Introduction
Frontotemporal dementia (FTD) and Alzheimer’s disease (AD) are both neurodegenerative disorders, yet their pathophysiology differs. The occurrence of AD is associated with the infection of the brain neurons, namely, the axons that act as neurotransmitters responsible for sending messages to the brain and storing memories (Miltiadous et al., 2021). Such an adverse impact on the neurotransmitters leads to the accumulation of neurofibrillary tangles and beta-amyloid plaques. On the contrary, as stated by Miltiadous et al. (2021), FTD leads to the degeneration of the islet and anterior temporal lobe, which is accompanied by the concentration of tau proteins or TDP-43 proteins (Scheltens et al., 2021). Both FTD and AD cause irreversible brain atrophy and can be characterized as highly progressive disorders.
Patient Symptoms and AD Theory
In the given case, the patient presents with clinical symptoms such as memory loss, changes in behavior and mood, as well as difficulties with problem-solving and decision-making. The client consistently shows an inability to navigate his neighborhood, as reported by his wife and neighbors (Porsteinsson et al., 2021). The issues with balancing his checkbook and deciding to install another security system also confirm the AD diagnosis.
Moreover, the onsets of aggressiveness and attempts to defend his behavior point to neurodegenerative processes (Porsteinsson et al., 2021). The need to have assistance with dressing and meals, as well as the family history of AD, should be noted among the clinical indicators. As for diagnostics that were provided for the given patient, they include hippocampal atrophy based on magnetic resonance imaging (MRI) and moderate dementia symptoms as a result of the mini-mental state examination (MMSE).
While an amyloid cascade hypothesis served as the foundational theory of explaining the causes of AD, modern research presents new theories as well. For example, Decourt et al. (2022) propose a multipathology convergence to chronic neuronal stress theory that prioritizes neuronal stress as the key activator of amyloid beta plaques, appearing to protect the central nervous system. According to Decourt et al. (2022), there is “the generation of longer peptides that are more prone to form multimers and fibrils, which are the most toxic forms of amyloid beta” (p. 41). In other words, when the mentioned plaques become overexpressed, they generate inflammation in the brain and suppress homeostasis.
In addition, the authors insist that various chronic pathological modalities can cause neuronal stress. This implies that the development of AD should be considered in relation to a range of factors affecting neurons. The multipathology convergence to chronic neuronal stress theory is based on the examination of clinical states of human neuropathology, which are substantiated by scientific observations (Decourt et al., 2022). Thus, speaking about the practical implications of the given theory, the recommendation is to gather an entire history of the medical conditions, paying attention to co-morbidity and individual risk factors.
Conclusion
The combination of the patient’s clinical signs allows us to conclude that he has a moderate stage of AD. In particular, confusion, memory loss, wandering, and impulsive behavior are the main symptoms. Scheltens et al. (2021) claim that significant memory loss and problems with decision-making are also characteristic of the middle stage of AD. The client’s inability to complete multistep tasks, such as dressing and eating, should be noted (Scheltens et al., 2021). The results of diagnostics also signal that the given patient is likely to have a progressive cognitive impairment.
References
Decourt, B., D’Souza, G. X., Shi, J., Ritter, A., Suazo, J., & Sabbagh, M. N. (2022). The cause of Alzheimer’s disease: The theory of multipathology convergence to chronic neuronal stress. Aging and Disease, 13(1), 37-60.
Miltiadous, A., Tzimourta, K. D., Giannakeas, N., Tsipouras, M. G., Afrantou, T., Ioannidis, P., & Tzallas, A. T. (2021). Alzheimer’s disease and frontotemporal dementia: A robust classification method of EEG signals and a comparison of validation methods. Diagnostics, 11(8), 1-12.
Porsteinsson, A. P., Isaacson, R. S., Knox, S., Sabbagh, M. N., & Rubino, I. (2021). Diagnosis of early Alzheimer’s disease: Clinical practice in 2021. The Journal of Prevention of Alzheimer’s Disease, 8, 371-386.
Scheltens, P., De Strooper, B., Kivipelto, M., Holstege, H., Chételat, G., Teunissen, C. E., & van der Flier, W. M. (2021). Alzheimer’s disease. The Lancet, 397(10284), 1577-1590.
