Alzheimer’s Disease with Malnutrition in Elderly

Running head: ALZHEIMER’S DISEASE
Alzheimer’s disease with malnutrition in elderly
Name of the Student
Name of the University
Author Note

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ALZHEIMER’S DISEASE
Alzheimer’s is one the common neuro degenerative disease among the older adults. It
is causes loss of quality of life along with cognitive and memory impairment (Jahn, 2013).
The following assignment aims to conduct an aged care related case study via conducting an
interview with an elderly person and one of his family members who is suffering from
Alzheimer’s and is malnourished. Based on the medical condition (Alzheimer’s and
malnutrition) gathered from the interview, the assignment will aim to provided a detailed
insight about the pathophysiology of the medical condition, including the contributing factor
behind the disease development. The assignment will also aim to throw light on the impact of
Alzheimer and its associated malnutrition on overall health of the person along with model
for care and associated legal or ethical dilemmas.
Health and Past History of the Interviewee
Mr. X is a 70 years old a retired government employee and was diagnosed with
dementia about two years ago. He lives alone in his two stored building after his wife passed
away three years ago. He has two sons and both of them are married and reside outside the
town due to job. During the interview, Mr. X was found saying that he could not remember
the exact incidence that turn around to his hospitalization. His son, he came to visit him in the
hospital informed that her felt lawn which resulted in traumatic head injury. Mr. X is also
malnourished and this is relevant from his severe muscle wasting and under weight. He said
that after his wife passed away, he developed depression. He also stated that during his 2
weeks admission in the hospital he stated forgetting things like taking medication. In his
discharge summary, the doctors highlighted that he has degenerative neuronal disease
(Alzheimer’s) that has progressed during his retried life, after his wife passed away. `the
discharge summary also highlighted that he is now on cholinesterase inhibitor. He is also
facing difficulty in feeding, moving around despite being on post-discharge medication.
During the interview, it was visible that he is facing difficulty in communicating because of

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ALZHEIMER’S DISEASE
his slurred speech along with occasional restlessness and agitation due to anxiety. His sense
of reasoning and judgement seemed to be distorted along with absence of coherence in
answering questions during the interview. Sometimes Mr. X repeats the same answers for
different questions. Based on the first hand information gather from one of his son, a mini-
mental state examination was undertaken one year age and it revealed 18 indicating signs of
cognitive impairment. Loss of memory, impaired judgement, and disruption of visual
perception, focus and reasoning are mostly observed among the patients suffering from the
neurodegenerative disease like Alzheimer’s (Jahn, 2013). Mr. X reported was also found
reporting that the food service that he has availed after the death of his wife, scarcely supplies
quality food on time. Moreover, he hates to go out to house and remains mostly seated and
suffers from loss of appetite. His son reported that he is also a patient of type 2 diabetes and
has sudden restriction of food and takes metformin regularly. He has also been detected with
mild symptoms of Alzheimer’s disease and hence has been on cholinesterase inhibitor for the
past 2 years.
Pathophysiology and contributing factor of Alzheimer’s among elderly patient
Alzheimer’s disease is one of the most common neurodegenerative diseases that
accounts for more than 80% of dementia cases worldwide (Kumar & Singh, 2015). It leads
towards the generation of progressive loss of memory, cognitive behavioural function and the
reduction in the ability to learn. Kumar and Singh (2015) have further opined that, amyloid
beta fibrils form oligomers in the brain which form amyloid plaques and thereby causing
synaptic impairment. Alzheimer disease falls under the umbrella disease of dementia.
Alzheimer’s disease mainly attacks the brain cells resulting in the significant loss of memory,
thinking and other cognitive impairment (Jack Jr, et al., 2013). Jack Jr. Et al. (2013) have also
stated that Alzheimer;s disease causes degeneration of the cortical and subcortical pyramidal
cells of the brains along with the degradation of the cholinergic neurons which are

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ALZHEIMER’S DISEASE
responsible for the maintenance of cognitive functions of the brain. The neuropathological
hallmarks of Alzheimer’s are detected by the presence of senile plaques (commonly known
as amyloid deposits) along with the deposition of the neurofibrillary tangles in the autopsied
brains. These neurofibrillary tangles are made up of hyperphosphorylated tau protein, which
are situated within the neurons, whereas senile plaques are mainly composed of amyloid-P
species, which aggregate within the extracellular space of the neurons (Jahn, 2013). These
signatures neuropathological changes begin in the entorhinal cortex and in the hippocampus
of the brain, which later spreads into the temporal, parietal, and frontal cortex of the brain.
All these neurological complications lead to the generation of memory loss along with
decrease in the cognitive function (Jahn, 2013). Alzheimer’s also leads to dementia due to
signification loss of the equilibrium of the association cortex. This disruption in the
equilibrium of the brain impairment in judgement, language, speech and gross motor
movements all these disrupts the normal daily activities. Alzheimer’s disease is known to be
associated with the decrease in the intake of food as people tend to forget about what they
have ate or whether they have consumed food or not and thereby leading to the development
of malnutrition of under nutrition (Droogsma, Van Asselt, Scholzel-Dorenbos, Van Steijn,
Van Walderveen, & Van der Hooft, 2013).
In case of Mr. X there are several contributing factors that have been responsible for
the development of Alzheimer and subsequent malnutrition. The first contributing factor
behind the development of Alzheimer’s in case of Mr. X is depression. Depression generated
during the later stages of life increases the susceptibility of mild cognitive impairment and
thereby increasing the chance of developing Alzheimer’s disease (Steenland, Karnes, Seals,
Carnevale, Hermida, & Levey, 2012). Comorbid depression leads to neuropsychiatric
complications that increase the susceptibility of developing Alzheimer’s disease (Sepehry,
Lee, Hsiung, Beattie, & Jacova, 2012). Sepehry et al. (2012) have further opined that