Alzheimer’s Disease: Overview and Analysis

Anonymous. (2009). Alzheimer’s and automobile safety studied. Journal of Gerontological Nursing, 35(4), 6.

This study aims at determining the suitability of individuals with Alzheimer’s disease in performing activities such as driving. It is suggested that evaluating the remembrance, visual and movement capabilities of individuals with Alzheimer’s disease away from the road can assist physicians in finding out the suitability of Alzheimer’s disease patients in driving. The study uses a total of 155 drivers out of whom 40 have the initial form of the disease while the remaining 115 do not have the condition. The participants are subjected to a blend of off-road checks that evaluate their memory, movement and visual abilities. The partakers are also allowed to drive a distance of 35 miles within and outside the city. The activities of the drivers during the test are recorded by a driving expert and are used to assess them for driving mistakes associated with the safety of the driver and other road users.

It is established that drivers diagnosed with Alzheimer’s disease perform a mean of 42 errors compared to the average of 33 errors made by the drivers without the diagnosis of the condition. In addition, the numbers of mistakes are increase with the increase in the age of the drivers. For example, a five-year increase in age translates to a 2.5% increase in driving errors regardless of the diagnosis of Alzheimer’s disease. It is also established that there is a positive correlation between the driving outcomes off-road and on-road in drivers with Alzheimer’s disease.

This paper provides evidence of the impact of age on memory and the ensuing inability to perform some tasks. The evidence reviewed in this paper is useful in advising against driving in patients with Alzheimer’s disease because allowing them to drive may increase the probability of causing road accidents.

Cranwell-Bruce, L. A. (2010). Drugs for Alzheimer’s disease. Medical-Surgical Nurses 19(1), 51-53.

This article provides a review of the available prescriptions used in the management of Alzheimer’s disease. Alzheimer’s disease (AD) is among the top ten leading causes of death in the United States. The condition is characterized by a progressive weakening of the neurons that facilitate the movement of the neurotransmitter acetylcholine. Consequently, a decline of cognitive and behavioral functions is evidenced. The author analyses two main classes of drugs that alleviate the symptoms of AD by slowing down the progression of the condition. These drugs are the cholinesterase inhibitors and blockers of the Nmethyl- D-aspartate (NMDA) receptors. The modes of action of the drugs are provided as well as their pharmacokinetics, which are vital information during pharmacological interventions. Various brand names under the two classes of drugs are provided. In addition, the author explains the advantages and disadvantages of each drug as well as the appropriate stage of the disease where the drugs are most effective. The dosages of the drug are given alongside useful patient advice regarding the use of the drugs. Information concerning bed rest and hydration when taking certain drugs is also provided. The side-effects of the drugs as reported by several clinical trials are provided for some of the drugs.

The paper provides an in-depth discussion of the pathophysiology of AD and provides the relevant medication that addresses the actual symptoms. This article is important in guiding a nurse practitioner in providing the appropriate medication to a patient with AD. The article also enlightens health care providers on the side-effects associated with the administration of certain AD drugs. Therefore, such information can help a nurse practitioner make an informed choice before prescribing an AD drug. The information can also be useful in helping patients to be psychologically prepared to experience certain discomforts while taking their medication.

Watson, E. & Yu, F. (2013). Monitoring exercise delivery to increase participation adherence in older adults with Alzheimer’s disease. Journal of Gerontological Nursing, 39(5), 11-14.

Exercises provide numerous health benefits to patients with advanced age. It has been suggested that exercise can decelerate the advancement of AD in older populations. However, the ability of bedside nurses to keep an eye over the involvement of the older population in exercise activities is unknown and is complicated by the intricacy and the effects of the signs of AD. Therefore, the researchers aim at presenting bedside nurses with instruments to sum up the actual exercises received by the patient to guarantee active participation in exercises in patients with AD. The authors analyze data from a previous study that involves the participation in normal intensity aerobics of 8 subjects above the age of 60 who are diagnosed with AD. The exercise sessions last between 10 and 45 minutes and are done thrice week for a period of 180 days. Several variables are monitored to capture the participation and the intensity of the exercises. They include the force of cycling, the length, rate, and observance. The patients’ heart rates and ratings of perceived exertion are used to estimate the intensity of the exercises.

It is established that the involvement of the bedside nurse enables the fulfillment of 74.3% of the exercise requirements. Therefore, the ability of bedside nurses to watch over the actual exercise delivery in terms of regularity, amount and extent is confirmed.

This article emphasizes the need for patient involvement in exercises due to the associated health benefits. Therefore, it provides guidance on how nurses should observe the participation, regularity, amount, and the extent of the exercises. It also gives the aspects that need to be recorded and observed by nurses to ensure adequate exercise.

Yu, F., Rose, K. M., Burgener, S. C., Cunningham, C., Buettner, L. L., Beattie, E., Bossen, A. L., Buckwalter, K. C., Fick, D. M., Fitzsimmons, S., Kolanowski, A., Janet, K., Specht, P., Richeson, N. E., Testad, I., & McKenzie, S. E. (2009). Cognitive training for early-stage Alzheimer’s disease and dementia. Journal of Gerontological Nursing, 35(3), 23-29.

In this paper, the authors review information on the consequences of nonpharmacological cognitive guidance on the indications of dementia in the initial phases of AD. The logic behind their study is that there are vast differences in the cognitive capabilities of individuals as well as their propensities to aging and neurodegenerative disorders. Therefore, it is impossible to come up with a straightforward threshold paradigm for the pathology of the condition that is applicable to everybody because cognitive destruction is an upshot of manifold factors. There is evidence that the brain is capable of reconstructing past experiences, even in instances of neurodegenerative disorders. The authors perform searches on four databases including the Cochrane Library, MEDLINE, CINAHL, and PsycINFO. The keywords used include “reality orientation” and “memory training” among others.

It is established that cognitive training entails any intervention that is aimed at enhancing cognition without the use of drugs. It is established that cognitive guidance enhances cognition, day-to-day activities as well as decision-making processes. Measures that center on certain familiar events and the pathology of AD are found to achieve higher efficiencies. The best results are achieved when these intervention measures are combined with drugs that improve cognitive abilities.

This paper provides useful information regarding the nonpharmacological measures to improve the outcomes of AD patients. This aspect is essential because nurse practitioners seek to provide holistic care to patients. Therefore, pharmacological interventions may not always be adequate in yielding the desired patient outcomes. The article illustrates activities from evidence-based studies that have been used to improve the cognitive functions of AD patients. Nurse practitioners can borrow some of these tactics and use them to improve the conditions of their patients.

References

Anonymous. (2009). Alzheimer’s and automobile safety studied. Journal of Gerontological Nursing, 35(4), 6.

Cranwell-Bruce, L. A. (2010). Drugs for Alzheimer’s disease. Medical-Surgical Nurses 19(1), 51-53.

Watson, E. & Yu, F. (2013). Monitoring exercise delivery to increase participation adherence in older adults with Alzheimer’s disease. Journal of Gerontological Nursing, 39(5), 11-14.

Yu, F., Rose, K. M., Burgener, S. C., Cunningham, C., Buettner, L. L., Beattie, E., Bossen, A. L., Buckwalter, K. C., Fick, D. M., Fitzsimmons, S., Kolanowski, A., Janet, K., Specht, P., Richeson, N. E., Testad, I., & McKenzie, S. E. (2009). Cognitive training for early-stage Alzheimer’s disease and dementia. Journal of Gerontological Nursing, 35(3), 23-29.

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