Extended Project Qualification essay - achieved an A/A*
Answering the question:
To what extent are the psychological treatments for Alzheimer’s disease truly effective compared to non-psychological treatments?
Question: To what extent are the psychological treatments for Alzheimer’s disease truly effective
compared to non-psychological treatments?
Abstract:
In this essay I am talking about a variety of different treatments that are available for Alzheimer’s
disease and assessing how effective they are at improving a patient’s quality of life and reducing
their symptoms. I will cover three forms of psychotherapy (Cognitive behavioural therapy,
interpersonal therapy and psychodynamic therapy) and two alternative treatments (drug therapy
and dietary changes). This will show how a disease with no cure and no identified cause can be
affected by both internal changes (drugs and dietary changes) and psychological interventions.
Introduction:
Alzheimer’s disease is the most common cause of dementia in the United Kingdom. It is a
progressive, irreversible and neurodegenerative disease which destroys memory, motor skills and
cognition. A common misconception is that Alzheimer’s and dementia can be used interchangeably
however, whilst Alzheimer’s is a specific disease, dementia is a word given to a set of symptoms
affecting brain function that get progressively worse and disturb the way someone lives their life.
These symptoms include deterioration in memory, thinking, behaviour and the ability to perform
even simple tasks. Dementia is not a side effect of aging, it is the result of diseases that damage the
brain, such as Alzheimer’s disease.
There are three main physical features of Alzheimer’s disease. Firstly, neurons in the brain lose the
connections between them, which means that messages and signals can’t be communicated to other
parts of the brain or body. The other two features are abnormalities of the brain tissue, these are
amyloid plaques and neurofibrillary tangles. 1 Amyloid plaques are abnormal clumps of beta-amyloids
that destroy connections between nerve cells, again disrupting the transmission of messages in the
brain. Lastly, neurofibrillary tangles are tangled bundles of abnormal tau protein which develops
inside of neurons and becomes toxic to the brain. 2 These features were identified by Doctor Alois
Alzheimer when he discovered the disease after conducting a post-mortem on a woman who had
died after suffering with memory loss, speech problems and unpredictable behaviour and he found
that she had these abnormalities in her brain tissue. 3 Due to this research, Alzheimer’s is known as a
neurodegenerative disease because its main cause of symptoms is the death of neurons and the loss
of the connections between them, which is caused by the abnormal build-up of proteins in the brain.
However, what causes these changes in brain structure and therefore what causes the disease is still
unknown.
Alzheimer’s disease progresses as the disease continues to attack the brain and its neurons, slowly
reducing the person’s ability to function normally. The first part of the brain to be attacked by
Alzheimer’s disease is the hippocampus, which is the part that controls aspects of our memory,
particularly, forming memories. This is why the initial symptom for many patients is an inability to
form new memories, meaning they may not be able to remember what they have just done and may
repeat themselves frequently4. As Alzheimer’s disease progresses, neurons continue to die which
increases the number of areas of the brain being damaged, in turn leading to more symptoms arising
, and pre-existing symptoms to get more severe. The role of neurons is to send messages to parts of
the body like muscles and organs to indicate that an action should be performed, so when the
connections between neurons die, these messages can’t be sent or received. This means even
simple tasks, such as picking up a cup or standing up, can become challenging or impossible. This
continues until the final stage of the disease where the damage is widespread and there has been a
significant shrinkage of the patient’s brain tissue. 5 This causes debilitating side effects on the body
such as the inability to move or feed oneself 6 and eventually leads to death. Alzheimer’s is often
noted as a cause of death, for example according to the Centres for Disease Control and Prevention
Alzheimer’s disease was the sixth-leading cause of death in the united states. 7 However, in many
other cases the complications stemming from Alzheimer’s are listed as the cause of death rather
than the underlying disease. Some of the most common complications that cause death in those
with Alzheimer’s are pneumonia, blood clots and infections. Pneumonia is the result of the
accidental inhalation of food due to patients having difficulty swallowing, this is the listed cause of
death in two-thirds of patients with dementia. 8 Patients are also at risk of fatal blood clots due to
possibly being bedridden in the late stages of the disease. Lastly, complications such as weight loss in
patients can lead to a weakened immune system, leaving them susceptible to dangerous infections. 9
Despite the primarily biological explanation for Alzheimer’s disease there are a range of different
treatments available. As currently there is no cure for this disease, none of these treatments have
the ability to bring back neurons or repair the broken connections, instead they aim to control the
symptoms and/or slow the progression of symptoms. These treatments can fit into one of two
categories: psychological and non-psychological. I have looked into three psychological treatments:
Cognitive Behavioural Therapy, Interpersonal Therapy and Psychodynamic Therapy. They are all
forms of psychotherapy which aim to help a patient understand how their personality, thoughts and
experiences have an impact on how they think, their behaviour and their relationships. 10
Understanding these things more helps them deal with their problems in a more constructive way,
therefore alleviating a lot of the distress caused by any dysfunction they are facing. I then
researched two non-psychological treatments: a high-fat low-carb diet treatment which aims to
combat cognitive decline and a drug treatment using Razadyne which aims to slow the progression
of symptoms.
In this essay I will explore the how each treatment works and how effective they are in treating
Alzheimer’s disease by improving patient’s quality of life and reducing symptoms. I will start with the
three psychological treatments I researched and then I will move onto the non-psychological
treatments. I will then compare the treatments to each other and talk about my personal experience
with a few of these treatment options.
Intro to Psychotherapy
As previously mentioned, all three psychological treatments I am looking at are forms of
psychotherapy. The different types of psychotherapies take different approaches and use different
5
("What Is Alzheimer's Disease?" 2017)
6
(Rettner 2016)
7
Ibid.
8
Ibid.
9
Ibid.
10
("Talking Therapies" 2020)
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