Alzheimer’s disease is extremely prevalent in the United States. It is sixth in the leading causes of all deaths and fifth in the leading causes of death in people 65 years of age and older. The disease is characterized by continuous deterioration in mental, functional, and behavioral abilities. Currently, approximately 5.4 million Americans suffer from Alzheimer’s disease. However, this number is expected to increase to a million persons with Alzheimer’s disease per year by 2050 due to the baby boom generation, resulting in a total prevalence of an estimated 11 to 16 million people affected by this disease.
Senile plaques and neurofibrillary tangles are known to be the key pathological hallmarks of Alzheimer’s disease. The finding of β-amyloid (Aβ) in senile plaques and genetic studies that found mutations in the amyloid precursor protein, presenilin 1 and presenilin 2 genes that led to the build-up of β-amyloid and early-onset familial dementia, resulted in the creation of the “Amyloid Cascade Hypothesis” (ACH). The ACH posits that abnormal production or incomplete clearance of the β-amyloid protein leads to extracellular amyloid plaque deposition, which then results in secondary events, such as hyperphosphorylation of tau protein and development of neurofibrillary tangles, inflammation, cell death in neurons, and dementia. These adverse events lead to deficits in neurotransmitters which are presumed to cause clinical manifestations of the disease.
At this time, no cure has been found for Alzheimer’s disease. However, drug and non-drug treatments are commonly used to improve cognitive and behavioral symptoms. Research is being done to discover new treatments to combat the disease and enhance quality of life for older adults with dementia. There are two types of medications approved by the Food and Drug Administration (FDA) that are used to treat cognitive symptoms of Alzheimer’s disease, such as loss of memory, cognitive functioning, and confusion. Cholinesterase inhibitors (also known as Aricept, Exelon, and Razadyne) and memantine (Namenda) are the two drugs that can help mitigate or stabilize these symptoms for a short period of time by influencing certain chemicals that play a role in transferring messages along the nerve cells of the brain. Physicians sometimes prescribe both types of drugs simultaneously, and also prescribe high doses of vitamin E to treat cognitive changes that occur because of Alzheimer’s disease.
Getting regular physical exercise is thought to be beneficial in lowering one’s risk of Alzheimer’s disease and vascular dementia. Exercise can have a direct beneficial effect on brain cells by elevating blood and oxygen flow in the brain. Maintaining a healthy diet may also help protect the brain from early cognitive decline. Older adults in nursing homes should have their diets regulated and health care staff should make sure their diet consists of low sugar and saturated fats, as well as plenty of vegetables, fruits, and whole grains. Many studies have also shown that older adults who regularly engaged in social activities and mentally stimulating activities often had a lower risk of cognitive deterioration and Alzheimer’s disease. Nursing home staff should encourage their patients to participate in social activities and engage with them in meaningful ways to improve their quality of life.