Alzheimer Disease (Nursing)

Excerpt

Dementia is a general term that refers to a decline in cognitive ability severe enough to interfere with activities of daily living. Alzheimer disease (AD) is the most common type of dementia, accounting for at least two-thirds of cases of dementia in people age 65 and older. Alzheimer disease is a neurodegenerative disease that causes progressive and disabling impairment of cognitive functions including memory, comprehension, language, attention, reasoning, and judgment. It is the sixth leading cause of death in the United States. Alzheimer disease is typically a disease of old age. Onset before 65 years of age (early onset) is unusual and seen in less than 10% of Alzheimer disease patients. The most common presenting symptom is selective short-term memory loss. The disease is invariably progressive, eventually leading to severe cognitive decline. There is no cure for Alzheimer disease, although there are treatments available that may improve some symptoms.

Symptoms of Alzheimer disease depend on the stage of the disease. Alzheimer disease is classified into preclinical, mild, moderate, and late-stage depending on the degree of cognitive impairment. The initial presenting symptom is usually recent memory loss with relative sparing of long-term memory and can be elicited in most patients even when not the presenting symptom. Short-term memory impairment is followed by impairment in problem-solving, judgment, executive functioning, lack of motivation and disorganization, leading to problems with multitasking and abstract thinking. In the early stages, impairment in executive functioning may be subtle. This is followed by language disorder and impairment of visuospatial skills. Neuropsychiatric symptoms like apathy, social withdrawal, disinhibition, agitation, psychosis, and wandering are also common in mid to late stages. Difficulty performing learned motor tasks (dyspraxia), olfactory dysfunction, sleep disturbances, extrapyramidal motor signs like dystonia, akathisia, and parkinsonian symptoms occur late in the disease. This is followed by primitive reflexes, incontinence, and total dependence on caregivers.,,