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Reply to this discussion. Alzheimer’s disease is the most common form of dementia. Recent articles have pointed towards a strong association between Alzheimer’s disease and levels of amyloid β, along with changes in the amyloid precursor protein (APP). During the initial cellular stages of Alzheimer’s, there seems to be a relationship between the increase in amyloid β levels and the propagation of tau pathology. The changes in the cleavage of amyloid precursor protein (APP) and the production of beta-amyloid (Aβ) fragments, along with the aggregation of hyperphosphorylated tau protein, combine cause a decrease in synaptic strength, loss of synapses, and neurodegeneration. Metabolic, vascular, and inflammatory changes, along with the presence of comorbid pathologies, play important roles in the progression of Alzheimer’s (Scheltens et al., 2021; Soria Lopez et al., 2019). The progression of Alzheimer’s disease starts with small memory lapses and can become bad enough that the patient finds it difficult to engage in conversation or otherwise interact with their surroundings. This condition affects brain regions responsible for cognition, recollection, and speech. A list of Alzheimer’s disease symptoms and other indicators includes: memory impairment severe enough to interfere with daily activities; challenges with managing finances and paying bills; difficulty completing routine tasks at home, work, or play; impaired or diminished judgment; misplacing items and the inability to find them; and changes in mood, personality, or behavior (Centers for Disease Control and Prevention, 2020). As advanced nurse providers, we need to be alert to this disease and make sure that patients are properly diagnosed when their symptoms indicate Alzheimer’s, or to exclude other conditions related to vitamin deficiencies or medication side effects. Patient education, which should include their family members, is just as important as treatment. Alzheimer’s disease is not simply a symptom of getting older. Memory problems often show up as an initial red flag for Alzheimer’s, and possibly other dementias. In supporting the families of patients at their bedside, it’s important to be empathetic and provide intensive care when necessary, and to timely refer patients to appropriate care facilities when needed. References Centers for Disease Control and Prevention. (2020). Alzheimer’s disease and related dementias. https://www.cdc.gov/aging/aginginfo/alzheimers.htm Scheltens, P., De Strooper, B., Kivipelto, M., Holstege, H., Chételat, G., Teunissen, C. E., Cummings, J., & van der Flier, W. M. (2021). Alzheimer’s disease. Lancet (London, England), 397(10284), 1577-1590. https://doi.org/10.1016/S0140-6736(20)32205-4 Soria Lopez, J. A., González, H. M., & Léger, G. C. (2019). Alzheimer’s disease. Handbook of Clinical Neurology, 167, 231-255. https://doi.org/10.1016/B978-0-12-804766-8.00013-3
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