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Mental Disorders in the US: Alzheimer’s Disease

Introduction

S: The patient is a 49-year-old female complaining of impermanent memory losses, unreasonable mood changes, and rare vision problems. She has been teaching Math for second-grade students for the last twenty years. She likes her job, and her cooperation with children makes her happy and satisfied. She is married and has two children who have already moved out but continue visiting parents from time to time. During the last three weeks, the woman discovers that she is not always able to answer her students’ questions. It happens not because she does not know the answer but because she cannot remember how to formulate this information. She prefers a healthy lifestyle without following some special diets. The patient states that she enjoys listening to music, but recently, she has experienced new emotions and cannot explain her mood changes, which causes misunderstandings in the family.

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The woman thinks that it could be depression because one of her friends moved to another city a month ago. However, the reason for her visit includes her memory and vision problems. She faced difficulties during reading books at nighttime and made a decision to buy Solaray Lutein Eyes in the nearest drugstore because she read that this supplement helps people with eye problems. In addition to these vitamins, the patient takes Rozerem one pill before going to bed to fall asleep quickly (not regularly). No allergies reported, as well as no serious chronic diseases in family history.

O: Height 5’4’’; weight 125lbs; blood pressure 120/85; heart rate 80 bpm; respiration rate 18 breaths per minute; temperature 97.5oF.

During the first physical examination, the patient looks normal, with a properly chosen dress, hairdo, and general look. No sources of pain are discovered, and eye problems do not disturb the woman at the moment. She is eager to talk and ask as many questions as possible, which signalizes about her desire to clarify what happens to her and how to stop irregular but provocative changes.

The mini-mental status examination is offered to the patient to check her cognitive functions and losses. She answers confidently and clearly but makes two mistakes in spelling and recall activities. In the spelling item, it seems like she tries to visualize the word and remember its letters. In recalling three words, she can repeat all the words with ease at first but pauses and forgets the last word when a delayed recalling is required. The woman demonstrates good results in reading, following immediate commands, and counting. Her orientation in time and place is correct, but she takes some time to call all colors, without specifying the cause of her pauses. An eye examination does not show any pathologies, and all her reflexes were normal.

A neurologic and mental status examination is performed to investigate the general condition of a patient. Additionally, it is necessary to send the patient for bloodwork to measure the level of beta-amyloid protein that influences the work of the brain. The results remove the possibility of vitamin deficiency in the body or the impact of other infections of the organism. Brain imaging (magnetic resonance imaging) shows no strokes, masses, or other problems, and positron emission tomography (PET) is recommended to detect changes (if any) in brain areas due to the possible deposits of beta-amyloids. A high level of beta-amyloid protein and sporadic memory challenges are the reasons for concern.

A: The patient is diagnosed with Alzheimer’s disease at an early onset. Although this form of the disease is rare, the woman has certain problems that cannot be ignored. Besides, the progress of this disease is hard to predict because the symptoms could get worse quickly or be identified with time and insignificant changes. Less likely diagnoses might be dementia (memory problems and behavioral changes), Korsakoff syndrome (vision changes and confusion), depression (mood changes). Each of these diagnoses could be the reason for the patient’s concerns, but the MRI results and the neurologic test make the doctor stop on Alzheimer’s, its possible outcomes on a person, and its progress in regard to the patient’s genetics, environmental factors, and interpersonal relationships.

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P: In the plan of treating the patient, one of the initial steps is to identify the stage of Alzheimer’s disease. The Global Deterioration Scale (GDS) was developed by Reinsberg to explain the symptoms of cognitive impairment and identify critical behavioral characteristics. The application of this method will help to choose the best way of treatment and cooperation with the patient. At this moment, the woman demonstrates the signs of mild cognitive impairment. During mutual tasks, co-workers could observe her inability to give direct answers and pauses in communication with children (subjective evidence). An interview with the patient (objective evidence) proves a memory deficit in some areas. Still, her denial of Alzheimer’s symptoms cannot be ignored, as it might provoke depression, anxiety, and other mood changes that determine interpersonal relationships.

When the patient learns about her diagnosis, it is the responsibility of the therapist to explain that no one drug is able to treat it for good. However, it is possible to help the patient and her family to deal with unpredictable mental and behavioral changes and slow down some symptoms. At this moment, the Food and Drug Administration (FDA) approves several methods of treatment for Alzheimer’s patients. To start with, Galantamine 4 mg should be taken twice a day (in the morning and in the evening) to control the signs of mild Alzheimer’s. This drug aims at improving the work of nerve cells for learning and thinking processes. To avoid unnecessary problems, a member of a family should control the intake process regularly (in case the patient forgets and confuses information). Regarding the current situation, it is not recommended to add some antidepressants but to focus on changes (if any) in the patient.

The creation of a supportive environment is another part of therapy that has to be offered to the woman. Communication with family members is necessary to explain the importance of such details as putting critical objects (keys or mobile phones) in the same places or finding secure locations for dangerous things (medications or alcohol). Another critical recommendation is based on technological progress and the possibility to track a person by means of GPS on the phone. Although these are not the direct responsibility of doctors and therapists, such hints will help caregivers facilitate a treatment process and provide the patient with the best available services. As soon as the patient gets to know that there is no cure for her disease, it should not be the reason for panic. An understanding of options is a good way to improve the quality of life and increase the number of regular check-ups and visits to other healthcare experts.

Behavioral therapies are effective for patients with Alzheimer’s at any stage. Physical and emotional comfort cannot be neglected either during daytime activities or while sleeping. Therefore, monitoring and keeping diaries should be introduced to the woman as a means to check basic needs (thirst, hunger, or fatigue). Still, it may be harmful to make the patient do everything independently because the symptoms could develop quickly. Therefore, the husband or their children must participate in her daily activities and assist (but never give orders or demonstrate precise control).

Summary

Alzheimer’s disease is a progressive disorder that changes the work of brain cells and leads them to death with time. It is one of the most causes of dementia that is frequently observed in more than 80% of cases (Weller and Andrew para. 1). Its main characteristics include the inability to think and behave adequately, problems in social skills development and maintaining, and, as a result, the lack of independent evaluations and assessments. Changes in memory and cognitive functions because of Alzheimer’s are commonly observed in patients who are older than 65 years, but if the disease is genetic, its first signs could be developed earlier. As a rule, it is impossible to predict or prevent this disorder, and many modern families try to find out if they are at risk or not. There is no specific cure that can definitely treat people from Alzheimer’s, and patients get access to medications and therapies by means of which they could slow down symptoms and improve their health conditions. Therefore, much attention is paid to education about Alzheimer’s and research of its treatment plans.

In modern healthcare and nursing practices, two hallmark pathologies have already been identified. There could be extracellular β-amyloid deposits in plaque or neurofibrillary tangles that lead to hyperphosphorylated tau (Weller and Budson para. 4). With time, synapses and neurons are lost, affecting different areas of the brain. Still, this aspect of the diseases remains poorly investigated, and researchers continue developing their theories about if it is possible to avoid negative outcomes and predict Alzheimer’s. There are many brochures and reports where the symptoms and signs are described, so people could address for help as soon as they feel changes. The most frequent complaints include memory loss, poor judgment, unreasonable repetition, and visuospatial dysfunction (Weller and Budson para. 1). In addition, people or their family members recognize behavioral and mood changes that are hard to control or explain.

Alzheimer’s is one of the well-known mental disorders in the United States, and American patients have special medical centers where they can receive help. A physical examination, direct communication with a person, laboratory testing, and brain imaging are the main diagnostic tools. Cerebrospinal fluid analysis and postern emission tomography are used to identify if the Alzheimer’s criteria are met (Weller and Budson para. 1). Doctors also investigate the patient’s family history and take several formal mental status tests to check memory and critical thinking abilities. To support patients and their families, medical experts recommend regular check-ups, professional caregiving, and the promotion of a supportive environment. Non-pharmacological treatment is one of the options, and drug therapies like the use of cholinesterase inhibitors are necessary to improve neurological symptoms. In general, Alzheimer’s may not have a cure, but it does not mean that patients should forget about medical assistance. Patient-doctor-family cooperation is a core element of a treatment plan.

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Work Cited

Weller, Jason, and Budson, Andrew. “Current Understanding of Alzheimer’s Disease Diagnosis and Treatment.” F1000Research, vol. 7, 2018. Web.

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StudyCorgi. (2022, January 23). Mental Disorders in the US: Alzheimer’s Disease. Retrieved from https://studycorgi.com/mental-disorders-in-the-us-alzheimers-disease/

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StudyCorgi. (2022, January 23). Mental Disorders in the US: Alzheimer’s Disease. https://studycorgi.com/mental-disorders-in-the-us-alzheimers-disease/

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StudyCorgi. "Mental Disorders in the US: Alzheimer’s Disease." January 23, 2022. https://studycorgi.com/mental-disorders-in-the-us-alzheimers-disease/.

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StudyCorgi. 2022. "Mental Disorders in the US: Alzheimer’s Disease." January 23, 2022. https://studycorgi.com/mental-disorders-in-the-us-alzheimers-disease/.

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StudyCorgi. (2022) 'Mental Disorders in the US: Alzheimer’s Disease'. 23 January.

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