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The author wishes to acknowledge Paper

The author wishes to acknowledge with the profound gratitude to his mother for the help and time she gave in doing this research, his father who was always there to support and ask if there were any problems. Sincere thanks is given to many friends for the inspiration and encouragement that she needed, the undying support and guidance by his friend Denice Van Del Rosario, Mariel Dela Cruz and above all, utmost debt is due to the LORD GOD for all, the strength, guidance, help and will power that HE showered unto me while doing and finishing this research work.

DEDICATION

This research work is lovingly dedicated to the Filipinos who inspired the author, his parents who gave their time in supporting the researcher, his friends who gave the encouragement and most of all, this is dedicated to the person who gave everything. The spiritual life, strength, will power and guidance of creator of all humans our dear “LORD.”

CHAPTER I

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INTRODUCTION

BACKGROUND OF THE STUDY

Alzheimer’s disease is known as mental deterioration and total incapacitation of the mind. It is known that almost all American people have this disease. Relatives of these persons neglect them and give no importance to their living. Hence, there are still some people ask what is the main cause of Alzheimer’s Disease, its signs and symptoms and the way how to develop the well being of the person.

With this kind of problem the author find in himself the interest that is needed to support and guide other people that such a disease occur.

Problem: What is the real cause of the disease, the signs and symptoms that occur in patients and how to improve patient’s well being?

Hypothesis: Alzheimer’s disease is known to exist by mutation. Loss of memory, reasoning and hyperactivity are some of its signs and symptoms.

SCOPE AND LIMITATIONS

The author limits his studies on:

1. The cause of Alzheimer’s disease

2. The biochemical changes that occur in Alzheimer’s disease patients

3. The sign and symptoms

4. Some useful ways to maintain and improve patients well being

5. The ratio of Americans affected by the disease

6. The pharmacotherapy in Alzheimer’s disease

OBJECTIVES

The author finds an interesting in choosing this topic because he wants to:

a. Awake the Filipinos and government that Alzheimer’s disease and it will be dreadful to our country.

b. Awake the interest of the doctors as well as researchers to find some ways or medicines to prevent or stop the disease.

c. Interest the doctor’s to find the real cause of this disease and to find out whether it is a gene factor or nor.

RELEVANCE OF THE STUDY

In the present study of our country as well as the past situations the Philippines is dealt with so many problems. A problem in the environment, which until now not yet given a solution. Another problem which our country faces is the political problem that gives us burden in bringing up our economy, economical problem is the main and major problem of our country today specially all the disasters an catastrophes that had happened and is happening now. The Filipinos knew that our country has different institutions that will help the government solve the problems which we are dealing with, such institutions are UNICEF* which is an institution for children, the FAD* which gives us information about agriculture and PMHA* which gives us information regarding mental health, mental retardation and organic brain syndrome. These institutions help the government in up bringing our economy and help people gain information’s regarding different ailments.

Philippines is known it’s abundant natural resources but all of these have not given us the opportunity to raise our economy. Maybe because the way our government runs or maybe it is the people who do nothing. That is the question? with so many problems and disasters which our country faces the author wants to awake the interest of the Filipinos in being a good citizen of our country, in order to solve those problems that we are facing and from there we will be ready for the new obstacles and disasters that will happen to us. and because we are strong and we have the so called unity we can withstand any problem or catastrophes that will happen again.

DEFINITIONS OF TERMS

Alzheimer’s Disease – characterized by gradual loss of memory, confusion, loss of reasoning, total incapacitation, brain degeneration and death.

Autopsy – an examination of a dead body to find the cause of death.

Dementia – is a lingering disease; it can be progressive, remain static or fluctuate.

Diagnosis – the act of fact or deciding the nature of a disease by examination or observation.

EEG (electroencephalogram) – tracing the brain waves made by an electroencephalograph.

Neurons – nerve cell body and all its processes.

Postmortem – analysis or relating to an event.

Senile Dementia – an irreversible mental deterioration and memory loss that is almost accompanied by numerous other difficulties in mental function.

Senility – is a pattern of progressive deterioration thought and behavior related to irreversible brain damage.

CHAPTER II

REVIEW RELATED LITERATURE

Merritt’s Textbook of Neurology, 7th edition, edited by Lewis P. Rowland.

This book gives us with the information regarding Alzheimer’s disease. This textbook mainly deals with the diseases of the brain and nervous system. on page 508, having the title Ataxias and dementia which was contributed by Robert Katzmen gives us a bird’s eye view regarding the disease.

New and Completed Medical and health Encyclopedia authored by Richard J. Wagman.

On this book, chapter 1 deals with definitions especially presenile which is known as Alzheimer’s disease. It also give us diagnosis in the disease.

Correlative Neuroanatomy and Functional Neurology, by Chusid

Discusses some characteristics of the disease and some changes that occur in the brain.

World book Medical Encyclopedia, 2nd edition.

All about definitions regarding health and diseases.

Britanica and Lexicon Encyclopedia under letter A

Gives information regarding Alzheimer’s disease.

Science journal, Vol. 3 p. 2.

In this journal discusses how to develop or improve patient’s well being

Organic Mental Disorders

This book gives us information regarding different disease and example of how to care patients and treat them, in this book it also gives us information on what to do with the patients and some Pharmacotherapy are also given.

CHAPTER III

METHODOLOGY

The method used by the author in this research work is the description type of method. At first, the researcher was confused on what method to use. But the, when the author finished reading all data’s and gather them. He then came up with a method which is descriptive type of methodology. The researcher thinks that in order for the readers to understand this topic easily he used this method. And because it is based on facts and not by the knowledge of anybody we can have an analyzation regarding the research work

CHAPTER IV

(PRESENTATION OF FINDINS AND INTERPRETATION)

HISTORY

Fist described in 1906 by a German neuropathology’s Alois Alzheimer. Alzheimer’s disease is though to occur in about the ratio of 1 case of senile dementia.

For many years, the term Alzheimer’s disease was limited to the description of cases with an onset in the presenism, that is, before the age of 65. Clinical pathologic, ultra-structural, and biochemical analyses indicate that Alzheimer’s disease and senile dementia a single process; there is now a consensus to consider a single disease.

The occurrence of the disease is indicated in the brain by the growth of so called neurotic plaque, constituting of degenerating nerve terminals and other materials and by the appearance of fibrous structures, called the neurofibrillary tangle within nerve cells. Thus, for such changes are observable only through autopsy, but emission tomography may yet become a diagnostic tool. One cause of the growth of a decline in the brain production of acetylcholine or important neurotransmitter. Disease brains also metabolize glucose at diminished levels, particularly in the cortex’s posterior parital lobe, and abnormally high levels of aluminum and silicon occur in disease region.

DEFINITION

Alzheimer’s disease

It is a condition affecting the brain, resulting in a rapid and severe deterioration of mental capacities. A brain disorder which affect both memory and reasoning abilities. Victims of Alzheimer’s disease, which is a form of acute dementia, or mental deterioration, undergo various changes. These include ability to concentrate, anxiety, irritability, agitation, withdrawal and petulance that keep them or less their way. They may have temper tantrums and engage in obsess ional behavior such as repeatedly washing dishes. This disorder is characterized by progressive dementia and dysphasia. It is degenerative brain disease characterized by death of nerve cells in the convulsion of frontal and temporal lobes of the cerebrum. This disease is the major cause of presenile dementia (dementia not associated with advanced age) and is also the largest single cause of senile dementia and irreversible mental deterioration and memory loss that I almost always accompanied by numerous other difficulties in mental function. Among its effects are speech disturbances, severe short term memory loss and disorientation leading to progressive loss of mental faculties. It is a neurological disorder of the brain. Once thought rare, because it was believed to be associated with the relatively rare case of presenile dementia, which strikes persons in their 40’s and 50’s, it is now considered that largest single cause of senile dementia.

SIGNS AND SYMPTOMS

Alzheimer’s disease presents as progressive dementia with increasing loss memory, intellectual function, and disturbances in speech. In the initial stages, there is a slight dulling of intellectual faculties. Thought process is slowed, ability to perform in the social and economic spheres is impaired and memory is defective. Disturbance of speech functions is a common early symptom. To these may be added various apraxia and various types of agnosias.

If the patient has into deterioration, he or she may become depressed, and depression is seen in about 25% of the patients. Agitation and restlessness are also common. Motor signs are common early in the course, but as the disease progresses, reflex changes may be noted and a slow, shuffling gait develops. Myoclonus and convulsive seizures occur in some patients late in the course. The clinical picture in the terminal stages is strikingly consistent. Intellectual activity cease and the patient become meek and are reduced to a vegetative condition. Generalized weakness and contradictions may develop in the terminal stages. Control of bowel and bladder function is lost. Commonly, the first clue maybe demonstration of unusual unreasonableness and impairment of judgment. The patient can no longer grasp the content of the situation at hand and reacts inappropriately. Memory gradually fades and recent events are no longer remembers, but events that occurred early in life can be recalled. The patient may wander aimlessly or get loss in his own house. There is progressive deterioration of physical progression of the process, and the patient becomes confined to bed at quite helpless.

This person may also be anxious, active, aggressive and impulsive delusions, hallucinations and confabulation may be observed. Memory impairment is usually severe room locations on the ward and has to be led to these areas.

CHARACTERISTICS

Postmortem brain studies have demonstrated characteristic changes occur in Alzheimer’s disease. (1.) Neurofibrillary tangles that appear to be irregular masses of neuro-filaments may take part in salutatory movements essential for exoplasmic flow might deprive the axon of essential protein and lead to neural dysfunction. Impaired intracellular function could then lead to an accumulation of toxic metabolites and cell death. Some factor affecting cytoplasmic protein may be involved in this disorder. (2.) Neurotic plaques (deposits that show neuro denervation). Neurotic plaques are compose of degenerating nerve terminals, reactive glial cells and fibrous material called amyliod. (3.) Granulovascular degeneration (fluid deposits and granulation in the neurons), and (4.) reduced enzyme activity particularly of noradrenalin and of choline acetyltranserase, which is required in acetylcholine synthesis.

BIOCHEMICAL CHANGES

Despite the devastating clinical changes that occur in Alzheimer disease, relatively few biochemical changes differentiate postmortem Alzheimer brain tissue from that of age-match normal individuals. The most consistent change is 50% to 90% reduction of the activity of choline acetyltranserase in the cerebral cortex and hippocampus. Because choline acetyltranserase, which is the biosynthetic enzyme for acetyl-choline, is found only in cholinergic neurons, it appears likely that there is selective loss of cholinergic neurons, particularly in cholinergic projection pathway from deep nuclei located in the septum near the dialogical bond of broca to the hippocampus, and from the nearby basal nucleus of meynert to the cerebral cortex and hippocampus of a normal compliment of postsynaptic muscarinic receptors. The degree cognitive deficit measured during life is roughly proportional to the loss of choline acetyltranserase.

PATHOLOGY

Alzheimer disease is characterized by atrophy of the cerebral cortex that is usually diffuse, although it may be more severe in the frontal and temporal lobes. The degree of atrophy is variable. Brains of affected individual weigh between 850g and 1250g at autopsy. Normal aging of the brain is also accompanied by the atrophy; there is an overlap in the degree of atrophy of brains obtained from elderly Alzheimer patients and unaffected patients of same age. On microscopic examination, there is a loss of both neurons and neuropil in the cortex and, sometimes, secondary demyllination in sub cortical white matter. With quantitative morphometry, it has been shown that the greatest loss is that of large cortical neurons. The most characteristic findings are the argentopilic senile plaque is found throughout the cerebral cortex and hippocampus, and the number of plaques is composed of enlarge, degenerating exonal endings surrounding a core composed mainly of extra cellular amyliod. The degenerating exonal buttons contain lysosomes, degenerating mitochondria, and paired helical filaments.

These paired helical filaments, which are about 20nm wide with a twist every 80nm along their length, constitute the chief element found in Alzheimer neurofibrillary tangle. These tangles consist of accumulation of these filaments within the body of a swollen neuron. Neurofibrillary tangles first occur in the hippocampus particularly tangles may be found throughout the cerebral cortex. Other less prominent but still common features of Alzheimer’s disease includes Granulovascular degeneration of pyramidal cells of the hippocampus and congophilic angioplasty. The hirano body, a rod like body containing Para crystalline material, first describe in the Guam parkinsonism-dementia complex, is also found in Alzheimer’s disease. Atherosclerotic-dementia changes are absent or are present only to a minor degree in most cases.

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