Tahseen Al-Zahra
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In this report, I will examine the different types, causes and symptoms of dementia, as
well as examine the effects of dementia on individuals who have the condition, as well
as investigate the concept of person-centred care for individuals who have dementia to
maintain quality of life and wellbeing. This report will focus on the case study of Dr.
Raymond Boston, a 76 year old man who has vascular dementia and has recently been
moved to a residential home.
Task 1
Dementia is a syndrome when an individual's cognitive abilities deteriorate owing to
damage to their brain cells. Dementia is an umbrella term for a variety of disorders
caused by abnormalities in the brain that result in memory loss. These conditions
include lewy body dementia, vascular dementia, frontotemporal dementia, mixed
dementia, and Alzheimer's disease.1
P1. Explain the Causes of Three Different Types of Dementia
P2. Explain the Symptoms of Three Different Types of Dementia
M1. Analyse how the Different Types of Dementia Might be Identified by Their
Symptoms
D1. Evaluate the Importance of Understanding how Different Types of Dementia
can Have a Progressive Effect on all Aspects of a Person’s Health and Wellbeing
Alzheimer’s Disease:
The links between nerve cells are destroyed in Alzheimer's disease. Protein levels in the
brain become abnormal, resulting in plaques that harm the brain's blood flow, which
leads to nerve cells starting to die. There are synapses between neurons that allow
neurotransmitters to flow through and deliver chemical messages all throughout the
nervous system2. Another aspect of Alzheimer's is the fact that connections between
neurons get destroyed, preventing neurotransmitters from passing across them and
resulting in delayed responses to stimuli owing to failure of signals being passed.
After a person reaches the age of 65, their risk of Alzheimer's doubles every 5 years 3,
explaining why Alzheimer's is so widespread in the elderly. As the entire UK population
ages, a growing number of individuals develop Alzheimer's disease, which is becoming
more prevalent as the human body begins to function less efficiently with age. The brain
shrinks with age, which might result in an excess of unstable molecules being created.
These molecules can cause proteins to get trapped inside the brain, causing neurons to
be damaged and hence Alzheimer's to develop.
1 (2019)
2 (Subramanian et al., 2020)
3 (2019)
,Tahseen Al-Zahra
50554530
Furthermore, people with Down syndrome are more likely to acquire Alzheimer's
because the genetic trigger for the condition can result in amyloid proteins forming in
tangles, which is a marker of the illness. Because there is evidence linking heart health
to brain health4, and many people with Down syndrome will have heart issues, this may
raise their risk of developing Alzheimer's.
Studies have connected an individual's cardiovascular health to their chance of
acquiring Alzheimer's, therefore things that negatively influence an individual's
cardiovascular health will have an effect on their likelihood of having Alzheimer's. An
Individuals' cardiovascular health is mostly affected by lifestyle factors and pre-existing
illnesses such as a lack of physical activity, obesity, poorly managed type 2 diabetes,
hypertension and high cholesterol5. Cardiovascular diseases are believed to induce
Alzheimer's because they can produce abnormalities that prevent blood and hence
oxygen from exiting the heart properly. If the brain does not receive enough oxygen, it
can become hypoxic, which can lead to cell damage and death, which is linked to
Alzheimer's disease and can produce symptoms.
Alzheimer's disease has been linked to a defective APOE gene on chromosome 19,
which has a function in fat metabolism in the body. Inheriting a defective variant of this
gene increases the likelihood of having the illness, particularly if the APOE gene, which
has been most closely associated with the disorder, is inherited. Nevertheless, having
the disease does not guarantee that an individual would get it because various variables
influence its development. Despite the fact that the gene has been connected to
Alzheimer's disease and therefore there is a hereditary relationship to the disorder, it is
still unknown how the gene raises the risk of developing the disorder 6.
A person's musculoskeletal system will suffer as a result of Alzheimer's disease.
Because Alzheimer's causes neurotransmitters to pass the synapse between neurons
at a much slower rate, a person will react to stimuli at a slower rate than someone
without Alzheimer's because electrical impulses within their brain fail to travel at a
suitable pace. As a result, mobility will be considerably impaired in an Alzheimer's
patient, resulting in poor balance, shorter steps and shaking or stiffness as muscles
become inflexible.
Individuals will face psychological alterations in addition to physical symptoms as a
result of Alzheimer's, as well as issues with short-term memory conversion to long-term
memory. Those with Alzheimer's disease are more likely to suffer from mental health
concerns such as depression7. Depression can therefore have a detrimental impact on
an individual's condition since depressive symptoms can prevent someone from
receiving therapy as one of the symptoms of depression is trouble leaving the house. If
an individual does not have home therapy, they may struggle to find the energy to
attend appointments and receive treatment that is necessary to keep them stable.
Similarly, experiencing memory loss could cause the person to forget that they have
4 (2022)
5 (FMG, 2022)
6 (2019)
7 (2020)
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appointments, leading to a negative impact on their health and wellbeing. If
appointments are not attended, a person's health and wellbeing will not be monitored,
which could result in a decline in their condition.
As Alzheimer's disease progresses, a person may become aggressive as they become
confused and end up losing control of their emotions, this may cause them to be
regarded as a hardship by their family as they will be difficult to keep safe, so they may
be placed in residential care to ensure their safety and health is monitored. If this
occurs, the person may suffer more with their mental health owing to feeling abandoned
because they will be unable to communicate with their family anytime they want. Yet,
living in a Care Home with many other people who have similar health issues may
assist to enhance their wellbeing since their social requirements will be satisfied as they
will be surrounded by other individuals.
While deterioration in memory is one of the major symptoms of Alzheimer's, it is
typically easier to detect when it is developing because it will be obvious when an
individual's memory starts to decline. Individuals can usually recognise the problem
immediately as a result of this. People in the later phases of Alzheimer's generally
exhibit more visible indicators of the disease as they struggle with daily chores such as
eating properly, carrying out personal care, and communicating. At this stage, full-time
care is usually needed since the individual cannot dependably execute activities
necessary to sustain life, such as eating. Additional help ensures that the individual's
health is preserved to the greatest extent feasible.
Because the condition resides in the brain and thus interferes with its capacity to
function normally in the early stages, symptoms will be predominantly psychological.
People with the condition may begin to exhibit symptoms associated typically with
mental illness, such as mood swings and hallucinations. These symptoms will largely
affect the individual. They may also have an impact on people around them, since
hallucinations may lead to the individual becoming aggressive or acting abnormally
towards others. Neuropsychiatric symptoms are identified as a crucial characteristic of
Alzheimer's disease8. Because many anatomical aspects of an individual with
Alzheimer's brain are related with neuropsychiatric symptoms, those suffering from
Alzheimer's frequently experience them. 4 Alzheimer's symptoms (sadness, psychosis,
apathy and agitation) have been related to various pathogenic processes linked with the
APOE gene, which can cause Alzheimer's.
Chemical changes in the brain will develop as a consequence of poor
neurotransmission, which can lead to mental health illnesses caused by low levels of
neurotransmitters such as serotonin, which can contribute to depression. Alzheimer's
and depression could lead to treatment resistance as a result of forgetting appointment
dates or lacking motivation to attend them. Individuals will worsen if these crucial
appointments are not attended because they will not be monitored, and their treatment
plan will not alter to accommodate their new needs.
8 (Network, 2022)
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Alzheimer's disease may have a significant detrimental impact on a person's well-being
owing to feelings of helplessness over their symptoms. Because many symptoms
cannot be managed by specialists and Alzheimer's cannot be reversed, individuals may
feel hopeless about their illness, leading them to discontinue therapy and gradually
deteriorate.
Alzheimer's is a progressive disorder in which symptoms worsen as the disorder
progresses and there are no significant differences in presentation from day to day. As
the condition advances, symptoms grow more severe and have a bigger influence on an
individual's everyday activities. Because Alzheimer's symptoms are predominantly
cognitive, they may be distinguished from other varieties of dementia due to the limited
presence of other symptoms. In the initial and middle stages of Alzheimer's, a person
will notice no physical deterioration other than that expected for their age, and thus
Alzheimer's cannot be confused with Parkinson's dementia or Lewy body dementia
because the main symptom of decreased motor function won't be present during the
diagnostic procedure. Nevertheless, many signs of Alzheimer's can also be found in
vascular dementia, thus distinguishing between the two conditions is critical to ensure
that therapy is effective. Memory loss, mood swings, sadness, and trouble
communicating verbally are all signs of dementia, and they can develop similarly in
each kind. A medical history can help establish which form of dementia is present more
accurately since specific features are present. A person's history will only be consistent
with one kind. If a person has a history of cardiovascular diseases or has recently
experienced a cerebral accident, they are more likely to develop vascular dementia
rather than Alzheimer's since strokes cause vascular dementia. Nevertheless, the
proportion for Alzheimer's is substantially lower at 20% 9.
Additionally, Alzheimer's progresses gradually while vascular dementia can progress in
a step-like pattern with symptoms declining and then remaining constant for some time.
Professionals can accurately identify which sort of dementia is being experienced by
observing how a person's symptoms grow. While diagnosing Alzheimer's, it is typical for
healthcare practitioners to rule out alternative explanations of the symptoms rather than
attempting to definitively identify the illness because there is no way to do so. As a
result, in order to correctly identify individuals with Alzheimer's disease, experts must be
able to distinguish between the many varieties of dementia based on their symptoms.
Vascular Dementia:
Several cerebral infarcts produce neuronal or axonal degeneration, impairing brain
function in vascular dementia. A cerebral infarction is a necrotic region of the brain that
develops in the blockage or constriction of the arteries, limiting oxygenation and causing
cell death10. Lack of oxygen in the brain produces hypoxia, which destroys neurons in
the brain and creates symptoms in the affected person, based on the affected area.
Vascular diseases such as atherosclerosis and cerebrovascular infarctions induce
vascular dementia11. Atherosclerosis is the irregular ageing of blood arteries that
9 (2019)
10 (2019)
11 (2021)
