Nursing Assignment: Alzheimer's Disease, Statistics, and Stages

This nursing assignment report provides a comprehensive overview of Alzheimer's disease. It begins by presenting global statistics on the prevalence of Alzheimer's, comparing data from Australia and the United States, and projecting future trends. The report then delves into the progression of the disease, outlining its various stages and the associated cognitive and behavioral changes. It discusses the impact of the disease on individuals and their families, and provides insights into the average survival time after diagnosis. Furthermore, the assignment explores different assessment tools, such as the Mini-Mental State Examination and the Geriatric Depression Scale, used to evaluate cognitive impairment and depressive symptoms in patients. It also mentions the use of neuroimaging techniques like MRI and CT scans to aid in diagnosis and track disease progression. The report references various research articles and studies to support its findings, offering a well-rounded understanding of Alzheimer's disease for nursing students.

Running Head: NURSING ASSIGNMENT
Nursing assignment
Name of the Student
Name of the University
Author Note

1NURSING ASSIGNMENT
Answer to question 1
According to the Australian statistics, more than 413, 106 people diagnosed with
Alzheimer’s. The people living with dementia comprise 55% of females and 45% of females.
This number is estimated to increase to 534,164 by the year 2025. Every day new members
joining to this population group are 244. The number of the new cases of Alzheimer’s will
accelerate in near future. It is estimated that by the year 2025, per day 318 new cases of
Alzheimer’s will be diagnosed (Alzheimer's Australia | Statistics, 2017).
Unlike Australia, the Alzheimer’s disease in US is the sixth leading cause of death. The
onset and prevalence of disease in US is worse. According to "Latest Alzheimer's Facts And
Figures", (2017), more than 5.5 million Americans are effected with Alzheimer’s. Out of this
population two third are women. In comparison to whites, the African-Americans are twice more
likely to be effected number is expected to rise to 16 million by 2050, which is far less then that
estimated in Australia. In US, every minute a new case of Alzheimer’s is detected. Since, 2000,
the deaths due to Alzheimer’s in US has increased by 89%. Out of the 5.5 million people living
with Alzheimer’s in US, 5.3 million are 65 years old and over. Approximately, 200,000
individuals are under 65 years. This group of people have younger-onset Alzheimer's. The
number of people in Australia with younger onset Alzheimer’s disease, is 25,938 (Withall et al.,
2014).
In Australia, 10% of the people aged above 65 years are effected by Alzheimer’s. The
severe form of dementia in Australia is represented among 20% of the people over 80 years of
age. In Australia Alzheimer’s is known to be the second leading cause of death. Each year in
Australia, 5.4% of all the death in males, members are dying due to Alzheimer’s and female

2NURSING ASSIGNMENT
counterparts comprise of 10.6%. This number of deaths is due to increasing deaths due to
Dementia (Alzheimer's Association, 2013). In US, one in 10 people of age 65or more are living
with Alzheimer’s. With the increase in number of older people, the prevalence of Alzheimer’s is
increasing. The population in US with the age 70 are expected to die before they turn 80 in 61%
of the cases ((James et al., 2014).
Answer to question 2
The rate of the progression of the Alzheimer’s disease is not same in all the people. It
varies from individual to individual. After the onset and through progression of the disease, the
patient eventually becomes completely dependent on other person. Finally, the death occurs
which in most cases is known to be due to other illnesses such as pneumonia. After the onset of
Alzheimer’s disease, an individual can survive for 20 years. The average number of years for
survival is seven to ten years. It indicates the fast rate of progression (Roberts et al., 2014).
Alzheimer’s disease is strongly evident between the ages 50-70 years. This disease
progresses very slowly. When it progresses, it tends to aggressively deteriorate the cognitive
function, memory power, in addition to the behavioural changes noticed in early stages of
disease. When the disease progresses, the patient finds difficult to speak and perform simple
activities of daily living. The cognitive function becomes poor that hampers the coordinate
movements. In the later stages, of the disease, walking ability is lost. Mobility is severely
hampered in later stages. Eventually, the patient becomes bed ridden and incontinent for
prolonged period. Inspite of several studies it is unknown if the accumulations of amyloid
protein tangles and corresponding changes in nerve cells can be referred as inevitable
progression (Mourao et al., 2016).

3NURSING ASSIGNMENT
The first stage of the disease is most for the researchers who will determine if there is a
possible biological changes. At this stage, the neuroimaging techniques are used for this purpose.
This mild stage can persist on an average for 2-4 years. The mild neurological exams at initial
stage includes testing for reflexes, speech, eye movement, sensation, coordination, strength and
muscle tone.
In the second stage the, Alzheimer’s progresses to cause mild cognitive impairment. It is
characterised by small changes to behaviour, thinking and memory. However, at this stage a
person may have normal cognitive function. The average period of this stage is 2-10 years. There
is no established cut off for diagnosing of the mild cognitive impairment. However, the Montreal
Cognitive Assessment. This assessment is specific for early Alzheimer’s disease (Van Steenoven
et al., 2014).
In the third stage, the disease progresses seriously that patient fails to function. The
person may develop visual and spatial problem. The reasoning skills and the judgment may be
severely impaired. At this stage, the activities of daily living are severely disturbed. After the
onset of the last stage a person may survive for 3 years. At this stage, the mini mental state
examination is used. The score is given out of 30. This score declines by 2-4 points each year. It
is appropriate for the severe form of dementia. This neurological assessment is useful to track
the progression of disease (Arevalo-Rodriguez et al., 2015).
In both, cases the score of less than 26 is indicative of cognitive impairment. Severe
dementia is indicated by score less than 12. In case of Antonio, the score of 22 is indicative of
cognitive impairment. In order to elicit depressive symptoms, The Geriatric Depression Scale is
used. A mild depression is indicated with the score >10 on the 30-item version. A score above 10

4NURSING ASSIGNMENT
is indicative of primary memory disorder. In case of Antonio, this test may probably give the
score above 10 as it is mentioned in the case study that the client is experiencing depression and
social withdrawl. In case of elderly, this scale is used to measure the following given in the
figure below. In case of Antonio, the other mentioned mental tests should also be conducted for
detailed identification of severity of the impairment (Conradsson et al., 2013).
Figure: The Geriatric Depression Scale
(Source: www.webstanford.edu)
Other than the mental tests some computerised tests are conducted to assess the presence
of any other disease similar to Alzheimer’s. Brain imaging including MRI or CT gives structure
and the functioning of the living brain. It clearly highlights the progression of the disease. These
tests are cleared by FDA (Jack et al., 2013).

5NURSING ASSIGNMENT
References
Alzheimer's Association. (2013). 2013 Alzheimer's disease facts and figures. Alzheimer's &
dementia, 9(2), 208-245.
Alzheimer's Australia | Statistics. (2017). Fightdementia.org.au. Retrieved 12 August 2017, from
https://www.fightdementia.org.au/statistics
Arevalo-Rodriguez, I., Smailagic, N., i Figuls, M. R., Ciapponi, A., Sanchez-Perez, E.,
Giannakou, A., ... & Cullum, S. (2015). Mini-Mental State Examination (MMSE) for the
detection of Alzheimer’s disease and other dementias in people with mild cognitive
impairment (MCI). BJPsych Advances, 21(6), 362-362.
Conradsson, M., Rosendahl, E., Littbrand, H., Gustafson, Y., Olofsson, B., & Lövheim, H.
(2013). Usefulness of the Geriatric Depression Scale 15-item version among very old
people with and without cognitive impairment. Aging & mental health, 17(5), 638-645.
Jack, C. R., Knopman, D. S., Jagust, W. J., Petersen, R. C., Weiner, M. W., Aisen, P. S., ... &
Lesnick, T. G. (2013). Tracking pathophysiological processes in Alzheimer's disease: an
updated hypothetical model of dynamic biomarkers. The Lancet Neurology, 12(2), 207-
216.
James, B. D., Leurgans, S. E., Hebert, L. E., Scherr, P. A., Yaffe, K., & Bennett, D. A. (2014).
Contribution of Alzheimer disease to mortality in the United States. Neurology, 82(12),
1045-1050.
Latest Alzheimer's Facts and Figures. (2017). Latest Facts & Figures Report | Alzheimer's
Association. Retrieved 12 August 2017, from http://www.alz.org/facts/#prevalence

6NURSING ASSIGNMENT
Mourao, R. J., Mansur, G., Malloy‐Diniz, L. F., Castro Costa, E., & Diniz, B. S. (2016).
Depressive symptoms increase the risk of progression to dementia in subjects with mild
cognitive impairment: systematic review and meta‐analysis. International journal of
geriatric psychiatry, 31(8), 905-911.
Roberts, R. O., Knopman, D. S., Mielke, M. M., Cha, R. H., Pankratz, V. S., Christianson, T.
J., ... & Rocca, W. A. (2014). Higher risk of progression to dementia in mild cognitive
impairment cases who revert to normal. Neurology, 82(4), 317-325.
Van Steenoven, I., Aarsland, D., Hurtig, H., Chen‐Plotkin, A., Duda, J. E., Rick, J., ... &
Moberg, P. J. (2014). Conversion between Mini‐Mental State Examination, Montreal
Cognitive Assessment, and Dementia Rating Scale‐2 scores in Parkinson's
disease. Movement Disorders, 29(14), 1809-1815.
Withall, A., Draper, B., Seeher, K., & Brodaty, H. (2014). The prevalence and causes of younger
onset dementia in Eastern Sydney, Australia. International psychogeriatrics, 26(12),
1955-1965.