NU4025 Introduction to Postgraduate Research Assignment Sample
Introduction
In addition to adding to the existing body of research on cross-cultural differences in the development of Alzheimer’s disease, the findings of this exploratory investigation will add to the body of knowledge on Alzheimer’s disease. According to the researchers, many of the attitudes voiced and patterns of knowledge shown are akin to those found in previous studies of Latino perspectives on Alzheimer’s disease and other dementias. Individuals from Mexico and Puerto Rico had more in common than they did in terms of their knowledge and views about Alzheimer’s disease, as well as their attitudes toward care, according to the study. As a result of these results, it is possible that underlying implicit cultural norms may be more important than inter-ethnic differences among Latinos in specific situations (Worker,2020).
The importance of avoiding overlooking essential geographical qualities that may have an influence on acculturation processes in the process of migration cannot be overstated. Populations residing in rural areas and those living in urban areas in densely populated Latino regions, for example, may have significant differences in cultural values; all of these features are crucial factors in the negotiation of cultural values among diverse groups. For a better understanding of possible interethnic differences and similarities in and across varied geographical regions, more inquiry is necessary.
Critique
Alzheimer’s disease (AD) is a degenerative neurological ailment that mostly affects the elderly and is often diagnosed in the latter stages of life. It is the most common cause of memory loss in the elderly. Qiu and colleagues (Qiu and colleagues) (2009). The great majority of cases of this ailment are caused by the gradual degeneration of neurons, which is the underlying cause of the disorder. Alzheimer’s disease (AD) is a neurologic ailment in which the brain shrinks as a consequence of a hereditary susceptibility, a process known as atrophy. As the brain deteriorates, it eventually results in the death of brain cells, which eventually results in the development of dementia (Jack et al., 2018). An individual with Alzheimer’s disease has a gradual loss of social, cognitive, behavioural, and thinking abilities over time, which has a negative impact on their capacity to operate independently in their everyday life, according to Davis et al. (2018). Another set of indications and symptoms that may occur include myoclonus, irregular gait, and stiffness, amongst others (Bature et al., 2017). The use of symptomatic treatment, on the other hand, may result in a temporary improvement of the condition as well as the prolongation or postponement of the degenerative process in some instances. Alzheimer’s disease is now considered incurable; nonetheless, there is presently no treatment available to alleviate its symptoms. Memory loss and confusion are the most prevalent indications of dementia, and they are also the most common symptoms of dementia, according to the Alzheimer’s Disease Association. Besides trouble concentrating, additional signs and symptoms may include difficulty processing visual pictures and noises, hearing difficulties, an inability to create spatial connections, and difficulties with writing and speaking. MacGill and his associates (2020). According to the Centers for Disease Control and Prevention (CDCP), Alzheimer’s disease (AD) is most likely to affect those over the age of 65, with the African American community being particularly vulnerable due to the high prevalence of 13.8 percent among African Americans in the United States.
Hispanics are the second most common group of persons to be diagnosed with Alzheimer’s disease, behind only white non-Hispanics, American Indians, Native Alaskans, Asians, and people from the Pacific Islands, who are the most numerous group of people diagnosed. According to the statistics, the prevalence rates for these categories vary depending on the population: 12.2 percent, 10.3 percent, 9.1 percent, and 8.4 percent, respectively, for men and women (Banks,2019).
Despite the fact that Alzheimer’s disease is one of the most frequent illnesses connected with old age, many individuals are still uninformed of the disease’s presence and the symptoms that it manifests in their lives. A large proportion of the general population, as well as people who suffer from Alzheimer’s disease, are commonly shunned and reviled by their families, communities, and the medical profession. It is becoming more difficult for them to engage in both major and little choices as a result of their diminishing capacity to think, concentrate, and make judgments. When elderly individuals are faced with terrible circumstances in their lives, it is this circumstance that is accountable for altering their behaviour. As a consequence of this ailment, they experience sad feelings. It was done on the 15th of November in the year 2021, on the 15th of November, to look for relevant stuff to post on the website. The search for studies for the current inquiry was carried out using the database MEDLINE WITH FULL, which can be accessible at www.medlineplus.com. The results of the search were presented in a table. “Alzheimer’s disease AND knowledge,” “Alzheimer’s disease AND attitude,” “Alzheimer’s disease AND attitude AND practises in Alzheimer’s disease,” “prevalence and incidence of Alzheimer’s disease,” and “Alzheimer’s disease AND healthy ageing” are some of the keywords that were utilised in the research. “Prevalence and incidence of Alzheimer’s disease” were two more keywords to look for. It was possible to access full-text articles from journals that were published after 2005; however, publications from journals that were published before 2005 were subject to restrictions. There were a total of 7016 items found at the start of the search, which was later cut down to 98 articles after duplicates were removed from the database. Participants in the study had to be at least 60 years old in order to be eligible to take part in the research. Two articles were selected for this critical assessment since they were both written in English and so qualified for inclusion. Additionally, Appendix 1 provides more in-depth information on the search for and selection of publications. This appendix also includes a PRISMA diagram, among other things (Oschwald,2020).
The two papers included in this collection were chosen for inclusion because they were the most relevant to the issue under consideration and the intended research approach at the time of selection. Each of the factors considered for the critical review were relevant to the issue under consideration: the method taken by the researchers, the population they chose, and the technique they used. When doing one sort of research, the qualitative method is utilised, and when conducting another type of study, the quantitative approach is used, and so on. It is through reading this book that one will gain a more complete understanding of the progression and development of Alzheimer’s disease, as well as the various ways in which people respond to the disease, adapt to it, acquire information about it, and alter their living practises in order to achieve better health outcomes.
According to the World Alzheimer Report 2016, dementia affects 47 million people worldwide, with an additional 9.9 million cases projected each year. In the United States, the prevalence of dementia is increasing. By 2040, it is expected that the proportion of dementia patients living in developing nations would increase from 60 percent in 2001 to 71 percent. Latin America is expected to have 4.1 million dementia patients by 2020, while North America is expected to have 9.1 million by 2040, according to current forecasts. In adults under the age of 60, dementia (11.2 percent) causes greater memory loss than cerebrovascular sickness (9.5 percent), musculoskeletal disorders (8.9 percent), cardiovascular diseases (5.0 percent), or cancer (5.0 percent) (5.0 percent). 2.4% of the population. It is anticipated that the yearly cost of caring for persons with dementia will reach $818 billion in the globe; the United States, Canada, and Europe will account for 70% of these expenses, respectively. Because of the immense financial burden dementia exerts on health-care systems across the globe, as well as the growing number of elderly people, major reforms will be required in the near future. Given that the number of persons suffering from dementia doubles every 20 years, it’s reasonable to expect that healthcare expenditures would rise in tandem.
Dementia, on the other hand, exacts an enormous toll on the lives of people who are affected by it.
Cuba is the “oldest” nation in Latin America, with about one-fifth of its population over the age of 60, according to the 2015 census. By 2020, when an anticipated 400,000 individuals will be 80 or older, this percentage will have increased to 25 percent of the population.
Scientists want to learn more about the elements that contribute to increased life expectancy via long-term studies on people, such as genetic predispositions, exposure to the environment, and psychological qualities such as trust and susceptibility, through long-term studies on individuals. In order to avoid old age, dependency, and death, researchers are increasingly delving into frailty.
It has already been finished the first and second stages of a long-term research on 2944 elderly Cubans, titled Aging and Alzheimer’s, which is now underway.
It began in 2003 with the goal of determining the prevalence and incidence of dementia, particularly Alzheimer’s disease, as well as other chronic noncommunicable diseases common in this age group (cerebrovascular disease, diabetes, hypertension), as well as identifying dementia risk factors and their links to these conditions, and conducting an in-depth analysis of these conditions’ genetic markers and the consequences for care and diversion. The study was funded by the National Institutes of Health. As a result of the second and third stages of a community intervention approach, it has already been determined which dementia patterns exist and how they affect the community.
The Aging and Alzheimer’s Longitudinal Project, which began in 2003 and has been ongoing since then, is the focus of this page’s debate. Researchers revealed a high incidence of dementia in Cuba, as well as its risk factors and the repercussions of dementia for caregivers and those in need of care, as a result of the study. A community intervention plan may be devised and executed in response to the lessons learned from these experiences.
Measurements like this were employed less often than other types of procedures. This is most likely owing to the more time-consuming and expensive technique, as well as the equipment that must be used. According to the literature, biomarkers may have been investigated using a variety of assays in a variety of studies, which might explain why their findings were inconsistent. A great deal has been done to investigate the diagnostic abilities of CSF A and tau. The CSF T-tau gene family includes many variants, including p-tau , A42 , NFL , and plasma T-tau. The timing and sequencing of anomalies in these factors, on the other hand, should be the focus of future research in order to enhance prognosis. It is necessary to have a complete grasp of how things change through time in order to fully appreciate measurement variance (i.e., age and time dynamics). Over a 30-day period, it has been demonstrated that A1–42, T–, and P–tau levels in the CSF remain stable , but further research over longer periods is required. Generally, we identified just a few studies that assessed biomarkers more than twice, and we discovered that testing biomarkers twice was the most often used strategy.
According to others, it is probable that intrusive CSF sample collection or prohibitively expensive tests were utilised as a cause of the problem. If more exact measurements are taken earlier and more often, it is possible to get a better understanding of the pathophysiology of Alzheimer’s disease (AD).
It is likely that this information will be utilised to impact the design of research trials investigating prospective treatments for Alzheimer’s disease. Patient compliance may be difficult to achieve because of the intrusive nature of the sample collection technique.
The fact that this study’s focus was so restricted means that it’s likely that some essential research was ignored. Through the screening of new published research, we may be able to identify papers that do not meet our inclusion criteria. Several publications were excluded from consideration for our analysis due to a lack of clarity in the published research. Because the research methodologies in numerous studies were unclear, it is possible that our results are not really reflective of the work that has been completed. Because all dementia studies was eliminated from the search, it is possible that instances of Alzheimer’s disease (AD) were overlooked. Because MRI cannot be used to provide a precise diagnosis of Alzheimer’s disease, there may be further variability in the outcomes of the study. Several studies discovered in this study may have mislabeled non-AD dementia as Alzheimer’s disease, which would be erroneous. It is possible that plasma or CSF have been used in certain research, although this has never been confirmed or denied. Even if the studies were not discovered via a search of the literature, more investigation into them is still conceivable. In research involving long-term cohorts, it is common practise to freeze samples such as plasma for future use.
There were various articles that were unclear when it came to revealing the study’s methodology, including where it was conducted and who was polled. The selection criteria and cognitive tests that were employed in the approach were not made publicly available at the time.
Researchers would benefit from detailed explanations of the methodologies that were used in each of the studies. When it comes to cohort studies, standardised reporting techniques may be advantageous.
In this paper, we offer models of cognitive decline in a well-characterized longitudinal cohort that occurs years before the clinical diagnosis of Alzheimer’s disease. It is obvious from these models that the shift from normal ageing to preclinical Alzheimer’s disease is a well-defined process. It was intriguing to see a change in visual ability three years before the clinical diagnosis was made. They have abruptly altered their behaviour in contrast to the prior longitudinal pattern, which was comparable to those who did not become deranged in their performance on speeded tests. These previously non-demented persons did not modify their behaviour over time. After a year of diminishing visuospatial skills, the overall level of cognitive talents began to rise. The components of Verbal and Working Memory showed inflection points a year before the clinical diagnosis was confirmed. In Verbal Memory, it is possible that the combination of episodic and semantic memory measurements on a single component is responsible for the delayed inflection point. Alternatively, if sufficient measurements of each kind of memory were available to determine distinct components, it is feasible that an earlier inflection point for episodic memory might be identified.
Almost immediately after the negative trend started, the pace of decline increased dramatically. Despite the fact that Working Memory was the most obvious of the four criteria, this was true for each of them. The difficulty of the tests, as well as the height or depth of the ceiling and floor effects, all influence the rate at which the patient’s condition deteriorates or accelerates. There are ceiling effects in the preinflection phase of three tests (the Boston Naming Test, a copy version of the Benton Visual Retention Test, and the WMS Mental Control) in the battery for non-dementia older people: the Boston Naming Test, the copy version of the Benton Visual Retention Test, and the WMS Mental Control. Using data from a battery that was originally designed in 1979 for research into mild dementia, we were unable to conduct our study since the battery lacked more contemporary working memory tests.
Important aspects in the long-term development of Alzheimer’s disease include the technique used to diagnose it as well as the cognitive tests used in the evaluation process. Obtaining reports of changes in function from earlier levels of function gathered by the CDR will take longer than test norms, particularly if the sample is already functioning at a high level. The inclusion of preclinical patients in non-demented samples has the potential to contribute to an overestimation of cognitive deterioration in the general population. 26 Contaminated samples as a consequence, making it more difficult to establish a regular diagnosis of dementia in clinical practise.
Summary
The study’s strengths include a replication of long-term outcomes patterns previously observed in a wider sample, which advanced in the subgroup of participants with autopsy-confirmed Alzheimer’s disease. The decrease rates in autopsied samples were much higher, but the acceleration rates in the general population were constant. The disease course of an Alzheimer’s disease (AD) patient who has had his or her autopsy verified may vary dramatically from the progression of an AD patient who has not had his or her autopsy confirmed. Another possibility is that the advanced group comprises people who do not have Alzheimer’s disease and, as a result, do not experience the same deterioration as the Alzheimer’s patients.
There are several ramifications of this research. Preclinical sickness may manifest itself as early indicators of visual-spatial and quick psychomotor abilities, and it is probable that these abilities may be revealed. Executive and attentional skills seem to be the most often impacted by preclinical loss, according to the evidence. ‘ When looking for early indicators of cognitive deficits, episodic memory tests such as word lists or paragraph recall may be ineffective since they ignore both the initial signs of sickness and the most quickly changing region of the brain. Once an inflection point has been achieved, the preclinical decline phase of the disease begins. Up until that moment, there had been no distinction between the course of Alzheimer’s disease and the progression of normal ageing. Although it is not possible to make a clinical diagnosis of Alzheimer’s disease using standard criteria, the growing body of longitudinal evidence indicates that there is a preclinical stage of Alzheimer’s disease characterised by insufficient cognitive decline that can be detected by longitudinal data from a variety of cognitive domains, not just memory.
References
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Worker, A., Dima, D., Combes, A., Crum, W.R., Streffer, J., Einstein, S., Mehta, M.A., Barker, G.J., Williams, S.C. and O’daly, O., 2018. Test–retest reliability and longitudinal analysis of automated hippocampal subregion volumes in healthy ageing and A lzheimer’s disease populations. Human brain mapping, 39(4), pp.1743-1754.
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