchers.

The following body of research seeks to make light of the recent findings in the search to establish preventive measures to counteract the early onset of Alzheimer's and subsequently find a cure for this disease. In the quest to learn more about Alzheimer's, scientists have considered a correlation between SDAT and mid-life neuroticism, ethnic predisposition, the association of impaired awareness of deficit and neuropsychiatric symptoms in early Alzheimer's as well as assessment of the effects of different medications such as Memantine and Donepezil (commonly known as Aricept).

In the first

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case study, Brown et al. seeks to highlight the importance of increasing the knowledge base on the factors associated with the onset of dementia as a tool to better understanding the different stages of Alzheimer's disease. The pre-morbid personality domain of Neuroticism constituted an interesting and theoretically plausible, yet uninvestigated, candidate for such an association. The study's aim was to examine whether midlife Neuroticism was associated with earlier age of onset of Alzheimer's disease (AD). This was a case-comparison study of 213 patients with probable AD. Detailed clinical information was collected for all patients including age of onset of dementia symptoms. One or two knowledgeable informants rated each patient's midlife personality retrospectively using the Neuroticism, Extraversion,

Openness Five-Factor Inventory (NEO-FFI) questionnaire. The relationship between midlife Neuroticism and age of dementia onset was evaluated using both correlational analysis and backward linear regression analysis. It was found that Midlife Neuroticism predicted younger age of dementia onset in females but not in males. The association found in females was independent of pre-morbid history of affective disorder.

Researchers have also considered genetic as well as ethnic predisposition to developing Alzheimer's. Leverage data from the National Survey of American Life -- a large, national probability sample that is enriched in American residents of African descent-to provide key information on mental health and substance abuse service utilization among older black adults. Neighbors et al. findings support that older African-Americans are less likely to receive professional mental health services. This study is unique in its ability to go beyond prior analyses that have traditionally focused on differences in service utilization among African-Americans compared with the majority group or another minority group. Instead, the authors are able to address directly the heterogeneity that exists among African-Americans and to examine differences in service use by key socio demographic and geographic variables. Although many population-based studies are considered advantaged if there is reasonable ethnic diversity, or representation of African-Americans

(e.g., 15%-30%), these scientists could actually take advantage the diversity within "diversity." Their work highlights both challenges and opportunities in meeting the needs of an aging population that includes increasingly longer-living African-Americans. For example, the authors found that African-Americans

aged 65 years and older are more likely to receive mental healthcare from general medical providers, rather than specialists. However, recruitment of racial and ethnic minorities in clinical trials remains problematic. Research with mentally ill persons offers additional challenges with recruitment and retention. Numerous barriers may impact successful recruitment and retention of ethnic minorities. One must be cognizant that there are unique issues involved in the recruitment of all racial and ethnic groups as well as geographical considerations (urban versus

rural). Yet, there are growing instances where researchers are able to outreach into communities and recruit multiracial samples that bring us closer to a representative sample of the targeted population.

In the pursuit of a better way of managing Alzheimer's, scientist has also attempted to make an association between impaired awareness deficits and neuro-psychiatric I it was designed as a multicenter single-blind, randomized, controlled trial with randomization to an intensive program or to usual care and 1 year follow-up. Data in this study was from the baseline examination. At baseline all patients and their primary caregiver were interviewed using separate structured questionnaires. The interviews were performed by the local project coordinator in each of the five centers. The study included 330 home-living patients with a recent clinical diagnosis (within less than 12 months of inclusion) of probable Alzheimer's disease, mixed Alzheimer's disease (defined as patients meeting the criteria forprobable Alzheimer's disease with minor vascular lesions, which could not explain the cognitive impairment), or dementia with Lewy bodies confirmed by the local specialist referral unit (memory clinic). In this study focusing on Alzheimer's disease, patients with dementia with Lewy bodies (n=9) were excluded. Thus, the study population consisted of 321 patients who met the criteria for probable Alzheimer's disease. This study did not find a significant association between the degree of insight and depressive symptoms, which is in accordance with some previous studies. It also failed to find depressive symptoms in patients with higher levels of insight might result from the fact that the patients had recently been diagnosed and that they were very early in the disease process. Further, patients participated in a psychosocial intervention study which may have caused selection bias. To summarize, the study showed that impaired awareness of deficits occursf requently in early Alzheimer's disease. It was also found that lower levels of awareness were significantly associated with the occurrence of neuro-psychiatry symptoms - even in early Alzheimer's disease. Specifically, patients with very poor insight have more neuro-psychiatry symptoms. Thus, when evaluating the need of patients and caregivers in early Alzheimer's disease, identification of impaired insight may be important.

the effects of neuro-psychotic medication like Memantine on senile dementia of Alzheimer's disease are also considered in order to better manage patient episode affected by the disease.. Memantine is a moderate-affinity, uncompetitive antagonist of N-methyl- D -aspartate receptors, approved for the treatment of moderate to severeAlzheimer's disease (AD). Available data suggest that, in addition to its benefits on cognition, function, and global status, memantine treatment may also help alleviate behavioral symptoms. This study provides an overview of the prevalence, assessment, and treatment of behavioral disturbances in AD, and summarizes current knowledge regarding the effects of memantine on the behavior of community-dwelling patients. A database search of EMBASE and PubMed (January 1992 to October 2008) for reports on memantine trials that involved outpatients with moderate to severe AD. All previously unpublished data were obtained from Forest Laboratories, Inc. Behavioral outcomes were assessed in three completed, double-blind, placebo-controlled trials. Overall, patients who received memantine performed better on behavioral measures than those treated with placebo. Post-hoc analyses suggest that memantine treatment was associated with a reduced severity or emergence of specific symptoms, particularly agitation and aggression. Prospective, well-designed trials are warranted to evaluate the efficacy of memantine in patients with significant behavioral symptoms. Similarly, to memantine, the cognitive effects of donepezil treatment in patients with Alzheimer's disease. Forty one patients with Alzheimer's were treated with donepezil at the baseline, all patients under went a brain scan prior to donepezil therapy. Research concluded that lower pretreatment regional cerebral fluid in the right orbital cortex which predicted a better response to donepezil… READ MORE

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Quoted Instructions for "Alzheimers Disease Alzheimer's Disease in Search" Assignment:

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*****¢The paper will be based on 5 empirical peer-reviewed research articles

â-¦NO REVIEW papers are allowed

â-¦feel free to cite additional articles to support your statements, but you are only required to focus on five articles

By now all of you have had the opportunity to read an empirical journal article (peer-reviewed articles) about some aspect of gerontology when you worked on your final papers for Introduction to Aging Part 1 and 2. Within your reading you encountered the techniques authors used to evaluate their theoretical suppositions. The purpose of this assignment is to focus on the methodological technique used within a journal, in order to explain it, evaluate its utility for addressing the topic area, and how it added to the knowledge within the field.

First, you will be required to select a topic within the field of geronotolgy (any topic covered withing Introduction to Aging Part 1 or 2) that you would like to examine. You MUST have your topic approved by the instructor by the date outlined in the course schedule.

Second, you will select five peer-reviewed journals where they have examined your chosen topic. Your peer-reviewed journals must be original empirical papers, they can NOT be review papers. The publications must be between 2002-2009. You can search the database of journals at Ryerson to find your five articles.

Third, you will read each article and identify the goals or aims of the researchers within the study. Why did they do this research? What questions were they trying to answer? How will this research contribute to the knowledge about your chosen topic? How is this work different than the research that has been done in the past within your topic area?

Fourth, you will read about the methodolgy used to examine the topic (what tools were used to examine the goals of the study?). You will identify the method and explain how the technique contributed to the findings of the study. For example, if a closed ended telephone survey was used to gather information about financial earnings in women, you will identify the method used and explain why this technique was used. It may be that the researchers were hoping to reach a larger demographic group of women, who are overlooked in traditonal techniques of assessment (i.e. tax returns, the SLID assessment), to gain valuable information about the income levels of senior women that do not contribute in the labour force.

Fifth, once you have explained each study and the associated methodolgy you will compare the utility of each of the five methodologies for addressing the topic area. What method is better for addressing what aspect of the topic? What are the flaws associated with each method? Can any of these methods be improved? How? How do these different methods uniquely contribute to the knowledge about the topic? Basically, the goal is to examine both the strengths and limitations associated with a specific methodolgy as they apply to your research topic.

Sixth, you will conclude your paper with a discussion about the overall contributions with respect to knowledge, that these five research articles have made.

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