HEALTH AND
WELLNESS
DANISH LATIF
Alzheimer's Disease
Alzheimer's disease, the most common form of dementia, is a
degenerative brain disease characterized by a relatively rapid,
progressive impairment in memory, judgment, decision-making,
performing routine tasks, orientation to time and physical
surroundings, and language.
Alzheimer's disease is diagnosed by excluding other causes for a
person's loss of cognitive function; a definitive diagnosis can
only be made through autopsy.
The incidence of Alzheimer's disease increases with age. One
percent of individuals 65 to 70 years have Alzheimer's disease.
no known cure
Medications may slow its progression, including drugs
that inhibit the degradation of acetylcholine within
synapses.
Thus, the primary focus is on palliative care and on the
prevention of secondary complications.
The involvement of psychologists in providing education,
support, and counseling is appropriate.
Caring
Extremely demanding on the caregiver, so intervention
should address the patient's secondary prevention needs
and the caregiver's primary and secondary prevention
needs.
Early stage of Alzheimer's disease, social isolation is an
issue.
In a later stage, bedridden with incontinence of bowel and
bladder has a high risk for integument breakdown.
Epilepsy
Repeated seizures that range from short lapses in attention to severe,
frequent convulsions. The seizures can occur several times a day or
once every few months.
The seizures are due to bouts of excessive electrical activity in the
brain. Usually, the brain region involved in the seizure remains the
same from one seizure to the next, so an individual's seizure
presentation is relatively predictable, although there can be dramatic
differences among individuals.
While the cause of the abnormal neural activity is not known, 70% of
individuals with epilepsy can be seizure-free with antiepileptic drugs.
Mistakenly, some clinicians views epilepsy as a condition
of children and young adults. In fact; older populations
have the greatest prevalence of epilepsy.
Often, the older individual's seizure is not of the grand
mal type but rather presents as brief gaps in conversation,
periods of confusion, blank stares, or unresponsiveness.
These may be small, treatable seizures, but too often, they
are described as "senior moments" and go untreated.
Secondary prevention in this population should focus on injury
prevention when the person is seizing. Protection may involve
having the person wear a helmet to prevent a head injury or hip
protectors to reduce the risk of a fractured hip if a fall were to
occur during a seizure.
Education for the individual and his or her family on what
occurs during a seizure and how to respond to that individual's
seizure.
Limits on high risk activities, such as driving, may be necessary.
Multiple Sclerosis
Pathology that damages the myelin that surrounds axons in the
central nervous system, resulting in sclerosis (scarring) and
neurological dysfunction. The multiple sclerotic areas, also
called a plaque.
The cause of MS is unknown; however, environmental and
genetic factors appear to interact to cause an autoimmune
dysfunction.
This condition most commonly affects young adults between the
ages of 20 and 40, with women affected twice as often as men,
and in individuals with a Northern European genetic history.
Early clinical manifestations of MS include fatigue; uncomfortable
sensations in the arms, legs, trunk, or face (eg, tingling,
numbness, .pain, burning, or itching); and muscle weakness.
These physical changes can be accompanied by psychological
changes, such as mood swings, euphoria, depression, or apathy,
problems with memory, judgment, or attention.
Since the demyelination process is unpredictable and may vary in
each individual, these subtle changes may not be recognized unless
it is a very aggressive pathology. The subtle onset and progression
make MS often difficult to diagnose.
According to the Merck Manual of Medical
People with multiple sclerosis can often maintain
an active lifestyle stationary bicycle, walking, swimming
or stretching reduces spasticity.
Physical therapy can help with maintaining balance,
walking ability, and range of motion as well as reduce
spasticity and weakness.
Peripheral Neuropathy
Polyneuropathy (Involving multiple nerves), such as
Guillian Barre syndrome (an acquired immune-mediated
inflammatory disorder)
Diabetic peripheral neuropathy (neuropathy caused by
diabetes mellitus)
It may affect only a single nerve or nerve root, such as
carpal tunnel syndrome (median nerve compression in the
wrist's carpal tunnel) or lumbar radiculopathy (nerve root
damage).
If motor function is disrupted, there will be flaccid paralysis of
the muscles innervated by the nerve(s).
If the phrenic nerve is involved, respiratory support is required
emergently to compensate for the paralyzed diaphragm.
If the nerves innervating the muscles of chewing or deglutition
are involved, alternative means for eating and aspiration.
Motor paralysis and sensory dysfunction can result.