DEGENERATIVE & MEMORY DISORDERS
DEGENERATIVE & MEMORY DISORDERS
Degenerative Disorders
Degenerative disorders occur when a certain part of the body, such as bodily tissues or an organ, gradually begins to deteriorate over a period of time, thus resulting in the tissue's or organ's failure to function properly and may even result in the entire body malfunctioning. There are many types of factors that may cause degenerative disorders. These include things such as infection, disease, a deficiency in the circulation, inflammation and even possibly, problems with the body's natural immune system.
A simple example of degeneration is the wrinkling of the skin, as we get older. This is due to the degeneration of the skin tissue and will take many years to progress although particular factors may speed this process up. These could be things like prolonged and regular exposure to the sun and frequently using a sun bed. There are many other degenerative disorders, some are unfortunately quite common like arthritis and cancer.
Arthritis is a debilitating inflammatory disease of the joints, with the symptoms being pain, stiffness and swelling. Sadly, as with the majority of degenerative disorders, there is no cure and nothing that can be done to prevent its progression, although there are a few treatments that help to relieve the symptoms and slow down the development of the disease, for instance, anti-inflammatory drugs and ultrasound. There are two common forms of arthritis - Osteoarthritis and Rheumatoid arthritis. Rheumatoid arthritis is the most severe and will affect around one in a hundred people, with the cause being swollen membranes of the joints. Osteoarthritis is the commonest form arthritis and one in ten people will suffer from it. Those that are at a greater risk from developing osteoarthritis, are those that have been involved in a lot of vigorous sports or exercises that puts strain on the joints. Unlike rheumatoid arthritis, osteoarthritis is caused by the wearing away of the membranes of the joints. Arthritis is often associated with the older generation, however, anyone of any age or gender could be struck down with the disease, including children under the age of sixteen. Juvenile chronic arthritis affects around a thousand children and begins with an acute 'flu' like illness that causes the joints to become stiff, swollen and painful. The majority of suffers will recover from this particular type of arthritis on their own.
Cancer also affects people at any age and is probably one of the most common causes of death. Cancer is a group of uncontrollable abnormal cells, otherwise known as a malignant tumour that invades the surrounding tissues and destroys them, no matter how much the body tries to prevent the cells from growing. Cancer cells may spread to different parts of the body in a process known as metastasis via the bloodstream or the lymphatic system, thus setting up secondary growths elsewhere. There are many different types of cancer dependant upon where the cells have grown. This can be anywhere on or in the body ranging from the brain and the lungs to the genitals and even the skin, as well as any other internal organs.
One form of cancer that is the commonest form in women is breast cancer (mammary carcinoma being the technical term). One in eleven people will suffer this illness at some point in their life. The first sign of breast cancer is usually a painless lump either in the breast or if the cancer has spread to the lymph nodes, then the lump may appear in the armpit, however a lump is not always the first sign. The breast suddenly changing shape, the nipple altering in appearance and a change in the texture of the breast are also signs. Only one breast is usually affected and like many other cancers, the actual cause of breast cancer is unclear, though women who have had a close relative such as a mother or sister who have had the disease are more at risk of contracting the disease themselves. Breast cancer is part of the group of tumours that spreads to other parts of the body. If the cancer is found early enough, then the tumour can be removed by surgery (lumpectomy) and in addition, other treatments such as radiotherapy, chemotherapy and hormone therapy will help to eradicate the cancer altogether and hopefully it will not return. Unfortunately, the return of the cancer is possible and if it does return in a more aggressive form or if it is found in the later stages, then a mastectomy may have to be preformed. A mastectomy involves the removal of the breast that is affected with cancer. Despite the fact that this is a major operation and an extreme change in a females anatomy, women will generally suffer less psychological harm than only having a lumpectomy, as there is less chance of a recurrence and therefore less anxiety.
Breast cancer is usually associated with women and often goes unnoticed that men can also just as easily suffer with breast cancer as they have a small amount of breast tissue under the nipple, it is therefore important that, not only women, but men as well, check there breasts for any abnormalities on a regular basis. This can be done by themselves in their own home in front of a mirror or by having a mammogram. Ten years ago, the death rate from breast cancer was high until the discovery of Tamoxifen. Tamoxifen is a drug that prevents oestrogen acting in the breast tissue. This blocking effect prevents tumours from growing more rapidly. Together with the treatments available today and the campaigns to make people aware of the signs, thankfully the death rate of breast cancer has been dramatically reduced in the last ten years. Another form of cancer that is also usually diagnosed with a painless lump is testicular cancer, which is cancer of the male's sex gland - the testicle or testis. There are two main types of this cancer. The first being seminomas, which usually affect the older age generation and is the least serious while the second one is the most common and is known as teratomas and affects males between the ages of twenty and forty. Other cancers that may develop in the testicles are embryomas, choriocarcinomas and a few other ones that are rare. As with breast cancer, men should check themselves regularly for any lumps or abnormalities. This should ideally be done in a warm bath as the scrotum will be relaxed in this atmosphere and the contents will be easily felt. If a lump is felt, then medical advice should be sought straight away, as this kind of cancer is easily treatable if caught in the early stages. Other types of cancer include Hodgkin's disease - cancer of the lymphoid tissue and Leukaemia - cancer of the organs that produce white blood cells, for example, lymphatic system or the marrow of some bones. A sarcoma is a cancerous growth of the connective tissues, such as cartilage, tendons, ligaments and muscles.
Probably one of the most familiar degenerative disorders is Parkinson's disease. Parkinson's was first discovered by James Parkinson in the late eighteenth century, hence the name. The disease is also referred to as Parkinsonism, paralysis agitans and shaking palsy and is one of the common causes of tremor in the elderly. The main symptoms of Parkinson's disease are tremor and slow movements, rigidity, slow walking, taking short jerky steps and with the arms hanging down the side of the body, the face may be expressionless and they may have unblinking eyes. In established Parkinson's, the sufferer is unable ...
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Probably one of the most familiar degenerative disorders is Parkinson's disease. Parkinson's was first discovered by James Parkinson in the late eighteenth century, hence the name. The disease is also referred to as Parkinsonism, paralysis agitans and shaking palsy and is one of the common causes of tremor in the elderly. The main symptoms of Parkinson's disease are tremor and slow movements, rigidity, slow walking, taking short jerky steps and with the arms hanging down the side of the body, the face may be expressionless and they may have unblinking eyes. In established Parkinson's, the sufferer is unable to get out of their chair, will often fall when standing, they will have a lack of coordination and develops minute handwriting.
The tremors in someone suffering from the disease are more noticeable in their hands and their head will nod backwards and forwards rhythmically. As the intelligence and mental powers of victims are not affected in the early stages, it is therefore not surprising that Parkinson's is often accompanied by depression, frustration, anxiety and emotional stress, particularly when their speech is impaired.
Parkinson's disease is described as 'idiopathic' which is term used to describe something of unknown cause, in other words, the reason why Parkinson's disease occurs is unknown, although it is understood what happens in the brain to cause these symptoms. In Parkinson's the cells that control coordination in the brain, degenerate thus losing the control of smooth movement. As a rule, the disease begins in the fifty to sixty age group and tends to affect more men than women. There are no blood tests or any other tests that can diagnose Parkinson's disease, although CT scans (special x-rays) and EEG scans (which measures the electrical brain waves) could reveal changes in certain parts of the brain. There are a number of drugs available to help with the symptoms, but it is a matter of trial and error to determine which specific drugs work on each individual. Although it is now a thing of the past, occasionally, brain surgery to destroy part of the brain in an attempt to block nerve pathways that cause the tremors may be preformed. In recent years, a new revolutionary surgery has been discovered called deep brain stimulation. This procedure involves inserting electrical wires in the brain, while the patient is still awake (and only numbed with a localised anaesthetic) through holes that have been drilled in the skull. The patient then only has to flick a switch to stop their tremors. This operation is very successful but very dangerous to carry out. While Parkinson's disease rarely cause death, there is sadly no known cure and as the disease progressively gets worse, it causes otherwise normal people to become invalids and totally dependant on other people for help.
Cirrhosis and Wernicke-Korsakoff Psychosis are other common degenerative disease. Cirrhosis is severe damage to the liver. Although it is often thought cirrhosis of the liver is due to excessive alcohol, this in fact is not true. Children and people, who do not even drink may also be affected. Too much alcohol may cause cirrhosis with other causes being hepatitis A, B and C, gallstones, toxins, poisons, drugs and a number of rare diseases such as Wilson's disease and Gaucher's disease. Cirrhosis is a result of the liver becoming hard and enlarged. The scar tissue that replaces damaged areas of the liver is unable to carry out the liver's vital functions of detoxifying poisons and producing protein. The more functioning liver cells are damaged, the more the signs of cirrhosis will become apparent. The sufferer is likely to suffer from jaundice and anaemia, they will be prone to bruising and will probably feel lethargic. Swelling of the legs and abdomen will steadily worsen, until the victim eventually dies from liver failure. Other than a liver transplant, cirrhosis is incurable. Vitamin supplements and nutritious diets are recommended and medication may aid in helping some of the symptoms until the liver ceases to function.
Wernicke-Korsakoff psychosis or encephalopathy as it is otherwise known, is brain damage due to a lack of vitamin B, in particular thiamine (vitamin B1). This disease usually occurs in alcoholics that neglect their diet and in the elderly that may be malnourished. Blood tests confirm the disease and treatment involves thiamine supplements that are initially given by injection and then later in tablet form. Provided the sufferers abstains from alcohol and eats a healthy, well balanced diet, together with cooperation and a continuation of the treatment, then the outlook is not as gloomy as the other degenerative diseases that have been mentioned.
Multiple sclerosis (MS) or disseminated sclerosis is a disease of the brain and spinal cord that interferes with the brains ability to control movements. The disease causes scattered parts of the brain and spinal cord to become damaged at random. These damaged areas fail to work properly and the nerve messages to the brain do not flow smoothly or even reach the brain at all resulting in paralysis. Sometimes the message may travel the wrong way and will consequently cause an abnormal tremor or movement. Multiple sclerosis is a result of the nerves being stripped of myelin, the insulating coat that surrounds them. Symptoms vary from one patient to another as damaged tissue can repair itself and become fully functional, whereas yet another nerve may become damaged and cause another symptom. The main characteristics of multiple sclerosis are problems with their vision, paralysis, tremor, poor balance and coordination, general tiredness and numbness. Patients may also experience difficulties in controlling arms or legs, speech problems and periods of blindness. There is no effective treatment although certain drugs such as steroids and particular therapies such as physiotherapy and speech therapy can slow the progression of the disease and may even go into remission. Other degenerative diseases that also affects the nerves in the brain and spinal cord include Motor neurone disease and Myasthenia gravis. Unlike multiple sclerosis, where the usual age group that is affected is between twenty and thirty-five, motor neurone disease is a condition that is regularly seen in people between the ages of thirty-five and seventy years of age. The main features of this disease are weakness and wasting of all the muscles in the body, starting with the smaller muscles of the hands and feet until eventually the entire body becomes paralysed. Difficulty with swallowing, talking and coughing are also symptoms. There is again no cure for motor neurone disease and the cause of the disease is also unknown. Physiotherapy on a regular basis is essential and the disease is always fatal within three to ten years of diagnosis.
Myasthenia gravis is a rare condition that is characterised by varying weakness of the muscles that the movement of eyes and eyelids and those that control swallowing. In severe cases the muscles used in walking and breathing are also affected, therefore if adequate treatment is not received, death eventually results from breathing difficulties. It can occur at any age and is caused as a result of blocked nerve signals.
There are some degenerative diseases that are congenital (passed on in genes from the parents to their offspring). An example of a degenerative genetic disease is cystic fibrosis. Typically one baby a day will be born with this serious and potentially fatal disorder, which was first discovered around fifty years ago. As cystic fibrosis is a recessive genetic condition, both parents therefore have to carry the faulty gene in order for the gene to be passed on. Even if both parents do posses the defective gene, only one in four children will actually be born with the disease. The condition cannot be detected during pregnancy, although screening parents to see if they are possible carriers of the recessive gene is sometimes successful.
Cystic fibrosis causes lung infections and digestive system problems. An abnormality in the system that governs how salt and water move in and out of the body's cells, causes problems with the glands, particularly in the lungs and gut, that secretes sweat, mucus and digestive juices. In the gut, as excess mucus is produced, food is therefore unable to digest properly and diarrhoea occurs that is also accompanied by an unpleasant odour and abdominal pain. A lack of appetite and consequent weight loss are possible results of these particular symptoms. In the lungs, the mucus becomes thick and sticky causing the lungs to clog up. In turn this causes the lung tissue to be destroyed and as already mentioned, infection occurs, such as bronchitis or pneumonia. Wheezing and shortness of breath and a hacking cough, sometimes with vomiting may also be present due to the blockage of the lungs with mucus. Because of the damage that occurs to the lungs, heart failure may eventually transpire.
Since the glands in the reproductive system are also affected, the patients are more often than not, infertile (unable to have children). They are therefore unable to directly pass the disease on.
Cystic fibrosis is diagnosed by various tests including chest x-rays, measuring the amount of salt in sweat, abnormal lung function tests and faeces tests. Treatments include medications to open airways (bronchodilators) and to loosen the thick mucus (mucolytics) and antibiotics are prescribed to treat lung infections. It may be necessary for the patient to actually take up to sixty tablets a day, which will include vitamin supplements that are designed to replace the lost digestive enzymes and aid weight gain. Regular sessions of physiotherapy are also essential in order to clear the lungs. Eventually the patient will more than likely need a lung and heart transplant. There is no cure for cystic fibrosis, though these days' patients often live into their thirties with their commitment and dedication to following a strict and comprehensive treatment regime, as opposed to twenty years ago, when living to twenty years would have been something of a medical marvel.
Other genetic degenerative diseases include Sickle cell anaemia and dystrophy, which occurs in many forms. Sickle cell anaemia or haemoglobin S disease as it is otherwise known, is an inherited condition that only affects black skinned people of African origin. The disease is due to an abnormality in the development of the red blood cells. Haemoglobin is the pigment found in red blood cells, that carries oxygen around the body. The usual shape for a red blood cell is circular which enables them to pass through the fine blood capillaries in order to travel to the parts of the body that requires oxygen. Unfortunately, the red blood cells of those that are affected with sickle cell anaemia produce an abnormal form of haemoglobin called haemoglobin S. Once the red blood cells that contain this form of haemoglobin have given up their oxygen, they then become an irregular shape. The commonest shape that they will become is a sickle shape or crescent moon shape, hence the name of the disease. The shape of these red blood cells means they cannot pass through the capillaries and they may also block the passage, preventing other red blood cells that contain oxygen from passing through. The symptoms include tiredness and weakness, the inability to heal properly and cope with infections, the victim may become jaundice with having a large spleen and they are prone to developing gallstones. Sufferers will experience acute pain in most parts of the body due to the clumping together of the abnormal red blood cells, which in turn will block small arteries. This also causes permanent damage to the heart, liver or any other organs where there are blocked arteries. There is no cure for sickle cell anaemia and the outlook is dismal, as many sufferers will probably die in childhood or during adolescence. In the meantime, treatments include prompt treatment of any infections that may arise and an adequate fluid intake and folic acid help to reduce abnormal cells from reaching crisis numbers. The faulty gene that causes sickle cell anaemia can be detected in blood tests and if two carriers of the gene have children together, the children will have a twenty-five percent chance of inheriting the disease. For the child to have full blown sickle cell anaemia, they will therefore have to inherit a faulty gene from each of the parents. On the other hand, if the child only inherited one faulty gene, it would therefore have the sickle cell trait. The sickle cell trait is not fatal and rarely causes any problems unless the individual is exposed to an environment that is low in oxygen, such as flying, as there may be a drop in oxygen, even in a pressurised cabin.
Dystrophy is the term used to describe a number of inherited disorders in which wastage of tissues occurs. Corneal dystrophy is a rare inherited disease in which cells in the cornea in the eye are damaged, causing sight to be impaired or even blindness. The most renowned form of dystrophy is muscular dystrophy. This disease prevents muscle cells to properly develop resulting in weakness and paralysis as a result of the muscle fibres gradually deteriorating and wasting away.
Huntington's chorea, Hunter syndrome, Hurler syndrome and Werdig-Hoffman syndrome are also diseases that have been passed from the parents to their children. Huntington's chorea is a distressing condition that affects muscle function and coordination. Unlike other congenital diseases, the symptoms of Huntington's chorea do not become evident until the patient is between the ages of thirty and fifty years, therefore the disease is often already passed on to the next generation before diagnosis has been confirmed. If this is the case, their children will then have the option as to whether or not they want to be tested for the disease. An advantage of having this test is that they were diagnosed with the illness, they may decide not to have children, as there would be a fifty percent chance of passing on the faulty gene. On the other hand, if they decided to have the test and it was confirmed that they did have the disease, this could have dramatic effects on them, psychologically and emotionally as they would have to live with the fact that they were going to get ill, as would not having the test and having to live with the possibility of developing the disease. Symptoms include irregular random movements of their face, arms and legs, irritability, moody and antisocial behaviour, restlessness, fidgeting, mental deterioration, premature senility and rigid muscles. These symptoms progress over several years and may even result in severe psychiatric disturbances. There is no effective treatment available, though some psychiatric drugs may help to reduce mood swings and drugs such as muscle relaxants may help with abnormal movements. Inevitably, death occurs within ten to twenty years of the symptoms first developing.
Hunter syndrome (mucopolysaccharoidosis type II being the medical term) is an uncommon inherited condition that is a deformity of the metabolic system. This disease prevents sufferers from eliminating particular substances (mucopolysaccharides, hence the medical name) from the body. This disease is accompanied by many disabilities including stiff joints, misshapen facial features, enlarged spleen and liver, heart abnormalities and mild mental retardation. Deafness may also occur. Hunter syndrome is diagnosed with certain blood tests, bone marrow tests and x-rays. There is no cure for this syndrome, though patients do have a moderate life expectancy. Hurler syndrome (mucopolysaccharoidosis type I) is very similar to Hunter syndrome. Patients with Hurler syndrome also have the inability to remove mucopolysaccharides from the body. Sufferers with Hurler syndrome have basically the same characteristics as those with Hunter syndrome except they will also have a short stature, spinal deformities and blindness. In both cases surgery is possible for heart abnormalities and facial defects, though patients with Hurler syndrome will suffer heart failure and death as a result in early childhood.
Werdig-Hoffman syndrome is an inherited, progressive, permanent wasting and weakening of the muscles. As the patient with this disorder develops weakening of the muscles in the trunk rather than their limbs, it increasingly makes their breathing difficult, until the point where pneumonia may occur. Muscle biopsy and electrical studies of the muscles are used to detect the syndrome. Physiotherapy may be of some use, but as there is no effective treatment at present, most sufferers will probably die before the age of five years.
Memory Disorders
The memory is the most complex function of the brain and the least understood. The exact nature and position of memory in the brain is still being debated amongst psychologists today. However, something of the types of memory that we possess is known. The memory requires several steps in order to function properly, for example, acquiring information, storing the information and being able to recall the information as and when it is needed. Information is stored in the memory in three different stages - intermediate, short term and long term. Intermediate memory only lasts for a few minutes and enables about five to ten item to be stored. This type of memory is quite susceptible to distraction. Short-term memory can last from just a few minute to a few hours, and has a larger storage capacity than intermediate memory. The information in the short term memory is sorted out into what is important and needs to be kept, this will be placed in the long term memory, and those that are not so important will be gradually discarded and will fade from memory. Long term memory can lasts from weeks to a lifetime. Long term memory consists of personal experiences and important events that have taken place in the past and knowledge. In order for long term memory to function properly, it needs the production of new proteins and new connections between nerve cells within the brain. Unfortunately, as we age our memory begins to deteriorate. In some people, they may develop a form of dementia.
Dementia is an irreversibly decline of mental ability, that is a result of physical changes in the brain. Dementia affects around ten percent of the UK population over the age of sixty-five. This is known as senile dementia and those that are affected with the condition under the age of sixty five are described as having presenile dementia. Early symptoms consist of the sufferer becoming restless and they will begin to lose their short term memory. Insomnia is also a consequence of dementia, as is confusion over things such as times, dates and days and unexpected mood changes. Everyday habits and events will also lose their natural logic, which ultimately causes the dementia patient to lose any sense of responsibility both for themselves and for others. Sooner or later, the patient will require round the clock nursing.
Dementia can be caused by a number of factors like injury, infection, and drug and alcohol addiction. It can even develop in the late stages of conditions such as syphilis and it has also been found to be hereditary in some cases. Other factors that results in dementia are diseases of the brain.
Alzheimer's disease used to be referred to as 'second childhood' or the person with the disease was described as eccentric. Today however, Alzheimer's disease is recognised as the most common form of dementia in an elderly person, although it is possible for people in their mid fifties to develop the disorder. The reason why Alzheimer's disease occurs is unclear. The first signs the sufferer will develop is short term memory loss, which may appear as regular bouts of simple mindedness that we all get from time to time though in reality it is much more serious. An example of the kind of memory loss an Alzheimer's patient will experience is for instance, the patient may remember who lived next door to them over twenty years ago, where as they will have forgotten what they did that particular morning. Gradually the patient will be unable to cope with day to day situations for example, they may become disorientated in otherwise usually familiar surroundings, they may lose the ability to concentrate and even be unable to recognise friends and members of the family. In the later stages, the patient will be unable to control their emotions, with their speech making little sense.
Looking after the mentally ill, with any form of dementia is a stressful task that takes up a lot of time. It also not only puts an enormous amount of pressure on the whole family, it can also be emotionally draining on everyone concerned, as seeing a loved one deteriorate is heartbreaking when there is nothing you can do to help. Although some families may feel obliged to look after the patient, it is important to recognise that there is help at hand and asking for this help does not mean you are a failure. The services that are there to help include 'meals on wheels', home help, day care and a clean linen service. There are charitable organisations such as Age Concern that also offer help in the form of 'granny sitting services' or help with lifts. Some geriatric hospitals have one or two beds set aside for respite care in order for the carers to have a break. In most cases, patients need to be placed in a home for full time care from professionals.
Although the memory disorders, that have been discussed so far, have all been incurable, there are some disorders that may affect the memory for a short period of time. A short period of time can mean anything from as little as a few hours, for instance, someone who has had a large amount of alcohol may wake up the next day and not remember what they did the previous evening, or the memory loss could last a few weeks. In either case, the important thing is that, the majority of the time it is not permanent. Short term memory disorders include organic brain syndrome and amnesia. Organic brain syndrome is a result of trauma or severe emotional disturbances, for example, fear and horror. These experiences cause memory disturbances as well as disorientation, poor logic and behavioural changes. Other triggers that may bring about this syndrome are epilepsy, the usage of drugs, cancer that is outside the head and severe infections.
A loss of existing memory is known as amnesia. There are a number of things that could cause this, for instance, injury to the brain that could be caused by a bow to the head, a stroke, a bleeding blood vessel, a tumour, and an abscess, an infection such as meningitis or encephalitis and convulsions. Other factors that may cause memory loss are hysteria, post traumatic stress syndrome, a number of psychiatric conditions, such as fugue states, high fever, exposure to extreme cold, dramatic changes in the blood chemistry, for example, low blood sugar and salt levels, deprivation of oxygen will cease the memory from working properly and all short term memory will be lost and a build up of cerebrospinal fluid will cause the memory to be lost under the pressure.
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