The research project requires that you select a disease, syndrome, etc. of interest, which affects a diverse population, and write a descriptive epidemiological analysis of that topic. Descriptive epidemiology is usually the first stage in studying the epidemiology of a disease or syndrome or other conditions. Your descriptive analysis will cover:
Person: Who is affected? (Examples include age, gender, and address.) Place: Where did the cases occur? (The geographic locations may show clusters or patterns.) Time: When did the outbreak occur (date, season, day of week, etc.)? You may obtain data from multiple sources, such as the National Center for Health Statistics, national, state, or local health departments, World Health Organization (WHO), texts, and the Internet. Make sure you cite your sources correctly. Your paper should be 6-7 pages in length, Cite at least 4 scholarly sources.
Solution
Epidemiological Analysis of Alzheimer
Abstract:
Introduction:
Identifying the risk factors of the disease in a population is the main object of epidemiological studies. There are three common question studies under the epidemiological studies, they are cohort studies, case-control studies, and cross-sectional studies. This research project is a descriptive epidemiological analysis of Alzheimer’s disease. The most common neurodegenerative disease that affects five million older people all over the world is Alzheimer’s disease. By 2050 the number of disease-affected patients will be going to increase by fourteen million.
Project description:
The main risk factor for the disease is included with genetic and environmental risk factors. There are two types of overall risk factors for Alzheimer’s disease they are modifiable and nonmodifiable risk factors. Traditionally there are two types of Alzheimer’s disease they are early-onset which happens before sixty-five years old and late-onset which happens after sixty-five years old. Alzheimer’s disease and related dementias (ADRDs) are a crisis associated globally, faced by the elder population and overall people of the society directly or indirectly. Before 2011 the most clinical trial conducted for dementia or Alzheimer’s are DSM-IV criteria or NINCDS-ADRDA criteria for the possibility of Alzheimer’s disease as criteria of inclusion. The NINCDS-ADRDA criteria for Alzheimer’s disease need the presence of neurofibrillary tangles and amyloid plaques.
Epidemiological analysis:
Identifying the risk factor of the disease, describing the distribution of the disease in the population, and searching for the reason for the disease are the main and important objects of epidemiological studies. Epidemiological studies included three common question studies they are case-control studies, cohort studies, and cross-sectional studies. The risk factors can cause the increased or decreased probability of the disease. The risk factors are included environmental factors, genetic factors, and behavioral characteristics. In the case of the cohort study, the person who is exposed to the risk factors is compared with the persons who are not exposed to the risk factors. The data obtained from the cohort studies gives the mortality rate and the incidence rate as the descriptive measure of frequency. Another way is also to give the relative risk and hazard ratio as the comparative measure. In studies, a case-control person suffering from the disease is compared with a person who does not have the disease. In cross-sectional studies, the disease status and the exposure are examined for a sample in various populations in a similar period. By considering the influence factor the Relative Risk is calculated via a regression model. From this, the extensive changes in frequency due to the specific risk factor can be determined (Ressing, Blettner & Klug, 2010)
Descriptive analysis:
In my descriptive analysis, I want to discuss the Alzheimer’s disease of my neighbor. She is a female of age seventy years. Her name is Sarah Williams. She stays two buildings next to my house. I have already discussed the frequent occurrence of dementia or Alzheimer’s disease among the American people. Her family first noticed her change in cognitive behavior. Some symptoms change that her family member noticed are loss of short-term or long-term memory, poor motor condition, identity confusion, judgment impairment, anxiety, aggression anger, restlessness, physical or verbal obstructs, hallucination, or seeing or hearing or feeling things that are not there.
After encountering these symptoms of her mother, Sarah’s daughter consulted with a doctor and they have done some Physical and neurological tests to determine the reasons for her abnormal behavior. The Physician also wanted to know her previous mental history. After having all the tests done doctor referred that Sarah is suffering from Dementia a type of Alzheimer’s disease. Not only, Sarah, but I have also known so many people who are suffering from the same syndromes. The doctor gave Sarah medications and told her family to take care of her. The rate of Alzheimer’s is increasing day by day in my locality. It is not an infectious disease but still, its occurrence is not less than that infectious disease. The doctor told the family of Sarah that currently there is no cure for the disease and her mother has to continue the medication that has been suggested by the doctor to reduce the symptoms of dementia temporarily.
I want to discuss the epidemiological background of the disease. Here is my discussion, I will discuss the studies of epidemiology and also a brief description of the disease like the rate of mortality of the disease, the incident rate of the disease, and the occurrence of the disease in the male and female gender. I will also discuss the diagnosis, treatment, and symptoms of the disease and the reasons behind the symptoms.
Alzheimer’s disease risk factors and symptoms:
The most common neurodegenerative disease that affects larger than five million older people in the United States, is Alzheimer’s disease. By 2050 the number of disease-affected patients will be going to increase by fourteen million. The Official report indicated that there is a large increase in Alzheimer’s disease recently. There is large heterogeneity in the clinical progression and presentation, still, Alzheimer’s disease is characterized by loss of cognition mainly memory. This disease is neuropathological with the presence of intracellular tangles of neurofibril and amyloid plaques of amyloid. This kind of neurodegeneration results in the loss of synapses and neural death. The risk factor of the disease is both genetic and environmental factors (Raghavan & Tosto, 2017).
The variability in genes is responsible for the disease risk of eighty percent of Alzheimer’s. Traditionally there are two types of Alzheimer’s disease they are early-onset which happens before sixty-five years old and late-onset which happens after sixty-five years old. Early onset of Alzheimer’s disease occurs in one to six percent of cases, which happens mainly due to genetic reasons. The Later onset Alzheimer’s disease happens in approximately ninety-five percent of cases. It has both environmental and genetic risk factor profiling. There are two types of overall risk factors for Alzheimer’s disease they are modifiable and nonmodifiable risk factors. Genetic studies have progressed much from linkage studies of the earlier days to Genome-wide association studies. Recently more high-throughput sequencing has been used for genome studies. However, due to the presence of epistatic and polygenic components, the missing heritability for Alzheimer’s disease is extensive. Alzheimer’s disease and related dementias (ADRDs) are a crisis associated globally, faced by the elder population and overall people of the society directly or indirectly.
Several Professional interest areas (PIAs) have been comprised by ISTAART based on the main scientific topic associated with Alzheimer’s disease and related dementias. Leading scientists have covered all important topics related to Professional Interest areas of Alzheimer’s disease. In the United States, a public insurance program is introduced by the Centres for Medicare and Medicaid Serves. People with age more than sixty-five are eligible for the advantages of health care insurance if they pay taxes for ten years. Medicare insurance claims are a useful source for the epidemiological survey of people suffering from dementia or Alzheimer’s.
Alzheimer diagnosis:
Before 2011 the most clinical trial conducted for dementia or Alzheimer’s are DSM-IV criteria or NINCDS-ADRDA criteria for the possibility of Alzheimer’s disease as criteria of inclusion. These clinically diagnostic Alzheimer’s diseases have to show the multidomain amnestic syndrome which interferes with the patient’s ability to live independently. The NINCDS-ADRDA criteria for Alzheimer’s disease need the presence of neurofibrillary tangles and amyloid plaques. For the use of clinical practices, the clinical criteria are generally simple with a sensitivity of 81% and a specificity of 73% respectively.
Now the main question is how can one detect the presence of neurofibril tangles and amyloid plaques via the presence of apolipoprotein E epsilon 4 alleles. Therefore, the trials based on the clinical criteria included patients not having Alzheimer’s disease pathology, in a large trial of bapineuzumab which is a monoclonal antibody to amyloid-beta, among them thirty-six percent were not the carriers of apolipoprotein E epsilon 4 allele, in their brain have a negative amyloid emission tomography of positron which indicates that there is an absence of fibrillar amyloid-beta pathology. There is sometimes an absence of specificity in the clinically diagnosed Alzheimer’s disease is also evident due to the lifestyle change and the environmental effect before the first symptoms of the disease or before showing the Alzheimer’s biomarker. Vascular health can be also promoted by changes in physical activity and diet, though it is unclear what is the main reason for the disease. However, studies of post-mortem have shown that Alzheimer’s disease and physical impairment of cognition are both correlated with the pathology of Alzheimer’s disease. In the case of in vivo studies have shown that Alzheimer’s pathology changes have been evident from the years to a decade before the modern era dementia is diagnosed.
Treatment for the disease:
The symptomatic treatment of the disease is using cholinergic enhancer treatment where doctors attempt to enhance the neurotransmission of cholinergic which is an early approach to Alzheimer’s disease treatment. An early pathological finding of Alzheimer’s disease is the loss of Cholinergic neurons of the basalis of the nucleus of Meynert. Though for the human trial, the agonists of the muscarinic receptor are unsuccessful the trial for the nicotine Patch is now running. To prevent the disease another thing is important which is the prolonged action of endogenous acetylcholine in the gray matter of the brain. For prolonged action acetylcholinesterase inhibitors are used which inhibit the acetylcholinesterase enzyme (Joe & Ringman, 2019).
Currently, three inhibitors are in use they are donepezil, rivastigmine, and galantamine. A relatively pure and FDA-approved acetylcholine esterase inhibitor is named Donepezil. A competitive inhibitor of acetylcholine is Galantamine. Therefore, the presence of galantamine can be seen mainly in the areas of the brain where the acetylcholine concentration is low. At the nicotinic Cholinergic receptor, Galantamine enhances the effect of acetylcholine. The third drug Rivastigmine is a combinational drug of acetylcholinesterase and butyrylcholinesterase inhibitor. None of the inhibitors of acetylcholine esterase has been approved for mild cognitive impairment still they are commonly used. Various studies have been done to find the role of acetylcholine in disease modification. The duration of the therapy is also controversial. The optimum duration of the therapy should be a six-month period for the benefit of cognitive. The inhibitors of acetylcholine maintain their efficacy for various severe dementia. A meta-analysis study has shown that donepezil was well tolerated and the benefit magnitude was similar with the population-dwelling community, which are studied most of the time in case of mild to severe disease. There is a negative impact of drug withdrawal. According to a meta-analysis, there is a decline in the cognitive score in patients who have been withdrawn from the acetylcholinesterase inhibitor treatment. It is suggested that with the discontinuation of the drug, there is an increased risk of psychosis in the patients. The tolerability of Acetylcholine is well, however, there are gastrointestinal side effects like vomiting, nausea which are common side effects.
Dementia among different genders:
Women have a higher incidence in case of AD occurrence than men. The gender differences in the case of the disease have been observed in later life when the infection point at which rate the disease has differed between men and women has also varied (Beam et al. 2018). Epidemiological analysis shows a prominent difference in men and women in the case of the occurrence of dementia or AD disease. Any dementia rate is relatively the same until the age of eighty. After eighty, women tend to reach more adverse effects of dementia than men.
Conclusion:
This research project has included a descriptive analysis of the case study of Alzheimer’s disease. Descriptive analysis included the age and gender of the patient. The symptoms of the disease have also been mentioned and described. Further, the project has also included the different occurrences of dementia among males and females.
References:
Beam, C. R., Kaneshiro, C., Jang, J. Y., Reynolds, C. A., Pedersen, N. L., & Gatz, M. (2018). Differences between women and men in incidence rates of dementia and Alzheimer’s disease. Journal of Alzheimer’s Disease, 64(4), 1077-1083.
Joe, E., & Ringman, J. M. (2019). Cognitive symptoms of Alzheimer’s disease: clinical management and prevention. Bmj, 367.
Raghavan, N., & Tosto, G. (2017). Genetics of Alzheimer’s disease: the importance of polygenic and epistatic components. Current neurology and neuroscience reports, 17(10), 1-10.
Ressing, M., Blettner, M., & Klug, S. J. (2010). Data analysis of epidemiological studies: part 11 of a series on evaluation of scientific publications. Deutsches Arzteblatt International, 107(11), 187.ease
