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Alzheimers disease is a neurodegenerative condition, which commonly occurs in older adults (National Institute on Aging, n.d., para. 1). It causes difficulties with everyday activities and significantly impairs the quality of life among older adults all over the world (National Institute on Aging, n.d., para. 1). Despite the numerous efforts to find an effective treatment, there are still no definitive measures to avert the brain damage caused by Alzheimers disease and to substantially relieve the symptoms (National Institute on Aging, n.d., para. 4). This report aims to examine the epidemiology of Alzheimers disease by looking into the history, symptoms, causes, and distribution of the condition.
History of Alzheimers Disease
Alzheimers disease was first noted by Dr. Alois Alzheimer, who examined the changes in the brain structure of a woman who died of a peculiar mental illness (National Institute on Aging, n.d., para. 2). In 1906, he described the diseases symptoms being profound memory loss, unfounded suspicions about her family, and other worsening psychological changes (Alzheimers Association Research Center, 2016, para. 1). The disease was named after Dr. Alois Alzheimer by a German psychiatrist Emil Kraepelin in 1910, whereas the first scales for the measurement of cognitive damage inflicted by Alzheimers were developed in 1968, allowing further study of the condition (Alzheimers Association Research Center, 2016, para. 2, 4).
In 1984, the researchers identified a new cerebrovascular protein beta-amyloid, which became the prime suspect in causing nerve cell damage associated with Alzheimers disease (Alzheimers Association Research Center, 2016, para. 9). Further development of Alzheimers studies resulted in the discovery of tau protein, a primary component of tangles and another possible cause of brain degeneration, as well as a deterministic Alzheimers gene that caused the researchers to believe in the hereditary nature of Alzheimers disease (Alzheimers Association Research Center, 2016, para. 11, 13). The first treatment emerged in 1987, while the first Alzheimers drug was approved in 1993 (Alzheimers Association Research Center, 2016, para. 12, 16). However, to this day, neither of the drugs was able to completely stop the degenerative processes in the brain, causing Alzheimers disease to become one of the six leading causes of deaths in the U.S. in 2010 (Alzheimers Association Research Center, 2016, para. 32).
Diagnostics and Symptoms
The main symptom of Alzheimers disease is severe memory impairment, which affects the everyday life of the patient (Alzheimers Association, 2016, p. 8). Other noticeable symptoms include difficulties to perform regular tasks, such as cleaning or day planning, confusion with time or place, speech problems, changes in mood and personality, and increased anxiety (Alzheimers Association, 2016, p. 8). It is common for the Alzheimers patients to withdraw from various activities, including social events (Alzheimers Association, 2016, p. 8). The cognitive functioning of the patients deteriorates to the point where they need help with core activities and struggle to recognize the closest family members or caregivers; however, as the Alzheimers Association (2016) notes, The pace at which symptoms advance from mild to moderate to severe varies from person to person (p. 8), which adds to the difficulties of diagnostics and treatment.
Diagnostics of Alzheimer is a tough process with no single method to determine the presence of the condition. Various approaches are used by physicians to discover Alzheimers disease, including referring to the patients medical and family history, assessing cognitive and functional skills, as well as more objective measures, such as blood testing and brain scanning (Alzheimers Association, 2016, p. 8). The latter technique is also one of the determining stages in the diagnostics of dementia: in cases where structural changes appear in advance of the visible symptoms, brain scanning allows to see the deterioration of neuron chains before any other symptoms can be perceived (Alzheimers Association, 2016, p. 9).
The recent advancements in the Alzheimers research have discovered that mild cognitive impairment could be used as an indicator of the early stages of Alzheimers disease: Research studies have shown that there are a variety of episodic memory tests that are useful for identifying those MCI patients who have a high likelihood of progressing to AD dementia within a few years (Albert et al., 2011, p. 272). Other methods of diagnosing Alzheimers disease include the Alzheimers Disease Assessment Scale, developed by Rosen, Mohs, and Davis (1984). The scale was designed specifically to evaluate the severity of cognitive and noncognitive behavioral dysfunctions characteristic of persons with Alzheimers disease (Rosen et al., 1984, p. 1356). The method includes rating a patient against the items on cognitive and non-cognitive subscales to determine the deterioration of memory, thinking, functioning, or other features defining Alzheimers disease (Rosen et al., 1984, pp. 1357-1359).
U.S. Statistics
Alzheimers disease, among other types of dementia, is widespread across the entire territory of the United States: an estimated of 5.6 million Americans of all ages have Alzheimers disease in 2016 , with over 5.2 million aged 65 and older (Alzheimers Association, 2016, p. 17). It is estimated that one in nine Americans over the age of 65 have Alzheimers disease, and this figure grows to one in three by the age of 85 (Alzheimers Association, 2016, p. 17).
Age is a crucial factor for the development of Alzheimer: out of all present patients with Alzheimer, only 4% are under the age of 65, whereas ages of 75 to 85 and 85 and older constitute 44% and 37% of cases respectively (Alzheimers Association, 2016, p. 17). A high prevalence of Alzheimers disease affects the overall statistics of dementia: Based on estimates from ADAMS, 14 percent of people aged 71 and older in the United States have dementia (Alzheimers Association, 2016, p. 17). Another factor that affects the prevalence of Alzheimers disease in America is gender. According to the Alzheimers Association (2016), two out of three patients with Alzheimers are females: Of the 5.2 million people aged 65 and older with Alzheimers in the United States, 3.3 million are women and 1.9 million are men (p. 18). One of the reasons for such tendency, according to researchers, is that women live longer than men, which makes them a risk group for Alzheimers disease in the older age (Alzheimers Association, 2016, p. 18). Other studies have shown that the incidence of Alzheimers in women is more tightly linked to the presence of the APOE-e4 genotype, one of the main risk factors for the condition (Alzheimers Association, 2016, p. 17).
Surprisingly, the prevalence of Alzheimers disease also varies among the states: for instance, Nevada has the lowest Alzheimers mortality out of all U.S. states, with only 11 annual deaths of Alzheimers per each 100 000 of residents (Alzheimers Statistics, 2015, para. 6). On the other hand, the highest rate of mortality has been found in North Dakota, with almost five times as many deaths as in Nevada (54 per each 100 000 residents) (Alzheimers Statistics, 2015, para. 6). It is unclear as to what has caused such a deviation, but some researchers argue that a lower education level (Alzheimers Association, 2016, p. 12) and a higher prevalence of Hispanic and African American ethnic groups in the area (Alzheimers Statistics, 2015, para. 6) could result in a higher incidence of Alzheimers disease.
Global Statistics
Alzheimers disease affects not only the Americans but also people all around the globe: according to the Worlds Alzheimers Report, Around the world, there will be 9.9 million new cases of dementia in 2015, one every 3 seconds (Alzheimers Disease International, 2015, p. iv). The global distribution of present dementia cases, 70% of which are caused by Alzheimers disease, is as follows: 9.4 million in America, 10.5 million in Europe, 4.0 million in Africa, and 22.9 million in Asia (Alzheimers Disease International, 2015, p. iv).
The distribution of Alzheimers prevalence according to areas of the globe shows that highest prevalence of Alzheimers disease is in Western Europe, whereas the least number of cases was found in Sub-Saharan Africa (Alzheimers Statistics, 2015, para. 1). These findings are surprising when the racial makeup of Alzheimers incidence is considered: studies show that out of Caucasian people aged 65-74, only 2.9% suffer from Alzheimers; the figure rises to 10.9% at the age of 75-84 and to 30.2% when they reach the age of 85 and older (Alzheimers Statistics, 2015, para. 4). The figures are a lot higher in African American and Hispanic backgrounds: African Americans aged 65-74 are at a 9.1% risk of having Alzheimers and the risk increases to 58.6% as they reach the age of 85 (Alzheimers Statistics, 2015, para. 4). Hispanic elders, on the other hand, have a lower prevalence of Alzheimer at the earlier age (65-74), however the risks rise steadily to 19.9% at the age of 75-84 and 62.9% at the age of 85 (Alzheimers Statistics, 2015, para. 4). In Asian regions, however, the age of the highest risk is 75-84, after which the incidence of dementia and Alzheimers disease decreases (Alzheimers Disease International, 2015, p. 2). Asian regions also show the highest rate of growth of new dementia cases: 49% of these will arise in Asia, compared with 25% in Europe, 17% in the Americas and 8% in Africa (Alzheimers Disease International, 2015, p. 68).
The difference between the racial makeup and the areal makeup of Alzheimers disease can be justified by two distinct factors. Firstly, on average, only one in four Alzheimers patients has been diagnosed (Alzheimers Statistics, 2015, para. 1), which means that in some areas with no set procedures for the diagnostics of Alzheimers disease, many of the people suffering from the condition will not be included in the statistical analysis for that area. Secondly, developing countries, such as many of the African countries, have a lower life expectancy, meaning that the majority of the people die before they reach the age of noticeable development of Alzheimers symptoms.
Conclusion and Outlook
Alzheimers disease today is a serious problem that impacts the quality of life of more than 44 million of people worldwide and is a subject of many research studies. Nevertheless, the outlook for the patients diagnosed with the condition is hardly promising. Alzheimers disease dramatically shortens the life expectancy of its patients: 61% of those who have Alzheimers are expected to die before the age of 80, compared to only 30% of those who do not have the disease (Alzheimers Association, 2016, p. 25). Moreover, the condition has an adverse effect on the quality of life of the affected people: Alzheimers is also a leading cause of disability and poor health (morbidity). Before a person with Alzheimers dies, he or she lives through years of morbidity as the disease progresses (Alzheimers Association, 2016, p. 26).
Apart from impacting the physical health of the patients, Alzheimers disease also has a traumatizing effect on their family and loved ones. It is not uncommon for people struggling with Alzheimers to not recognize their own children and spouses, as well as to have frequent mood swings, severe anxiety, and even aggressive behavior (Alzheimers Association, 2016, p. 33). Caregivers aim to provide some relief to the patients and their families, however, it is far more important to address the cause of the problem by creating an effective treatment or devising precautionary measures: Modest advances in therapeutic and preventive strategies that lead to even small delays in the onset and progression of Alzheimers disease can significantly reduce the global burden of this disease (Brookmeyer, Johnson, Ziegler-Graham, & Arrighi, 2007, p. 186). Many researchers efforts are now concentrated on exploring the causes of Alzheimers disease (Sperling et al., 2011, p. 281) to bring us one step closer to creating a treatment, giving many sufferers of Alzheimers and their families hope for a better future.
References
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Alzheimers Association (2016). 2016 Alzheimers disease facts and figures. Web.
Alzheimers Association Research Center (2016). Major milestones in Alzheimers and brain research. Alzheimers Association. Web.
Alzheimers Disease International (2015). World Alzheimer report 2015.
Alzheimers statistics (2015). Alzheimers.net.
Brookmeyer, R., Johnson, E., Ziegler-Graham, K., & Arrighi, H. M. (2007). Forecasting the global burden of Alzheimers disease. Alzheimers & Dementia, 3(1), 186191.
National Institute on Aging (n.d.). About Alzheimers disease: Alzheimers basics. Alzheimers Disease Education and Referral Center. Web.
Rosen, W. G., Mohs, R. C., & Davis, K. L. (1984). A new rating scale for Alzheimers disease. American Journal of Psychiatry, 141(11), 1356-1364.
Sperling, R. A., Aisen, P. S., Beckett, L. A., Bennett, D. A., Craft, S., Fagan, A. M.,& Phelps, C. H. (2011). Toward defining the preclinical stages of Alzheimers disease: Recommendations from the National Institute on Aging Alzheimers Association workgroups on diagnostic guidelines for Alzheimers disease. Alzheimers & Dementia, 7(3), 280292.
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