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Running head: ALZHEIMER’S DISEASE RESEARCH FINAL
1
ALZHEIMER’S DISEASE RESEARCH FINAL 22
Alzheimer’s Disease Research Final
Dalia Catalan
Florida National University
Alzheimer’s Disease Research Final
Phase one
Introduction
Alzheimer's disease tends to be a progressive, irreversible
ailment that impacts the normal functioning of the brain slowly
destroying the thinking and memory-related skills and as it
progresses it limits the patient the ability to conduct simple
tasks ("What Is Alzheimer's Disease?," 2020). Researchers
suggest that approximately 6 million American citizens older
than 65 years of age have dementia which is caused by
Alzheimer's disease. In most patients, the symptoms of this
condition begin to be identified when they are in their mid- the
60s. This condition is often ranked as one of the top ten causes
of death in the United States, but following a recent
investigation, the condition has climbed the ladder and it is
currently ranked as the top five leading cause of death in the
United States. Often the disease is categorized with cancer and
heart disease as the main cause of death among the older
population. This paper will focus on planning research that is
focused on understanding Alzheimer's disease, its causes
symptoms and its impact on the older population.
Problem identification
Alzheimer's disease tends to be the most common cause
of dementia among the older population around the world. The
condition impacts the normal functioning of the brain hence
causing the loss of cognitive functioning such as reasoning,
remembering and thinking. Also, it impacts behavioral abilities
to the extent of the victim not being able to conduct various
daily essential activities ("What Is Alzheimer's Disease?,"
2020). The severity of the brain damage from the mildest stage
where the normal function of a person is impact and it
progresses to a most severe stage and the victim must be
dependent on the people around him or her for basic activities
related to daily living. The condition is most popular among the
older population and its estimated that the condition has
impacted about 6 million senior American citizens' normal
function and also it is a leading cause of death among this
population ("Alzheimer's Disease Fact Sheet," 2020).
Significance of the Problem to Nursing
With a significant population estimated to be victims of
Alzheimer's disease in the United States, it is most likely that
individuals in the nursing practice will encounter patients
suffering from this condition either in their personal lives on in
their careers. Thus, it is essential for the nurses to be able to
understand and recognize the Alzheimer's Disease symptoms,
treatment approaches, and options as well as learn how to
effectively interact with this vulnerable population ("Update on
Alzheimer’s: What Nurses Should Know," 2020).
To be able to provide quality health care services the
nurse practitioner needs to understand the various vital
components that support better working conditions with the
patient. The nurse should emphasize clear communication and
individualized care, meaning that he or she must develop clear
instructions and communication approaches that are adaptive to
the patient's needs. Also, it essential for the nurse to understand
the emotion behind the patient’s behavior or communication.
Additionally, behavioral activities that are related to
Alzheimer's Disease may also jeopardize the safety of the
patient thus the nurse practitioner needs to develop strategies
that ensure the safety of the patient is not at risk. Moreover, the
nurse practitioners need to understand that the patient’s
behavioral activities are not personal ("Update on Alzheimer’s:
What Nurses Should Know," 2020). Thus, they need to develop
various strategies of working with Alzheimer's Disease patients
such as written reminders, engaging the patient in activities,
distraction, redirection and providing the patient with the
needed assistance. In addition, it is the duty of the nurse to
ensure that the patient’s family is provided with the required
support because it tends to be an emotional experience that may
turn to be a crisis if it is not addressed appropriately. Also,
essential for the nurse to be mindful of the progression of the
condition while caring for the patient and his or her family as
well as learn to work holistically. Through the provision of
quality care and informed understanding of the condition may
generate a positive relationship with the patients and their
families hence positively improving the condition.
Purpose of the Research
The main purpose of the research is to attain an in-depth
understanding of Alzheimer's Disease, its causes, its impact on
human health and the essential care required to effectively
improve the condition. For instance, being a progressive and
irreversible ailment, the research will provide the required
information regarding how the condition advances from mild
memory-related issues to severe brain damage. Also, a better
understanding of why the progression of the condition varies
with every patient will be attained through the research. Often
the condition may progress for about 20years and the victim
patient may live an average of about ten years after being
diagnosed with the condition. Additionally, the research will aid
with information on the various treatment approaches or
maintenance strategies for the condition ("Alzheimer's Disease
Fact Sheet," 2020).Also, the research will improve the
understanding of why no specific factor causes the condition but
the condition is often linked to age advancement, family
history, and a particular protein known as apolipoprotein. Other
related considerations to the ailment are education,
environment, diet, as well as viral influences.
Research Questions
1. Why is Alzheimer Disease ranked among the highest cause of
death among the older population?
2. What are the various approaches are used by the nurse
practitioner to ensure the condition does not get severe and out
of hand?
Master’s Essentials
Alzheimer's Disease is a leading cause of dementia and
death among the older population. Also, there is no specific
cause of the ailment as well as the condition has no cure.
Additionally, the diagnosis of the condition may only be
attained through an examination of the brain tissue during an
autopsy. Additionally, the probable diagnosis may be attained
through a medical history, neuropsychological and medical
testing, and brain scans. However, the continuum of Alzheimer's
Disease may include mild symptoms, moderate symptoms and
severe symptoms ("Alzheimer's Disease Fact Sheet," 2020). A
patient with mild symptoms tends to demonstrate memory loss,
inability to learn new things, tends to be unorganized, limited
attention span. On the other hand, a patient who is in his or her
moderate stage he or she tends to display noticeable behavioral
changes, inability to identify other people, getting lost in a
familiar environment, has poor judgment, and experiences sleep
disruptions. Lastly, when a patient is in the severe stage he or
she tends to experience the inability to recognize him or herself
as well as other people, he or she has an incoherent speech, has
repetitive behavior, weight loss and incontinence as well as
difficulty swallowing. Nurses need to develop various effective
care strategies to ensure that the patient’s AD condition does
not progress into a more severe stage.
Phase Two
Brief Literature Review
Following the intense impact of this condition among the
older population several pieces of research have been conducted
to enable the health care providers to attain more knowledge to
develop various strategies to reduce the impact among the
affected population and also to be able to reduce its mortality
rate. According to Pal, Siotto, Prasad, and Squitti (2015), they
asserted that as the life expectancy in the industrialized
countries continues to increase, brain-related issues and
cognitive related issues continue to increase hence becoming a
significant issue in human health. Additionally, cognitive
decline tends to occur while one ages tend to have negative
impacts on the patient’s quality of life because it mainly
disrupts the patient’s memory as well as learning abilities (Pal,
Siotto, Prasad, & Squitti, 2015). In their research where they
focused ion understanding how copper intake may influence the
occurrence of the Alzheimer’s Disease, they were able to
understand that copper mainly acted as a causative aspect in the
Amyloid-β peptide (Aβ) hence showing significant relation
between copper and Alzheimer’s Disease in regards to cognitive
performances. Additionally based on the findings from their
research it was identified that modification in the drinking
water or dietary supplements, and diets in the various subjects
with ascertaining copper dysfunctions may be a less costly
approach to delay or prevent of Alzheimer’s Disease onset (Pal,
Siotto, Prasad, & Squitti, 2015)
According to Bagad, Chowdhury, & Khan, (2013) they
asserted that Alzheimer’s Disease (AD) is a popular
neurodegenerative condition which is known for causing
dementia among the elderly population. Additionally, various
pieces of evidence provide suggestions that Amyloid-β peptide
(Aβ) contributes significantly in the Alzheimer’s Disease
pathogenesis, but still, the underlying mechanisms continue to
be uncertain (Bagad, Chowdhury, & Khan, 2013). However, the
authors argued that sufficient knowledge has been attained
within the past several years in regards to Alzheimer’s disease;
diagnosis, care pattern, epidemiology as well as the economic
impacts. Being a common ailment among the older population
the research conducted towards understanding the health
condition has enabled the health care providers to appropriately
establish effective trial designs as well as outcomes for
different stages of the condition (Bagad, Chowdhury, & Khan,
2013). Thus, to be able to continue improving the understanding
of this condition the disease's treatment guidance needs to
updated constantly to take into account new evidence to be able
to effectively benefit the health care providers as well as the
patients. However, as the aging population continues to
increase, new medication to manage AD and the various reforms
occurring within the health care system will need the integration
of the newly attained understanding to be able to effectively
understand the various needs of patients suffering from AD as
well as their families (Bagad, Chowdhury, & Khan, 2013).
Also, De Paula, J. (2012) argues that the intracerebral
amyloidosis begins to develop in the AD patient in an approach
that is dependent on age, but the recent evidence shows that in
some patients the AD signs and symptoms of the disease may be
noticed as early as between thirty and forty years of age, but the
condition continues to increase as one approach old age (De
Paula, 2012). The author also asserts that Alzheimer's Disease
may be clinically defined based on three different phases: 1.
The pre-symptomatic Alzheimer’s Disease- this is an AD phase
which tends to last for and extended period of time before
Amyloid-β peptide (Aβ) within the brain begins to overproduce
as well as accumulate reaching a sensitive level of triggering
the amyloid cascade (De Paula, 2012). 2. The Pre-dementia
phase- this is an AD phase that the early pathology is present.
Often it ranges from mild neuronal dystrophy to early-stages
Braak pathology, additionally the AD phase may last for several
years based on the patient’s resilience as well as the brain
reserve. 3. Clinically defined dementia phase of AD defines the
AD in regards to the severity of the functional and cognitive
impairment (De Paula, 2012). This phase comprises of an
excessive neuritic plaques accumulation as well as
neurofibrillary tangles the impacted brain segments that bear an
association with the global impairment magnitude. However,
advanced technologies that focuses on the functional and
structural neuroimaging, as well as cerebrospinal fluid
biochemical analysis may demonstrate a correlation of
intracerebral amyloidosis among the population suffering from
mild, pre-dementia symptoms (De Paula, 2012).
Also, Bhushan, Kour, Kour, Gupta, Sharma, &
Yadav(2018) assert that Alzheimer's is the leading influencer of
memory loss among the elderly population all over the globe.
Research shows that the neurodegenerative condition impacts
approximately 10% of the individuals above the age of 65 and
about 50% of the people above 85 years of age. In the United
States, there are about 4 million people suffering from AD and
their annual cost of treatment stands at approximately
$100billion (Bhushan et al., 2018). This makes it be listed
among the leading causes of death in the United States hence
becoming more prevalent in several other countries. Generally,
Alzheimer's causes the brain size to shrink, leading to the brain
cells having progressively fewer nerve cells and limited
connection. Thus, to be able to improve the treatment and
prevention research, there is a need to consider measures for
present interventions (Bhushan et al., 2018). This may aid in
improving providing a better understanding of providing
support for the individuals suffering from Alzheimer’s Disease
as well as raise public awareness regarding the mental
condition. Currently, disease-modifying drugs related to
Alzheimer’s Disease have not been developed, but several
options may reduce the symptoms of the condition as well as aid
in the improvement of quality of life.
According to Hane, Lee, & Leonenko (2017), the
research towards understanding Alzheimer’s Disease has
significantly grown over the years, especially following the
separation and recognition of the amyloid-β attained from post-
mortem study of the brain acquired from the Alzheimer’s
Disease. In addition, the authors asserted that the various
advances have significantly improved the understanding of the
condition and reinforced its complexity (Hane, Lee, &
Leonenko, 2017). However, following the multifactorial and
complexity nature of the Alzheimer’s Disease has contributed to
some of the health care researchers to develop a hypothesis that
the condition is not an ailment in technical sense, rather it is a
form of syndrome, gathering of pathologies which tend to
manifest themselves as common symptoms mainly being
associated to age, memory loss as well as personality changes.
Despite the hypothesis being true or false, the health care
providers precisely understands the complexity associated with
Alzheimer’s Disease and its pathophysiology may not be
described individually through the abnormal metabolism of
Amyloid-β peptide (Aβ) (Hane, Lee, & Leonenko, 2017).
Methodology and Design of the Study
The study will utilize the action research design to be in
a position to effectively attain a better understanding of
Alzheimer’s Disease by effectively answering the research
questions developed by the researcher which are: 1. Why is
Alzheimer Disease ranked among the highest cause of death
among the older population? and 2. What are the various
approaches are used by the nurse practitioner to ensure the
condition does not get severe and out of hand? The research
design will analyze the information attain from the secondary
sources and literature review hence developing a better and
improved understanding of Alzheimer’s Disease complexity.
Sampling Methodology
The information for the research will be attained from a
secondary source and to ensure that the information acquired
relevant a simple sampling methodology will be employed to
enable the efficient retrieval of information. The secondary
sources to be utilized in the research will not be older than
seven years to ensure that the information acquired from the
sources is not outdated. Additionally, the information will be
attained from valid scholarly sites to ensure that the information
being used in the research has been validated by health care
organizations.
Necessary Tools
The major objective of the study is to achieve a precise
understanding of the Alzheimer’s Disease, the causes of the
condition, the impact it has on human quality of life and the
necessary care required to be able to reduce the symptoms of
the condition. For instance, the condition being an irreversible-
progressive condition, the study will offer essential information
on how the ailment progresses from mild memory loss to
severe damage of the brain. Additionally, a better understanding
on to why the advancement of the condition differs from patient
to another. Thus, the information being used in the research will
be attained from online sources, hence the main tool that will be
used in the research to collect data would be the internet.
Phase Three: Implementation
Research Background
Alzheimer's disease is a common brain condition that is linked
to tends dementia amongst the elderly population. This health
condition tends to affect the brain’s normal functioning and in
turn causing the victim to lose his or her cognitive ability such
as thinking remembering as well as reasoning. In addition, the
also affects the behavioural ability of an individual to a point
where the patient is often not able to successfully perform
different essential daily life activities (Bagad, Chowdhury, &
Khan, 2013). Furthermore, the brain damage severity tends to
progress from mild stage where the normal functioning of the
victim is impacted to the severity stage where the victim is
required to depend on other people for him or her to conduct his
or her daily activities.
The condition tends to be quite common in individuals beyond
the age of 65 as well it is estimated to have impacted an
approximate population of 6 million senior citizen in the United
States. The health condition is regarded to be the major cause of
death among people in this age bracket. The aim of this research
study is to acquire and in-depth knowledge of the brain
condition, it main causes, the appropriate care required to
improve the condition as well as the impacts the condition has
on the human health. For example, through the research one will
be in a position to understand the progressive and the
irreversible status of the disease from the mild memory related
to severe brain damage Additionally a better understanding of
the progression status varying from one patient to another will
be attained (Bagad, Chowdhury, & Khan, 2013). Often this
health condition tends to gradually progress over a period of
approximately 20years and the patient may live an approximate
of ten years after the diagnosis o the health condition has been
determined. Also, the research study will assist with provision
of the different medication strategies for this ailment. The study
will also enhance a better understanding Also of the reason as to
why there have not been identified a specific cause of the
ailment but it is majorly related to family history, advancement
in age as well as excess of specific protein called apoliprotein.
Other related factors linked to this health condition are
environment, diet, viral influences as well as education.
Implementation plan
A table will be developed with the aim of outlining all the
essential tasks that need to be completed in the research’s
project proposal timeline. The table will comprise of a
significant date for attaining research responses from the
subjects, application of ethical approval and interviewing the
participants. In a situation where the research needs are reduced
the researcher will be pushed to limit the number of interviews
being conducted but still be in a position to achieve the required
information. However, since the survey time will be recorded, it
is essential to reduce the transcription time. Additionally, it will
be needed to limit the research assistants’ employment.
Interviewing process is a critical segment of the study that may
need a research-assistants, to aid in acquiring notes which
enable the researcher to be in a position to develop a valid and
effective research report. If the study recruits few participants
there will be no needs to employ a research assistant, however
there will be additional components in the time chart that will
not be altered.
Protocol Review and Approval Application
The research approval on ethics as well as protocol review will
utilize two basic approaches. The first approach that will be
implemented, will be the submission of the research proposal
for an approval by an appropriate board, this is important
because the research study is majorly focusing on the human
subjects ("IRB Review and Approval Process," 2018). The
proposal submission will ensure that the interaction with the
research subjects will offer access to their personal information
to accomplish the study process. The research project will also
focus on recruiting individuals with Alzheimer’s disease in
order to be in a position to understand its impact on the patient
and how it contributes to dementia.
Generally, any research study that tends to involve human
subjects needs to be approved as well as a protocol needs to be
submitted for a critical review. If the protocol review conducted
by the board determines the research study to have minimal or
zero risk to the human participants then the research project
will be eliminated from the reviewing process ("IRB Review
and Approval Process," 2018). Often it is mandatory that the
research studies that tend to involve human as subjects are
required to collect information prior to being approved.
However, in case there are any alterations following the data
gathering process, then modification will be needed to be
submitted for a review as well as approval.
Information letter and Informed Consent Forms to the
participants
During the implementation planning process in the
research study the researcher will be required to make sure that
every participant information material need to include a
statement of consent as well as an information letter. These two
documents need to have an appropriate letter head and in
addition the ethics committee will be needed to ascertain what
the study will involve. Also, the agreement form needs to be in
alignment with the protocol. Additionally, it is essential to
make sure that the study title clearly printed on every page of
the agreement form (Siegle, 2015). Also, the background
segment of the form will offer a clear as well as detailed outline
regarding the subjects that will be asked to take part in the
research study and any benefits that may be anticipated in the
research. Also, the main purpose of the research study will be
briefly outlined in the form to show kind of information that the
researchers will be looking for from the research subjects.
Another important component that will be included in the
consent form will be the techniques or the various procedures
that the research will utilize as well as the duration of time that
will be allocated to the study (Siegle, 2015). More essentially,
the information letter as well as the consent from will portray
the various benefits of the research study to the society or any
other form of monetary compensation provided to the subjects
in the research study.
Project timeline
Table 1: Project Timeline
1. Protocol review and ethics approval application for the study
2 weeks
1. Compliance procedures with the essential standards
1 week
1. Information letter to participants
5 days
1. Consent form to participants
2 days
1. Confidentiality agreement for the research personnel
3 days
1. Conducting the study
6 weeks
1. Compiling the data
1 week
1. Writing the final report
1 week
1. Presentation
1day
Project Budget
Table 2: Project Budget
Research assistants
1. Making posters
1. Taking notes during interviews
1. Literature review Assistance
$ 100.00
$ 150.00
$ 250.00
Travel
$ 200.00
Accommodation
$ 550.00
Food
$ 520.00
Total
$1770.00
Commitment
The researchers of the project will concentrate on the data
collection process in the basis of information that will be
documented during the data gathering process. Additionally, the
researchers will observe highly confidential levels during the
research process. Patients with Alzheimer’s disease and are
undergoing the maintenance as well as treatment process will be
the main target of the research study.
After making sure that all the needed resources are present, the
human subjects or the participants will be invited to take part in
the research study. The research study will focus on utilization
of the action research design to attain a better understanding of
the Alzheimer’s disease through answering the research
questions. To make sure that a successful research has been
attained the researchers will be required to adhere to the study’s
implementation plan. Also, the research study will be beneficial
to the health care sector because it will be able to add some
knowledge on the Alzheimer’s disease hence enabling the health
care providers to be in a position to develop more appropriate
approaches of treating and caring for Alzheimer’s disease
patients.
Phase Four: Results
Alzheimer’s Disease has been a common cause of
dementia among the elderly population in society. The illness
tends to affect the brain’s normal functioning which in turn
causes the elimination of cognitive functioning such as
thinking, remembering as well as reasoning. Additionally, the
condition also tends to affect the victims' behavioral abilities to
a point where the patient is not in a position to engage in his or
her daily life activities by himself or herself. Previous
researches have provided evidence that the severity of this
condition on the brain begins from a mild stage where the
normal functioning of the victim is impacted and gradually
progresses to a severe stage where the victim depends on the
people around him or her to complete their basic daily activities
("What Is Alzheimer's Disease?," 2020). The illness tends to be
quite popular among the elder population and currently, it is
estimated to have affected about 6 million senior citizens’
normal function as well as its common cause of death among
this population.
Purpose of the Research
The main aim of this research was to achieve a critical
understanding of Alzheimer’s Disease, its main causes, the
impacts it has on human health as well as the important care
required to be able to improve this condition on the patient. The
research will provide an understanding of why the condition is
regarded to be progressive as well as irreversible disease and
how it advances from mild memory damage to severe memory
damage. Another essential aspect that the research contributed
is understanding why the progression of the condition tends to
vary from one patient to another. Often the condition may
progress for about 20years and the victim patient may live an
average of about ten years after being diagnosed with the
condition ("Alzheimer's Disease Fact Sheet," 2020).
Additionally, the research will aid with information on the
various treatment approaches or maintenance strategies for the
condition. Also, the research will improve the understanding of
why no specific factor causes the condition but the condition is
often linked to age advancement, family history, and a
particular protein known as apolipoprotein. Other related
considerations to the ailment are education, environment, diet,
as well as viral influences.
Research Questions
1. Why is Alzheimer's Disease ranked among the highest cause
of death among the older population?
2. What are the various approaches are used by the nurse
practitioner to ensure the condition does not get severe and out
of hand?
Research Results
The research study conducted comprised of 150
randomly picked participants of ages between 65 and above who
were drawn from the local health care facility. All the
participants picked for the study were all diagnosed with
Alzheimer’s disease as well as they indicated different
symptoms due to their different stages of the disease. About 90
of the participants suffered from mild brain damage thus, they
were able to conduct various life-related activities on their own.
While the remaining 40 participants suffered from severe brain
damage and this limited them from being able to conduct
essential life activities on their own, thus they require a nurse
or a family member to present to assist them to complete these
essential activities. The patient with mild- brain damage often
came in the health facility for treatment and then they would go
back home, while the patients with severe- brain damage were
hospitalized. Additionally, the research focused on studying the
patients’ features as well as the demographic variables such as
education level, marital status, age, exercise as well the form of
treatment the patient received during their hospitalization
period. Additionally, based on the patients’ characteristics as
well as demographics, a statistical similarity was developed
(P>0.05). Also, there was no significant difference between the
two groups (test and control group). The Standard deviation, as
well as the mean score in regards to the test group’s age
bracket, was (75.53 ± 4.1). On the other hand, the standard
deviation, as well as the mean score of the control group’s age
bracket, stood at (67.76 ± 3.2).
Through the utilization of the t-test, it was determined
that both groups under research portrayed several similarities in
their mean age (P = 0.69) (Hess & Hess, 2017). The
occupational variable presented the highest frequency of 3.1%
as almost all the participants were retired. On the other hand,
the variable representing the marital status presented a
frequency of 9.3%. The frequency indicated that most of the
participants (75%) ( test and control group) were literate.
Additionally, it was identified that all the participants suffered
from Alzheimer’s disease and they all had one time in their life
used oral medication to improve their memory ability. Most of
the participants (90%) asserted that they did not understand the
main cause of the disease, while about 20% of the participants
asserted it was aged related. All the participants asserted that
they had received information regarding the condition of their
health care providers. The t-test, Chi-square, as well as the
Fisher’s Exact test, was used to attain the values from both
groups (Test and Control groups) (Hess & Hess, 2017). The
findings indicated no significant statistical difference between
the two research groups as portrayed in the table below.
Variable
Results
Control Group
Frequency Percentage
Test Group
Frequency Percentage
Test type
Marital Status
Single
Married
Divorced
10 10
35 70
18 20
20 40
69 60
0 0
Exact Fisher’s
Test P>0.05
Education Level
Illiterate
Literate
15 30
30 70
20 40
78 60
Exact Fisher’s
Test P>0.65
Exercise
Infrequent
Frequent
36 75
23 25
64 55
32 45
Pierson P > 0.5
Type of Treatment
Oral Medication
Therapy
65 90
12 10
70 95
8 5
Pierson P > 0.5
Source of information
Nurse Practitioners
Physicians
12 30
34 70
7 15
56 85
Exact Fisher’s
Test P>0.05
Table 1. Information based on personal and test groups
The standard deviation, as well as the average score of the test
group regarding the awareness of the condition prior to the
intervention, stood at (46.43 ± 5.1), but the score gradually
improved to (55.74 ± 4.57) after the 6 weeks of intervention via
the educational program. Prior to the intervention, the standard
deviation, as well as the mean score which was related to the
participants' attitude towards the condition, stood at (18.25 ±
4.78), the score of the test group was at (30.21 ± 12) but
following the educational intervention, the score shifted to
(25.74 ± 4.6) however, prior to the educational intervention, the
tendency of self-care among the test group stood at (30.21 ±
12), but following the intervention the score improved to (46.28
± 16). On the other hand, the t-test findings indicated a
significant statistical difference between the values (P < 0001),
before and after the educational intervention. As per the results
attained from the research the standard deviations as well as the
mean scores of awareness, attitude as well as self-care at the
beginning of the research stood at (18.73 ± 3.5, 29.5 ± 6.1, and
53.65 ± 5.2) but following the educational training on the
family members of the patients within the control group the
scores moved to (18.71 ± 3.7, 29.75 ± 6.5, and 53.75 ± 5.35). In
addition, the t-test results of the control group indicated that
there was no significant statistical difference among the values
(Hess & Hess, 2017). The table below provides a tabulation of
the standard deviation and mean score of awareness, self-care as
well as attitude of the Alzheimer’s condition in both groups.
Study Group
Variables
Mean (±SD)
P
Before
After
Difference
Self- Care
Control
Intervention
29.5 ± 6.1
30.21 ± 12
29.75 ± 6.5
46.28 ± 16
0.25 ± 0.4
16.07 ± 4
P < 0.863
P < 0.001
Attitude
Control
Intervention
18.73 ± 3.5
18.25 ± 4.78
18.71±3.7
25.74± 4.6
0.02 ± 0.2
7.49 ± 0.18
P < 0.842
P < 0.001
Awareness
Control
Intervention
53.65 ± 5.2
46.43 ± 5.1
53.75 ± 5.35
55.74 ± 4.57
0.10 ± 0.15
9.31 ± 0.53
P < 0.863
P < 0.001
Table 2. Tabulation of the standard deviation and mean score of
awareness, self-care as well as attitude of the Alzheimer’s
condition in both groups
Limitations of the study
The research project had its upside and downside. The upside of
the research was that it provided an understanding that
education interventions regarding the Alzheimer's condition
may aid patients to be able to contain the condition at the mild
stage limiting it to progress to the severe stage through
engaging in activities that promote brain functionality.
However, the research project had its limitations on the
downside which were, one the research project was conducted
on a single health care facility, hence promoting a highly
controlled setting, which leads to the findings not appropriate to
be utilized in other populations suffering from the condition.
Additionally, another limitation of the project study was that
the participants' population of 150 individuals was not
sufficient to allow the generalization of the findings. However,
the research project sets a platform for conducting future
research studies on Alzheimer’s Disease. The future study may
focus on understanding why the condition impacts the senior
citizen more than young people.
Conclusion
This condition is often ranked as one of the top ten causes of
death in the United States, but following a recent investigation,
the condition has climbed the ladder and it is currently ranked
as the top five leading cause of death in the United States. Often
the disease is categorized with cancer and heart disease as the
main cause of death among the older population. The findings
from the research have indicated that the progressive status of
the condition may be controlled ensuring the patient condition
does get severe. Additionally, the research provided
information on the various treatment approaches or maintenance
strategies for the condition. Also, the research it has contributed
in improving the understanding of why no specific factor causes
the condition but the condition is often linked to age
advancement, family history, and a particular protein known as
apolipoprotein.
Learning Experience
The learning experience attained from conducting the
research was quite positive as it provided me with more
knowledge regarding the conditions. I was able to attain an in-
depth understanding of how the condition tends to progress
from a mild brain damage stage to a more severe brain damage.
Also I was able to understand that the progressive state of the
condition may controlled through engaging several activities
involving the brain to ensure it’s active. Also after conducting
the research it opened new opportunities that would enable me
to effectively further my research on the health condition to be
able to acquire more knowledge and its impact on the society.
References
Alzheimer's Disease Fact Sheet. (2020). Retrieved from
https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet
Bagad,, M., Chowdhury, D., & Khan, Z. A. (2013). Towards
understanding Alzheimer's Disease: An Overview. Research
Journal of Pharmaceutical, Biological and Chemical
Sciences, 4(4), 286-298. Retrieved from
https://www.researchgate.net/publication/273768877_Towards_
understanding_Alzheimer's_Disease_An_Overview
Bhushan, I., Kour, M., Kour, G., Gupta, S., Sharma, S., &
Yadav. (2018). Alzheimer’s disease: Causes & treatment – A
review. Annals of Biotechnology, 1(1). Retrieved from
https://meddocsonline.org/annals-of-biotechnology/alzheimers-
disease-causes-and-treatment-a-review.pdf
De Paula, J. (2012). Alzheimer's disease. Sub-cellular
biochemistry, 65(352). doi:10.1007/978-94-007-5416-4_14
Hane, F. T., Lee, B. Y., & Leonenko, Z. (2017). Recent
Progress in Alzheimer’s Disease Research, Part 1:
Pathology. Journal of Alzheimer's Disease, 57(1), 1-28.
doi:10.3233/jad-160882
Hess, A. S., & Hess, J. R. (2017). Understanding tests of the
association of categorical variables: the Pearson chi-square test
and Fisher's exact test. Transfusion, 57(4), 877-
879. https://doi.org/10.1111/trf.14057
IRB Review and Approval Process. (2018, December 20). Office
of Research at UC Santa
Cruz. https://officeofresearch.ucsc.edu/compliance/services/irb3
5_about_decisions.html
Pal, A., Siotto, M., Prasad, R., & Squitti, R. (2015). Towards a
Unified Vision of Copper Involvement in Alzheimer's Disease:
A Review Connecting Basic, Experimental, and Clinical
Research. Journal of Alzheimer's Disease, 44(2), 343-354.
doi:10.3233/jad-141194
Siegle, D. (2015, February 28). Research Ethics and Informed
Consent. Educational Research Basics by Del
Siegle. https://researchbasics.education.uconn.edu/ethics-and-
informed-consent/
Update on Alzheimer’s: What Nurses Should Know. (2020).
Retrieved from https://www.rn.com/nursing-news/update-on-
alzheimers-what-nurses-should-know/
What Is Alzheimer's Disease? (2020). Retrieved from
https://www.nia.nih.gov/health/what-alzheimers-disease
Running head ALZHEIMER’S DISEASE RESEARCH FINAL1ALZHEIMER’S DI.docx

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Running head ALZHEIMER’S DISEASE RESEARCH FINAL1ALZHEIMER’S DI.docx

  • 1. Running head: ALZHEIMER’S DISEASE RESEARCH FINAL 1 ALZHEIMER’S DISEASE RESEARCH FINAL 22 Alzheimer’s Disease Research Final Dalia Catalan Florida National University Alzheimer’s Disease Research Final Phase one Introduction Alzheimer's disease tends to be a progressive, irreversible ailment that impacts the normal functioning of the brain slowly destroying the thinking and memory-related skills and as it progresses it limits the patient the ability to conduct simple tasks ("What Is Alzheimer's Disease?," 2020). Researchers suggest that approximately 6 million American citizens older than 65 years of age have dementia which is caused by Alzheimer's disease. In most patients, the symptoms of this condition begin to be identified when they are in their mid- the 60s. This condition is often ranked as one of the top ten causes of death in the United States, but following a recent investigation, the condition has climbed the ladder and it is currently ranked as the top five leading cause of death in the United States. Often the disease is categorized with cancer and
  • 2. heart disease as the main cause of death among the older population. This paper will focus on planning research that is focused on understanding Alzheimer's disease, its causes symptoms and its impact on the older population. Problem identification Alzheimer's disease tends to be the most common cause of dementia among the older population around the world. The condition impacts the normal functioning of the brain hence causing the loss of cognitive functioning such as reasoning, remembering and thinking. Also, it impacts behavioral abilities to the extent of the victim not being able to conduct various daily essential activities ("What Is Alzheimer's Disease?," 2020). The severity of the brain damage from the mildest stage where the normal function of a person is impact and it progresses to a most severe stage and the victim must be dependent on the people around him or her for basic activities related to daily living. The condition is most popular among the older population and its estimated that the condition has impacted about 6 million senior American citizens' normal function and also it is a leading cause of death among this population ("Alzheimer's Disease Fact Sheet," 2020). Significance of the Problem to Nursing With a significant population estimated to be victims of Alzheimer's disease in the United States, it is most likely that individuals in the nursing practice will encounter patients suffering from this condition either in their personal lives on in their careers. Thus, it is essential for the nurses to be able to understand and recognize the Alzheimer's Disease symptoms, treatment approaches, and options as well as learn how to effectively interact with this vulnerable population ("Update on Alzheimer’s: What Nurses Should Know," 2020). To be able to provide quality health care services the nurse practitioner needs to understand the various vital components that support better working conditions with the patient. The nurse should emphasize clear communication and individualized care, meaning that he or she must develop clear
  • 3. instructions and communication approaches that are adaptive to the patient's needs. Also, it essential for the nurse to understand the emotion behind the patient’s behavior or communication. Additionally, behavioral activities that are related to Alzheimer's Disease may also jeopardize the safety of the patient thus the nurse practitioner needs to develop strategies that ensure the safety of the patient is not at risk. Moreover, the nurse practitioners need to understand that the patient’s behavioral activities are not personal ("Update on Alzheimer’s: What Nurses Should Know," 2020). Thus, they need to develop various strategies of working with Alzheimer's Disease patients such as written reminders, engaging the patient in activities, distraction, redirection and providing the patient with the needed assistance. In addition, it is the duty of the nurse to ensure that the patient’s family is provided with the required support because it tends to be an emotional experience that may turn to be a crisis if it is not addressed appropriately. Also, essential for the nurse to be mindful of the progression of the condition while caring for the patient and his or her family as well as learn to work holistically. Through the provision of quality care and informed understanding of the condition may generate a positive relationship with the patients and their families hence positively improving the condition. Purpose of the Research The main purpose of the research is to attain an in-depth understanding of Alzheimer's Disease, its causes, its impact on human health and the essential care required to effectively improve the condition. For instance, being a progressive and irreversible ailment, the research will provide the required information regarding how the condition advances from mild memory-related issues to severe brain damage. Also, a better understanding of why the progression of the condition varies with every patient will be attained through the research. Often the condition may progress for about 20years and the victim patient may live an average of about ten years after being diagnosed with the condition. Additionally, the research will aid
  • 4. with information on the various treatment approaches or maintenance strategies for the condition ("Alzheimer's Disease Fact Sheet," 2020).Also, the research will improve the understanding of why no specific factor causes the condition but the condition is often linked to age advancement, family history, and a particular protein known as apolipoprotein. Other related considerations to the ailment are education, environment, diet, as well as viral influences. Research Questions 1. Why is Alzheimer Disease ranked among the highest cause of death among the older population? 2. What are the various approaches are used by the nurse practitioner to ensure the condition does not get severe and out of hand? Master’s Essentials Alzheimer's Disease is a leading cause of dementia and death among the older population. Also, there is no specific cause of the ailment as well as the condition has no cure. Additionally, the diagnosis of the condition may only be attained through an examination of the brain tissue during an autopsy. Additionally, the probable diagnosis may be attained through a medical history, neuropsychological and medical testing, and brain scans. However, the continuum of Alzheimer's Disease may include mild symptoms, moderate symptoms and severe symptoms ("Alzheimer's Disease Fact Sheet," 2020). A patient with mild symptoms tends to demonstrate memory loss, inability to learn new things, tends to be unorganized, limited attention span. On the other hand, a patient who is in his or her moderate stage he or she tends to display noticeable behavioral changes, inability to identify other people, getting lost in a familiar environment, has poor judgment, and experiences sleep disruptions. Lastly, when a patient is in the severe stage he or she tends to experience the inability to recognize him or herself as well as other people, he or she has an incoherent speech, has repetitive behavior, weight loss and incontinence as well as difficulty swallowing. Nurses need to develop various effective
  • 5. care strategies to ensure that the patient’s AD condition does not progress into a more severe stage. Phase Two Brief Literature Review Following the intense impact of this condition among the older population several pieces of research have been conducted to enable the health care providers to attain more knowledge to develop various strategies to reduce the impact among the affected population and also to be able to reduce its mortality rate. According to Pal, Siotto, Prasad, and Squitti (2015), they asserted that as the life expectancy in the industrialized countries continues to increase, brain-related issues and cognitive related issues continue to increase hence becoming a significant issue in human health. Additionally, cognitive decline tends to occur while one ages tend to have negative impacts on the patient’s quality of life because it mainly disrupts the patient’s memory as well as learning abilities (Pal, Siotto, Prasad, & Squitti, 2015). In their research where they focused ion understanding how copper intake may influence the occurrence of the Alzheimer’s Disease, they were able to understand that copper mainly acted as a causative aspect in the Amyloid-β peptide (Aβ) hence showing significant relation between copper and Alzheimer’s Disease in regards to cognitive performances. Additionally based on the findings from their research it was identified that modification in the drinking water or dietary supplements, and diets in the various subjects with ascertaining copper dysfunctions may be a less costly approach to delay or prevent of Alzheimer’s Disease onset (Pal, Siotto, Prasad, & Squitti, 2015) According to Bagad, Chowdhury, & Khan, (2013) they asserted that Alzheimer’s Disease (AD) is a popular neurodegenerative condition which is known for causing dementia among the elderly population. Additionally, various pieces of evidence provide suggestions that Amyloid-β peptide (Aβ) contributes significantly in the Alzheimer’s Disease
  • 6. pathogenesis, but still, the underlying mechanisms continue to be uncertain (Bagad, Chowdhury, & Khan, 2013). However, the authors argued that sufficient knowledge has been attained within the past several years in regards to Alzheimer’s disease; diagnosis, care pattern, epidemiology as well as the economic impacts. Being a common ailment among the older population the research conducted towards understanding the health condition has enabled the health care providers to appropriately establish effective trial designs as well as outcomes for different stages of the condition (Bagad, Chowdhury, & Khan, 2013). Thus, to be able to continue improving the understanding of this condition the disease's treatment guidance needs to updated constantly to take into account new evidence to be able to effectively benefit the health care providers as well as the patients. However, as the aging population continues to increase, new medication to manage AD and the various reforms occurring within the health care system will need the integration of the newly attained understanding to be able to effectively understand the various needs of patients suffering from AD as well as their families (Bagad, Chowdhury, & Khan, 2013). Also, De Paula, J. (2012) argues that the intracerebral amyloidosis begins to develop in the AD patient in an approach that is dependent on age, but the recent evidence shows that in some patients the AD signs and symptoms of the disease may be noticed as early as between thirty and forty years of age, but the condition continues to increase as one approach old age (De Paula, 2012). The author also asserts that Alzheimer's Disease may be clinically defined based on three different phases: 1. The pre-symptomatic Alzheimer’s Disease- this is an AD phase which tends to last for and extended period of time before Amyloid-β peptide (Aβ) within the brain begins to overproduce as well as accumulate reaching a sensitive level of triggering the amyloid cascade (De Paula, 2012). 2. The Pre-dementia phase- this is an AD phase that the early pathology is present. Often it ranges from mild neuronal dystrophy to early-stages Braak pathology, additionally the AD phase may last for several
  • 7. years based on the patient’s resilience as well as the brain reserve. 3. Clinically defined dementia phase of AD defines the AD in regards to the severity of the functional and cognitive impairment (De Paula, 2012). This phase comprises of an excessive neuritic plaques accumulation as well as neurofibrillary tangles the impacted brain segments that bear an association with the global impairment magnitude. However, advanced technologies that focuses on the functional and structural neuroimaging, as well as cerebrospinal fluid biochemical analysis may demonstrate a correlation of intracerebral amyloidosis among the population suffering from mild, pre-dementia symptoms (De Paula, 2012). Also, Bhushan, Kour, Kour, Gupta, Sharma, & Yadav(2018) assert that Alzheimer's is the leading influencer of memory loss among the elderly population all over the globe. Research shows that the neurodegenerative condition impacts approximately 10% of the individuals above the age of 65 and about 50% of the people above 85 years of age. In the United States, there are about 4 million people suffering from AD and their annual cost of treatment stands at approximately $100billion (Bhushan et al., 2018). This makes it be listed among the leading causes of death in the United States hence becoming more prevalent in several other countries. Generally, Alzheimer's causes the brain size to shrink, leading to the brain cells having progressively fewer nerve cells and limited connection. Thus, to be able to improve the treatment and prevention research, there is a need to consider measures for present interventions (Bhushan et al., 2018). This may aid in improving providing a better understanding of providing support for the individuals suffering from Alzheimer’s Disease as well as raise public awareness regarding the mental condition. Currently, disease-modifying drugs related to Alzheimer’s Disease have not been developed, but several options may reduce the symptoms of the condition as well as aid in the improvement of quality of life. According to Hane, Lee, & Leonenko (2017), the
  • 8. research towards understanding Alzheimer’s Disease has significantly grown over the years, especially following the separation and recognition of the amyloid-β attained from post- mortem study of the brain acquired from the Alzheimer’s Disease. In addition, the authors asserted that the various advances have significantly improved the understanding of the condition and reinforced its complexity (Hane, Lee, & Leonenko, 2017). However, following the multifactorial and complexity nature of the Alzheimer’s Disease has contributed to some of the health care researchers to develop a hypothesis that the condition is not an ailment in technical sense, rather it is a form of syndrome, gathering of pathologies which tend to manifest themselves as common symptoms mainly being associated to age, memory loss as well as personality changes. Despite the hypothesis being true or false, the health care providers precisely understands the complexity associated with Alzheimer’s Disease and its pathophysiology may not be described individually through the abnormal metabolism of Amyloid-β peptide (Aβ) (Hane, Lee, & Leonenko, 2017). Methodology and Design of the Study The study will utilize the action research design to be in a position to effectively attain a better understanding of Alzheimer’s Disease by effectively answering the research questions developed by the researcher which are: 1. Why is Alzheimer Disease ranked among the highest cause of death among the older population? and 2. What are the various approaches are used by the nurse practitioner to ensure the condition does not get severe and out of hand? The research design will analyze the information attain from the secondary sources and literature review hence developing a better and improved understanding of Alzheimer’s Disease complexity. Sampling Methodology The information for the research will be attained from a secondary source and to ensure that the information acquired relevant a simple sampling methodology will be employed to enable the efficient retrieval of information. The secondary
  • 9. sources to be utilized in the research will not be older than seven years to ensure that the information acquired from the sources is not outdated. Additionally, the information will be attained from valid scholarly sites to ensure that the information being used in the research has been validated by health care organizations. Necessary Tools The major objective of the study is to achieve a precise understanding of the Alzheimer’s Disease, the causes of the condition, the impact it has on human quality of life and the necessary care required to be able to reduce the symptoms of the condition. For instance, the condition being an irreversible- progressive condition, the study will offer essential information on how the ailment progresses from mild memory loss to severe damage of the brain. Additionally, a better understanding on to why the advancement of the condition differs from patient to another. Thus, the information being used in the research will be attained from online sources, hence the main tool that will be used in the research to collect data would be the internet. Phase Three: Implementation Research Background Alzheimer's disease is a common brain condition that is linked to tends dementia amongst the elderly population. This health condition tends to affect the brain’s normal functioning and in turn causing the victim to lose his or her cognitive ability such as thinking remembering as well as reasoning. In addition, the also affects the behavioural ability of an individual to a point where the patient is often not able to successfully perform different essential daily life activities (Bagad, Chowdhury, & Khan, 2013). Furthermore, the brain damage severity tends to progress from mild stage where the normal functioning of the victim is impacted to the severity stage where the victim is required to depend on other people for him or her to conduct his or her daily activities. The condition tends to be quite common in individuals beyond the age of 65 as well it is estimated to have impacted an
  • 10. approximate population of 6 million senior citizen in the United States. The health condition is regarded to be the major cause of death among people in this age bracket. The aim of this research study is to acquire and in-depth knowledge of the brain condition, it main causes, the appropriate care required to improve the condition as well as the impacts the condition has on the human health. For example, through the research one will be in a position to understand the progressive and the irreversible status of the disease from the mild memory related to severe brain damage Additionally a better understanding of the progression status varying from one patient to another will be attained (Bagad, Chowdhury, & Khan, 2013). Often this health condition tends to gradually progress over a period of approximately 20years and the patient may live an approximate of ten years after the diagnosis o the health condition has been determined. Also, the research study will assist with provision of the different medication strategies for this ailment. The study will also enhance a better understanding Also of the reason as to why there have not been identified a specific cause of the ailment but it is majorly related to family history, advancement in age as well as excess of specific protein called apoliprotein. Other related factors linked to this health condition are environment, diet, viral influences as well as education. Implementation plan A table will be developed with the aim of outlining all the essential tasks that need to be completed in the research’s project proposal timeline. The table will comprise of a significant date for attaining research responses from the subjects, application of ethical approval and interviewing the participants. In a situation where the research needs are reduced the researcher will be pushed to limit the number of interviews being conducted but still be in a position to achieve the required information. However, since the survey time will be recorded, it is essential to reduce the transcription time. Additionally, it will be needed to limit the research assistants’ employment. Interviewing process is a critical segment of the study that may
  • 11. need a research-assistants, to aid in acquiring notes which enable the researcher to be in a position to develop a valid and effective research report. If the study recruits few participants there will be no needs to employ a research assistant, however there will be additional components in the time chart that will not be altered. Protocol Review and Approval Application The research approval on ethics as well as protocol review will utilize two basic approaches. The first approach that will be implemented, will be the submission of the research proposal for an approval by an appropriate board, this is important because the research study is majorly focusing on the human subjects ("IRB Review and Approval Process," 2018). The proposal submission will ensure that the interaction with the research subjects will offer access to their personal information to accomplish the study process. The research project will also focus on recruiting individuals with Alzheimer’s disease in order to be in a position to understand its impact on the patient and how it contributes to dementia. Generally, any research study that tends to involve human subjects needs to be approved as well as a protocol needs to be submitted for a critical review. If the protocol review conducted by the board determines the research study to have minimal or zero risk to the human participants then the research project will be eliminated from the reviewing process ("IRB Review and Approval Process," 2018). Often it is mandatory that the research studies that tend to involve human as subjects are required to collect information prior to being approved. However, in case there are any alterations following the data gathering process, then modification will be needed to be submitted for a review as well as approval. Information letter and Informed Consent Forms to the participants During the implementation planning process in the research study the researcher will be required to make sure that every participant information material need to include a
  • 12. statement of consent as well as an information letter. These two documents need to have an appropriate letter head and in addition the ethics committee will be needed to ascertain what the study will involve. Also, the agreement form needs to be in alignment with the protocol. Additionally, it is essential to make sure that the study title clearly printed on every page of the agreement form (Siegle, 2015). Also, the background segment of the form will offer a clear as well as detailed outline regarding the subjects that will be asked to take part in the research study and any benefits that may be anticipated in the research. Also, the main purpose of the research study will be briefly outlined in the form to show kind of information that the researchers will be looking for from the research subjects. Another important component that will be included in the consent form will be the techniques or the various procedures that the research will utilize as well as the duration of time that will be allocated to the study (Siegle, 2015). More essentially, the information letter as well as the consent from will portray the various benefits of the research study to the society or any other form of monetary compensation provided to the subjects in the research study. Project timeline Table 1: Project Timeline 1. Protocol review and ethics approval application for the study 2 weeks 1. Compliance procedures with the essential standards 1 week 1. Information letter to participants 5 days 1. Consent form to participants 2 days 1. Confidentiality agreement for the research personnel 3 days 1. Conducting the study 6 weeks 1. Compiling the data
  • 13. 1 week 1. Writing the final report 1 week 1. Presentation 1day Project Budget Table 2: Project Budget Research assistants 1. Making posters 1. Taking notes during interviews 1. Literature review Assistance $ 100.00 $ 150.00 $ 250.00 Travel $ 200.00 Accommodation $ 550.00 Food $ 520.00 Total $1770.00 Commitment The researchers of the project will concentrate on the data collection process in the basis of information that will be documented during the data gathering process. Additionally, the researchers will observe highly confidential levels during the research process. Patients with Alzheimer’s disease and are undergoing the maintenance as well as treatment process will be the main target of the research study. After making sure that all the needed resources are present, the human subjects or the participants will be invited to take part in the research study. The research study will focus on utilization of the action research design to attain a better understanding of
  • 14. the Alzheimer’s disease through answering the research questions. To make sure that a successful research has been attained the researchers will be required to adhere to the study’s implementation plan. Also, the research study will be beneficial to the health care sector because it will be able to add some knowledge on the Alzheimer’s disease hence enabling the health care providers to be in a position to develop more appropriate approaches of treating and caring for Alzheimer’s disease patients. Phase Four: Results Alzheimer’s Disease has been a common cause of dementia among the elderly population in society. The illness tends to affect the brain’s normal functioning which in turn causes the elimination of cognitive functioning such as thinking, remembering as well as reasoning. Additionally, the condition also tends to affect the victims' behavioral abilities to a point where the patient is not in a position to engage in his or her daily life activities by himself or herself. Previous researches have provided evidence that the severity of this condition on the brain begins from a mild stage where the normal functioning of the victim is impacted and gradually progresses to a severe stage where the victim depends on the people around him or her to complete their basic daily activities ("What Is Alzheimer's Disease?," 2020). The illness tends to be quite popular among the elder population and currently, it is estimated to have affected about 6 million senior citizens’ normal function as well as its common cause of death among this population. Purpose of the Research The main aim of this research was to achieve a critical understanding of Alzheimer’s Disease, its main causes, the impacts it has on human health as well as the important care required to be able to improve this condition on the patient. The research will provide an understanding of why the condition is regarded to be progressive as well as irreversible disease and how it advances from mild memory damage to severe memory
  • 15. damage. Another essential aspect that the research contributed is understanding why the progression of the condition tends to vary from one patient to another. Often the condition may progress for about 20years and the victim patient may live an average of about ten years after being diagnosed with the condition ("Alzheimer's Disease Fact Sheet," 2020). Additionally, the research will aid with information on the various treatment approaches or maintenance strategies for the condition. Also, the research will improve the understanding of why no specific factor causes the condition but the condition is often linked to age advancement, family history, and a particular protein known as apolipoprotein. Other related considerations to the ailment are education, environment, diet, as well as viral influences. Research Questions 1. Why is Alzheimer's Disease ranked among the highest cause of death among the older population? 2. What are the various approaches are used by the nurse practitioner to ensure the condition does not get severe and out of hand? Research Results The research study conducted comprised of 150 randomly picked participants of ages between 65 and above who were drawn from the local health care facility. All the participants picked for the study were all diagnosed with Alzheimer’s disease as well as they indicated different symptoms due to their different stages of the disease. About 90 of the participants suffered from mild brain damage thus, they were able to conduct various life-related activities on their own. While the remaining 40 participants suffered from severe brain damage and this limited them from being able to conduct essential life activities on their own, thus they require a nurse or a family member to present to assist them to complete these essential activities. The patient with mild- brain damage often came in the health facility for treatment and then they would go back home, while the patients with severe- brain damage were
  • 16. hospitalized. Additionally, the research focused on studying the patients’ features as well as the demographic variables such as education level, marital status, age, exercise as well the form of treatment the patient received during their hospitalization period. Additionally, based on the patients’ characteristics as well as demographics, a statistical similarity was developed (P>0.05). Also, there was no significant difference between the two groups (test and control group). The Standard deviation, as well as the mean score in regards to the test group’s age bracket, was (75.53 ± 4.1). On the other hand, the standard deviation, as well as the mean score of the control group’s age bracket, stood at (67.76 ± 3.2). Through the utilization of the t-test, it was determined that both groups under research portrayed several similarities in their mean age (P = 0.69) (Hess & Hess, 2017). The occupational variable presented the highest frequency of 3.1% as almost all the participants were retired. On the other hand, the variable representing the marital status presented a frequency of 9.3%. The frequency indicated that most of the participants (75%) ( test and control group) were literate. Additionally, it was identified that all the participants suffered from Alzheimer’s disease and they all had one time in their life used oral medication to improve their memory ability. Most of the participants (90%) asserted that they did not understand the main cause of the disease, while about 20% of the participants asserted it was aged related. All the participants asserted that they had received information regarding the condition of their health care providers. The t-test, Chi-square, as well as the Fisher’s Exact test, was used to attain the values from both groups (Test and Control groups) (Hess & Hess, 2017). The findings indicated no significant statistical difference between the two research groups as portrayed in the table below. Variable Results Control Group
  • 17. Frequency Percentage Test Group Frequency Percentage Test type Marital Status Single Married Divorced 10 10 35 70 18 20 20 40 69 60 0 0 Exact Fisher’s Test P>0.05 Education Level Illiterate Literate 15 30 30 70 20 40 78 60 Exact Fisher’s Test P>0.65 Exercise Infrequent Frequent 36 75
  • 18. 23 25 64 55 32 45 Pierson P > 0.5 Type of Treatment Oral Medication Therapy 65 90 12 10 70 95 8 5 Pierson P > 0.5 Source of information Nurse Practitioners Physicians 12 30 34 70 7 15 56 85 Exact Fisher’s Test P>0.05 Table 1. Information based on personal and test groups The standard deviation, as well as the average score of the test group regarding the awareness of the condition prior to the intervention, stood at (46.43 ± 5.1), but the score gradually improved to (55.74 ± 4.57) after the 6 weeks of intervention via the educational program. Prior to the intervention, the standard deviation, as well as the mean score which was related to the
  • 19. participants' attitude towards the condition, stood at (18.25 ± 4.78), the score of the test group was at (30.21 ± 12) but following the educational intervention, the score shifted to (25.74 ± 4.6) however, prior to the educational intervention, the tendency of self-care among the test group stood at (30.21 ± 12), but following the intervention the score improved to (46.28 ± 16). On the other hand, the t-test findings indicated a significant statistical difference between the values (P < 0001), before and after the educational intervention. As per the results attained from the research the standard deviations as well as the mean scores of awareness, attitude as well as self-care at the beginning of the research stood at (18.73 ± 3.5, 29.5 ± 6.1, and 53.65 ± 5.2) but following the educational training on the family members of the patients within the control group the scores moved to (18.71 ± 3.7, 29.75 ± 6.5, and 53.75 ± 5.35). In addition, the t-test results of the control group indicated that there was no significant statistical difference among the values (Hess & Hess, 2017). The table below provides a tabulation of the standard deviation and mean score of awareness, self-care as well as attitude of the Alzheimer’s condition in both groups. Study Group Variables Mean (±SD) P Before After Difference Self- Care Control Intervention 29.5 ± 6.1
  • 20. 30.21 ± 12 29.75 ± 6.5 46.28 ± 16 0.25 ± 0.4 16.07 ± 4 P < 0.863 P < 0.001 Attitude Control Intervention 18.73 ± 3.5 18.25 ± 4.78 18.71±3.7 25.74± 4.6 0.02 ± 0.2 7.49 ± 0.18 P < 0.842 P < 0.001 Awareness Control Intervention
  • 21. 53.65 ± 5.2 46.43 ± 5.1 53.75 ± 5.35 55.74 ± 4.57 0.10 ± 0.15 9.31 ± 0.53 P < 0.863 P < 0.001 Table 2. Tabulation of the standard deviation and mean score of awareness, self-care as well as attitude of the Alzheimer’s condition in both groups Limitations of the study The research project had its upside and downside. The upside of the research was that it provided an understanding that education interventions regarding the Alzheimer's condition may aid patients to be able to contain the condition at the mild stage limiting it to progress to the severe stage through engaging in activities that promote brain functionality. However, the research project had its limitations on the downside which were, one the research project was conducted on a single health care facility, hence promoting a highly controlled setting, which leads to the findings not appropriate to be utilized in other populations suffering from the condition. Additionally, another limitation of the project study was that the participants' population of 150 individuals was not sufficient to allow the generalization of the findings. However, the research project sets a platform for conducting future research studies on Alzheimer’s Disease. The future study may focus on understanding why the condition impacts the senior citizen more than young people.
  • 22. Conclusion This condition is often ranked as one of the top ten causes of death in the United States, but following a recent investigation, the condition has climbed the ladder and it is currently ranked as the top five leading cause of death in the United States. Often the disease is categorized with cancer and heart disease as the main cause of death among the older population. The findings from the research have indicated that the progressive status of the condition may be controlled ensuring the patient condition does get severe. Additionally, the research provided information on the various treatment approaches or maintenance strategies for the condition. Also, the research it has contributed in improving the understanding of why no specific factor causes the condition but the condition is often linked to age advancement, family history, and a particular protein known as apolipoprotein. Learning Experience The learning experience attained from conducting the research was quite positive as it provided me with more knowledge regarding the conditions. I was able to attain an in- depth understanding of how the condition tends to progress from a mild brain damage stage to a more severe brain damage. Also I was able to understand that the progressive state of the condition may controlled through engaging several activities involving the brain to ensure it’s active. Also after conducting the research it opened new opportunities that would enable me to effectively further my research on the health condition to be able to acquire more knowledge and its impact on the society. References Alzheimer's Disease Fact Sheet. (2020). Retrieved from https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet Bagad,, M., Chowdhury, D., & Khan, Z. A. (2013). Towards understanding Alzheimer's Disease: An Overview. Research Journal of Pharmaceutical, Biological and Chemical Sciences, 4(4), 286-298. Retrieved from
  • 23. https://www.researchgate.net/publication/273768877_Towards_ understanding_Alzheimer's_Disease_An_Overview Bhushan, I., Kour, M., Kour, G., Gupta, S., Sharma, S., & Yadav. (2018). Alzheimer’s disease: Causes & treatment – A review. Annals of Biotechnology, 1(1). Retrieved from https://meddocsonline.org/annals-of-biotechnology/alzheimers- disease-causes-and-treatment-a-review.pdf De Paula, J. (2012). Alzheimer's disease. Sub-cellular biochemistry, 65(352). doi:10.1007/978-94-007-5416-4_14 Hane, F. T., Lee, B. Y., & Leonenko, Z. (2017). Recent Progress in Alzheimer’s Disease Research, Part 1: Pathology. Journal of Alzheimer's Disease, 57(1), 1-28. doi:10.3233/jad-160882 Hess, A. S., & Hess, J. R. (2017). Understanding tests of the association of categorical variables: the Pearson chi-square test and Fisher's exact test. Transfusion, 57(4), 877- 879. https://doi.org/10.1111/trf.14057 IRB Review and Approval Process. (2018, December 20). Office of Research at UC Santa Cruz. https://officeofresearch.ucsc.edu/compliance/services/irb3 5_about_decisions.html Pal, A., Siotto, M., Prasad, R., & Squitti, R. (2015). Towards a Unified Vision of Copper Involvement in Alzheimer's Disease: A Review Connecting Basic, Experimental, and Clinical Research. Journal of Alzheimer's Disease, 44(2), 343-354. doi:10.3233/jad-141194 Siegle, D. (2015, February 28). Research Ethics and Informed Consent. Educational Research Basics by Del Siegle. https://researchbasics.education.uconn.edu/ethics-and- informed-consent/ Update on Alzheimer’s: What Nurses Should Know. (2020). Retrieved from https://www.rn.com/nursing-news/update-on- alzheimers-what-nurses-should-know/ What Is Alzheimer's Disease? (2020). Retrieved from https://www.nia.nih.gov/health/what-alzheimers-disease