Pathophysiology I: Alzheimer's Disease Case Study Assessment

This case study analyzes Alzheimer's disease, examining its diagnosis, risk factors, and public health implications. It explores the diagnostic process, including neurological examinations, lab tests, neuropsychological tests, and brain imaging techniques like MRI and PET scans. The study contrasts Alzheimer's with depression, highlighting the use of tools like the ACE-R for differentiation. It also delves into the epidemiology of the disease, citing statistics on mortality rates in Australia and discussing both modifiable and non-modifiable risk factors such as age, genetics, smoking, obesity, high blood pressure, and diabetes. The case study of R.M. emphasizes the interplay of genetic and environmental factors, along with the impact of age and gender. Finally, it explores lifestyle interventions, including physical activity and smoking cessation, as strategies for reducing the risk of Alzheimer's disease, underscoring the role of healthcare professionals in providing information and support. The assignment is a detailed analysis of the disease, its impacts, and potential interventions.

Running head: HEALTHCARE
Healthcare
Name of the Student
Name of the University
Author Note

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1.a. Progressive loss of brain cells indicates the occurrence of Alzheimer’s disease
(Alzheimer’s, 2015). Evaluating the mental conditions of the patient before starting any other
tests plays an important role in understanding the mental condition of the patien. (Dubois et
al., 2016). Firstly, it is important to find out whether the patient is having any problem in the
cognitive skills. Secondly, evaluation of changes in behaviour. Thirdly, evaluation of effects
of the disorder in daily life events (Dubois et al., 2016). These evaluations can be done by
involvement of a neurologist. Diagnosis of the disease involves several tests including
neurological examinations, lab tests, neuropsychological tests and brain imaging
(Alzheimer’s, 2015)..
Neurological Examinations
It is performed to evaluate the neurological health of the patient. In this case several
aspects such as muscle activity, sight and hearing activity, coordination, balance and reflexes
are evaluated (Alzheimer’s, 2015).
Lab tests
Memory loss can be connected with vitamin deficiency, thyroid disorder etc. Hence, blood
test play a major role to rule out other reasons behind memory loss (Gibson et al., 2016).
Neuropsychological tests
The concept of neuropsychological tests is based on the relationship between brain
and functioning of an individual. Alzheimer’s disease Assessment Scale- Cognitive is an
important neuropsychological test used by neurologists to diagnose Alzheimer’s disease
(Alzheimer’s, 2015).
Brain imaging
It is mostly used to find out abnormalities related to mental illness other than
Alzheimer’s disease. The abnormalities include stroke, trauma, tumours etc. Magnetic

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resonance imaging (MRI) and Computerized tomography scan (C.T. scan) are normally used
in this case (Alzheimer’s, 2015).
Positron emission tomography (PET) is used to find out the degeneration of brain
cells. Fluorodeoxyglucose PET scan is used to find out the areas in brain where nutrient
metabolism is significantly and it is an important part to distinguish Alzheimer’s disease from
other dementias (Alzheimer’s, 2015).
1.b. It is important to develop treatment measures which has specificity towards a
particular disease. According to several studies, similar symptoms of Alzheimer’s syndrome
and depression make it challenging to the patients to diagnose the problem specifically. The
Addenbrooke’s Cognitive Examination- Revised (ACE-R) is a screening test of dementia
which can be implemented to identify the difference between Alzheimer’s disease and
depression (Rotomskis et al., 2015). Several studies reported that ACE-R is a useful tool
which is accurate enough to detect patients with Alzheimer’s disease and differentiate them
from depression (Rotomskis et al., 2015). Neuropsychological analysis of individuals
diagnosed with depression and Alzheimer’s disease indicated the distinct differences in ACE-
R results. Alzheimer’s disease is characterized by severe impairment in attention and
orientation along with language and memory subsets, and moderate impairment in verbal
fluency (Rotomskis et al., 2015). On the other hand, depression is characterized as mild
impairment in the ACE-R score which includes low scores in verbal fluency and memory
related tasks (Rotomskis et al., 2015).
2. According to Australian Bureau of Statistics (2019), Alzheimer’s disease and
dementia are found to be the reason behind a significant number of death in Australia in
2013. The report describes that the death rate due to Alzheimer’s increased around 32%
during 2009-2013. Moreover, 7.4% of total death was occurred due to problems related to

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Alzheimer’s disease. Thereafter, statistics of 2015 indicated that the death rate due to
Alzheimer’s disease was 35/day.
3. There are several risk factors which can influence Alzheimer’s disease. These factors
can be grouped under two types such as non-modifiable risk factors and modifiable risk
factors.
Non modifiable risk factors include
Age
Age one of the most important risk factors of Alzheimer’s syndrome. Numerous
studies reported that the Alzheimer’s disease is mostly prevalent in people aged more than 65
(Flores et al., 2015).
Family history
Some literature supported the fact that Alzheimer’s disease can be transferred from
one generation to another due to genetic transformation (Wolters et al, 2017).
Genetic modifications
In most of the cases Alzheimer’s disease occurred due to the mutation in different sets
of genes and it is mostly predominant in elderly adults (Hutton, Pérez-Tur & Hardy, 2017).
There are several modifiable life style factors which are linked with patients diagnosed with
Alzheimer’s syndrome
Smoking
Several literature supported the fact that people with a smoking habit are prone to
develop Alzheimer’s disease compared to the non-smokers. Hence, reduction in smoking
habit can lead to reduction of risks related to the disease (Xu et al., 2015).

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Obesity
Obesity is connected with lower level of physical activity. Apart from that smoking is
also reported for its influence in obesity. There are several complications which can occur
due to obesity such as diabetes, hypertension, high cholesterol etc (Xu et al., 2015).
High blood pressure
High blood pressure is a reason behind damage of the arteries and blood circulation
and different studies reported that Alzheimer’s disease is linked with health conditions related
to hypertension. High blood pressure can be reduced by implementing healthy diet and
exercise (Xu et al., 2015).
Diabetes
According to Xu et al. (2015), diabetes mellitus and Alzheimer’s syndrome are
closely related. Moreover, the risk of developing dementia is comparatively higher in case of
patients with diabetes mellitus than normal individuals. Diabetes mellitus can be controlled
by following personalized diet and exercise.
Lipid profile
Individuals with high level of cholesterol during their mid age can develop health
issues related to dementia. Hence, reduction of high cholesterol can help to avoid the chances
of Alzheimer’s disease (Xu et al., 2015).
4. According to the case study, it is understood that, there is a history of Alzheimer’s
disease in the family of R.M. Different studies supported the fact that, the disease can be
hereditary. However, development of Alzheimer’s syndrome can occur due to both genetical
and environmental factors. In case of R.M, genetic factors plays the vital role in development
of the disease. However, influences of the environmental factors was not described in the
case study. The case of R.M. is indicating the connection between age and dementia. R.M is

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an 85 year old woman and age is mostly connected with the disorder (Flores et al., 2015).
Apart from that, some literature described that, occurrence of Alzheimer’s syndrome is high
in women compared to men. Hence, gender of R.M can be an important risk factor which can
influence development of Alzheimer’s disease (Nebel et al., 2018).
5. Life style interventions can involve in reduction of risks related to Alzheimer’s
disease. The actual mechanism behind lifestyle improvement and prevention of the disease is
not yet understood. However, different studies highlighted the connection between different
health stresses and dementia (Kivipelto, Mangialasche & Ngandu, 2018). According to
different reports, physical activity plays major role in reducing metabolic and vascular risk
factors related to Alzheimer’s disease (Kivipelto, Mangialasche & Ngandu, 2018). Smoking
is a major reason which can lead to different risk factors related to the disease (Kivipelto,
Mangialasche & Ngandu, 2018). Hence, avoiding smoking can be the first step to reduce the
chances of the disease. Reduction of smoking can lead to reduction of risk factors related to
diabetes, hypertension and cholesterol. Hence, the chances of developing the disease will be
reduced (Kivipelto, Mangialasche & Ngandu, 2018). Apart from that, consumption of
nutritional food along with regular physical activity play a significant role to control the
health conditions such as diabetes, hypertension etc. Hence, Alzheimer’s syndrome can be
prevented by involving in the mentioned activities. The involvement of hospitals and health
professionals can play a major role to provide the information regarding the risk factors and
prevention methods of Alzheimer’s disease.

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Reference
Alzheimer’s, A. (2015). 2015 Alzheimer's disease facts and figures. Alzheimer's & dementia:
the journal of the Alzheimer's Association, 11(3), 332.
Australian Bureau of Staistics (2019). Retrieved on: August 9 2019. Retrieved from:
https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/3303.0~2015~Main
%20Features~Dementia~10002
de Flores, R., La Joie, R., Landeau, B., Perrotin, A., Mézenge, F., de La Sayette, V., ... &
Chételat, G. (2015). Effects of age and Alzheimer's disease on hippocampal subfields:
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474.
Dubois, B., Hampel, H., Feldman, H. H., Scheltens, P., Aisen, P., Andrieu, S., ... & Broich,
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Gibson, G. E., Hirsch, J. A., Fonzetti, P., Jordon, B. D., Cirio, R. T., & Elder, J. (2016).
Vitamin B1 (thiamine) and dementia. Annals of the New York Academy of Sciences, 1367(1),
21.
Hutton, M., Pérez-Tur, J., & Hardy, J. (2017). Genetics of Alzheimer’s. Essays in
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Kivipelto, M., Mangialasche, F., & Ngandu, T. (2018). Lifestyle interventions to prevent
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& Maki, P. M. (2018). Understanding the impact of sex and gender in Alzheimer's disease: a
call to action. Alzheimer's & Dementia, 14(9), 1171-1183.

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Rotomskis, A., Margevičiūtė, R., Germanavičius, A., Kaubrys, G., Budrys, V., & Bagdonas,
A. (2015). Differential diagnosis of depression and Alzheimer’s disease with the
Addenbrooke's Cognitive Examination-Revised (ACE-R). BMC neurology, 15(1), 57.
Wolters, F. J., van der Lee, S. J., Koudstaal, P. J., van Duijn, C. M., Hofman, A., Ikram, M.
K., ... & Ikram, M. A. (2017). Parental family history of dementia in relation to subclinical
brain disease and dementia risk. Neurology, 88(17), 1642-1649.
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