This page is devoted to Alzheimer’s Disease. Alzheimer’s disease has been called the disease that strips us of our humanity. It literally robs one of their memories, and therefore their life. Although many CNA’s have worked with residents who have been dx with Alzheimer’s, most of us don’t have a clue what it is like to live it.
Presented here are some basic thoughts on causes, symptoms, , diagnostic criteria, stages and models of care. CNA’s should have a good base of knowledge on these topics.

Alzheimer’s disease was first described by German psychiatrist Dr. Alois Alzheimer in 1907 when he performed an autopsy on a 51 year-old woman who died of a strange disease that caused memory & language impairment.

Causes
There are many therories about what causes Alzheimer’s, but nothing has been proven. Autopsies performed on victims have shown brain mass that is very small in size, with a lot of plaques and tangles- that are not found in people who do not have Alzheimer’s. It is not known whether these plaques and tangles are the cause, or result of Alzheimer’s.

Symptoms
Early symptoms, such as memory loss, may be attributed to the forgetfulness associated with ageing. Gradually, the loss of cognitive function disrupts the patient’s ability to perform common daily activities, such as paying bills, driving, and housekeeping. Some people remain unaware of their symptoms, while others are painfully aware of the fact that they are losing mental function.

Symptoms of Alzheimer’s disease include the following:
· Aphasia (i.e., loss of ability in comprehension of spoken or written language, naming objects, fluency, etc.)
· Apraxia (e.g., inability to perform physical tasks such as dressing, eating)
· Delusions
· Easily lost and confused
· Inability to learn new mental tasks
· Loss of judgment, reason, and cognitive abilities
· Loss of inhibitions and belligerence
· Social withdrawal
· Visual hallucinations
In end-stage Alzheimer’s disease, patients may become bedridden and need help with eating and getting out of bed to use the bathroom. Patients also may experience convulsions and seizures and may become incontinent.

Diagnosis
The diagnosis involves taking a detailed history of symptoms and ruling out other treatable medical and psychological conditions that cause dementia (loss of cognitive function), such as the following:
· Depression
· Head trauma
· Infection (e.g., HIV, syphilis)
· Intoxication or withdrawal from medication, poison, or substance of abuse
· Kidney disease
· Liver disease
· Neurodegenerative diseases (e.g., Creutzfeldt-Jakob, Huntington’s)
· Seizures
· Thiamine or vitamin b deficiency
· Thyroid disease
· Tumor
Normal effects of aging must be ruled out as well.
A mental status examination reviews systems of higher mental function. This involves asking questions to evaluate mental functions and making observations of the patient’s behavior, appearance, and attitude. Questions are designed to assess orientation, memory, attention and appearance, and attitude; concentration, insight and judgment, general intellectual functions (e.g., calculation; common knowledge, such as What is the capital of the United States?; identifying similarities and differences between words) . Slowly progressive loss of memory and orientation, normal lab test results, and brain imaging scans that show atrophy of the cerebral cortex and hippocampus indicate a diagnosis of Alzheimer’s disease.

Tests
Routine blood, serum, and plasma analysis can identify the presence of most diseases mentioned. Brain imaging studies are capable of identifying the presence of tumor, head trauma, and neurological conditions. Magnetic resonance imaging (MRI) or computed tomography (CT) scans show diffuse atrophy of the cerebral cortex and hippocampus in Alzheimer’s disease. Neuroimaging may be normal early in the disease.