Nadzam 1

Meghan Nadzam

ENG 101E-14

Dr. Cassel

2 November 2018

Annotated Bibliography

My topic is concerned with how the mental disease of dementia affects a wide range of

our world’s population with its multiple causes and effects. How does dementia develop over

time? What kind of tolls does it take on family members, loved ones, or care givers? How does

dementia affect the human body and mind? What is the difference between Alzheimer’s and

dementia? The number of individuals inflicted with dementia has increased over the past few

years, and today’s scientists keep searching for a cure and more diagnosis symbols to possibly

prevent the tedious struggle millions go through each day. How does dementia affect day-to-day

activities and those loved ones around us?

Ferrari, Camilla, et al. “The Diagnosis of Dementias: A Practical Tool Not to Miss Rare

Causes.” Neurological Sciences, vol. 39, no. 4, Apr. 2018, pp. 615–627. EBSCOhost,

doi:10.1007/s10072-017-3206-0. Accessed 29 October 2018.

According to Camilla Ferrari in the journal article of The diagnosis of dementias: a

practical tool not to miss rare causes from the University of Florence on December 2nd, 2017,

dementia, alongside its number-one cause, Alzheimer’s, represents a large venue of disorders

due to the tests carried out by basic blood tests and brain neuroimaging, and because of those

tests we, can identify three main subgroups causing dementia: predominant gray matter atrophy,

white matter disease, and basal ganglia pathologies.

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The experiment on predominant gray matter atrophy highlights neurodegenerative causes

of dementia and some lysosomal storage disorders. While taking diagnostic steps, researchers

can use genetic testing and MRIs to observe possible repetition of certain genes or the brain’s

frontal and temporal lobes shrinking, causing difficulties in thinking and abnormal behavior.

The analysis of white matter disease, however, triggers other diseases such as vascular

dementia, mitochondrial disease, and leukodystrophies. When MRIs are conducted, or other

diagnostic steps are taken, doctors can confirm vascular dementia with the visual signs of stroke

and microbleeds and leukodystrophy with the degeneration of spinal tissues, causing a slight

hump or arc of the back. These forms of testing can also confirm mitochondrial disease with the

decreasing amount of mitochondrial enzyme activities or the mutation of mitochondrial DNA.

According to clinical features in the article, the other main subgroup, basal ganglia

pathologies, happen because of rapid accumulation of metal pathologies like iron, copper, or

calcium. Tests contracted by the doctors of the University of Florence can correlate increased

metal pathologies with two diseases: Wilson’s disease and Fahr’s disease. Wilson’s disease is an

inherited disorder that shows too much copper to appear in the organs, causing abdominal pain

and poorly controlled movements. Fahr’s disease, also known as idiopathic basal ganglia

calcification, is a rare, genetically dominant, inherited neurological disorder that is characterized

by large deposits of calcium in areas of the brain that control movement. This is paired with the

stiffness of limbs, poor speech, and eye impairments. Wilson’s disease can be treated, but

unfortunately, neither disease has been cured or to lessen the causes of dementia.

With all the physical evidence given in the article provided by Camilla Ferrari and her

associates at the University of Florence and this day’s technology, the diagnosis of dementia has

slowly started to take shape and the task of identifying disorders to cure dementia suggests a
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wide variety of causes, diagnosis possibilities, and investigation procedures. Ferrari’s assessment

on the worldly issue generates a broad horizon for the field of neurological science, possibly

laying groundwork for future scientists to build onto in order to continue the analysis of

dementia.

This academic journal entry is a valuable resource for my research paper because it gives

clear, dignified facts that provide structure to my fat questions. The site also displays charts and

tables with side-effects of each major cause of dementia and what symptoms go along with each

cause. This article seems to give actual research results and will back up any “skinny” questions

that revolve around my fat questions. Its main aim is to share research findings with the

scientific, neurological world and benefit the goal of finding a solution to dementia.

Graff-Radford, Jonathan, M.D. “Dementia.” Mayo Clinic, Mayo Foundation for Medical

Education and Research (MFMER), Aug. 2, 2017, https://www.mayoclinic.org/diseases-

conditions/dementia/symptoms-causes/syc-20352013. Accessed 29 October 2018.

Jonathan Graff-Radford, M.D. and his associates present their research on dementia in

immense detail and subcategories branching off from dementia and its general status of causing

memory loss.

Beginning with symptoms, many things can cause dementia, and the symptom depends

on the cause. The main two types of changes are cognitive and physiological. Cognitive changes

are usually noticed by another person who lives with the dementia patient. These changes

include confusion, difficulty doing complex tasks, difficulty with problem-solving, or basic

memory loss. Physiological changes include personality changes, depression, paranoia, and

agitation. Now, Graff-Radford goes deeply into the descriptions of each irreversible and treatable

cause of dementia. These diseases are linked to dementia through genetics, blood types,
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mutations in DNA, head trauma, the immune system, or even medications. Progressive

dementias, or dementias that are not reversible, include Alzheimer’s, vascular dementia, Lewy

body dementia, Huntington’s disease, traumatic brain injury, or Parkinson’s disease. Some can

be reversed with treatments, like immune disorders, nutritional deficiencies, reactions to

medications, or brain tumors. There are many factors that lead to dementia, and living life is a

risk in its own way. Some risks that cannot be changed include age, family history of dementia,

or the possibility of Down syndrome, where many people with Down syndrome develop early-

onset Alzheimer’s disease. However, there are some risk factors you can change, and these

include alcohol use, blood pressure control, depression, diabetes, and smoking. If these risks are

watched and managed, complications can still arise such as inadequate nutrition, pneumonia,

inability to perform self-care tasks, and even death from infection or coma. Unfortunately, there

is no sure way to prevent dementia from occurring, but there are some things that patients can

do. One could keep their mind active, be physically and socially active, do no smoke, and lower

your blood pressure.

This research page specifically targets families with a loved one who has dementia and

calls out to those who wish to find out if they have the symptoms of dementia. Graff-Radford

gives great detail in each of his categories of dementia and is easily giving out the information

the audience wishes to find. I believe his goal is to help as many people as he can, and I think he

is succeeding with his in-depth paragraphs and knowledge on the subject. This source is

trustworthy because the Mayo Clinic staff list is easily accessible and has specialists and editors

for each subject the clinic researches, along with their degrees earned as proof. Their labels are

not hidden in order convey a safe environment and a safe source for the worried audience.
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The well-researched information and very specific facts allows me to give my essay the

proper depth it deserves in order to reach out to my readers with a better perspective. This source

answers my fat question with well-rounded answers on how dementia begins and the symptoms

that tag along with those causes.

Mitchel, Wendy. “I Had Alzheimer’s. But I Wasn’t Ready to Retire.” The New York Times, 7

September 2018, page A21, https://www.nytimes.com/2018/09/07/opinion/early-onset-

alzheimers-work.html. Accessed 31 October 2018.

Wendy Mitchell was diagnosed with early-onset Alzheimer’s in July of 2014. She had

been working as an administrator at the British National Health Service for more than 20 years

and loving it, but because of her disease, her date for early retirement was already marked on her

calendar. She was 58 years old and had been experiencing memory loss and difficulty with

simple words for two years. Mitchell was still a capable employee despite her challenges, and

she understood her needs because she worked in the health system. “In Britain, more than 40,000

people under the age of 65 have dementia. In the United States, there are an estimated 200,000

with early-onset Alzheimer’s.” Employees like Mitchell are valuable in this day’s working world

and Alzheimer’s is a slow-moving disease, so Mitchell’s brain and intelligence is not going

anywhere fast. Mitchell makes adaptations, and her colleagues are willing to help her out with

different systems of working. They create a color-coded Post-it note system with each color

specifying a team member and their projects Mitchell helps with, or they email her with

questions instead of coming to her office and expect answers. Mitchell has found ways to adapt

her life and now that she no longer works for the National Health Service, she uses her energy to

work with charities and dementia support organizations. Mitchell will keep working and believes

that work will keep her disease “at bay”.

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I see Mitchell as an author trying to reach out to those also with early-onset Alzheimer’s

and she is trying to tell them that your busy life schedule should not stop because of some

disease. Yes, it may need to be adjusted, but your job should not be a burden if you are doing

something that you love. I believe that this source is great evidence supporting that dementia

should not stop you from continuing to live your life. This opinion piece shows the upsides of

dealing with early-onset and how to positively deal with the symptoms.

The author of the article, Wendy Mitchell, is a famous memoir writer who worked

alongside the British National Health Society for 20 years and then spent time travelling around

the country raising awareness on her passion for her research on dementia and Alzheimer’s. I

believe that this is a credible source because this woman not only worked in the field where her

disease mattered, but she then made a difference in the medical community with an

autobiography on her journey with Alzheimer’s. This will answer my fat question by showing

that will hard work and determination, dementia could be worked with and give another real-life

example other than my grandfather.

Brodaty, Henry, and Donkin, Marika. “Family caregivers of people with dementia.” PubMed

Central (PMC: Dialogues Clin Neurosci), vol. 11, no. 2, June 2009, pp. 217-228,

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181916/. Accessed 31 October 2018.

According to Henry Brodaty, MD and DSc, professor at the Primary Dementia

Collaborative Research Centre and School of Psychiatry at the University of New South Wales

in Sydney, Australia, family caregivers of people with dementia are crucial to the life of their

patients. His work alongside Marika Donkin, BA-Psychology of the Academic Department for

Old Aged Psychiatry at the Prince of Wales Hospital in Sydney, Australia shows that there are

positive and negative effects of being a caregiver and that the negativities are often influenced by
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burden and strain. The authors analyze who caregivers are, which are mostly family and friends

of the 30 million people with dementia. The reason why caregivers do what they do revolves

around their love for the patient, but speaking negatively, one could also have a sense of duty,

guilt, pressure, greed, or to receive attention. The authors have found, along with backing

evidence and statistics, that caregivers of those with dementia have higher levels of burden than

other caregivers of other diseases and issues. The authors also access the many types of effects

dementia causes caregivers. Caregivers have lives outside of taking care of those with dementia,

such as employment, child care, relationships, and education. Brodaty introduces the concept of

“role captivity” and how that the burden can cause immense strain, physiological and physical

morbidity, isolation, financial problems, anxiety, and depression. There are three theories on why

caregiver distress is linked to duration of dementia: the longer the caregiver remains in their role,

they adapt to the demands of the patient; the longer the caregiver remains in their role, the more

likely negative outcomes occur; and the reason caregivers experience stress is because they are

more likely to admit their loved on to a nursing home to remove themselves from the job of

caregiver. Caregiving has been proven as a life-altering job, and sometimes it can be too much

on an individual, so they have the option of placing their loved on in a home specialized to their

disease or medical problem. Family caregivers are necessary for the support of loved ones with

dementia, despite the burdens and trifles they go through each day.

I believe that the authors’ goal was while describe the stress and struggles of a caregiver

with statistics and specific examples from past studies, they also assert the importance of a

caregiver in the lives of the family of the one with dementia and the patient themselves. They

reach out to an audience who may need assistance in finding a caregiver or if their already-

present caregiver needs an explanation onto why so much turmoil and burden is upon them. This
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is generally focused on an audience specifically involved with a dementia patient or for other

researchers looking for answers. Both audience types will benefit because of the cited

information and multiple statistic listings within the article.

I find the authors to be very credible due to their backgrounds as members of universities

and departments specialized in psychiatry and dementia research. A list of references is at the

bottom and citations are labeled throughout the article, showing evidence of the author’s research

and results from their findings. Both authors also have degrees in their fields, making them

trustworthy sources and professionals in their jobs. Knowing that this source is credible, I can

apply the information to my fat question by mentioning the stress of those that care for dementia

patients in a way that it affects their family members and loved ones. Because most caregivers

are family members, I can answer pieces of my fat question and build up on the emotional appeal

and connect it to my research proposal.

Varnam, William. “How to Mobilise Patients with Dementia to a Standing Position.” Nursing

Older People, vol. 23, no. 8, Oct. 2011, pp. 31–36. EBSCOhost,

ezproxy.wittenberg.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&d

b=a9h&AN=66478774&site=ehost-live. Accessed 29 October 2018.

According to William Varnam, back care manager at Nottinghamshire Healthcare NHS

Trust in Nottingham, England, there is an intervention used to assist people with dementia from a

sitting position to a standing position, and that doing this will help aid movement and being

active, no matter at what age or state, is healthy. Throughout Varnam’s experiments, focus

groups involving therapy staff, and questionnaires, he found that intervening in the active lives of

dementia patients should be included in care programs. Varnam’s methods came along with

questions such as when assisting a person with dementia, what difficulties do you encounter, and
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how do you overcome these difficulties? These types of questions were included in the

questionnaires, along with unusual circumstances that the people answering the questions had to

analyze and address the circumstance. Three tables address these circumstances recorded in

diaries that Varnam kept with him, and each outcome of the interventions had ratings relating to

sound, equipment, environment, and focused instruction; all things required for assisting a

dementia patient with movement. Varnam’s results were determined with participants selecting a

patient and trying out a range of interventions on them depending on their severity of illness. The

rate of success with each patient was then recorded based on level of improvement, A being

major improvement, B being moderate, C being slight, D being no difference, E being making

things worse, and F being not sure of a change. Due to the nature of each dementia case within

each patient, Varnam could not specifically determine the reactions of each patient because their

abilities and mood could impede interventions. However, no particular intervention tested proved

to be the most successful, but the use of interventions clearly positively influenced the patients

based on the knowledge of the patient and their caregivers.

I believe that Varnam’s purpose of his scientific analysis paper was to inform other

scholars and researchers of his research and findings, making this an academic paper for an

academic, researching audience. Varnam’s ability to provide such a source is proven with his

extensive references at the end of the paper and his time spent as a back-care manager at the

Nottinghamshire Healthcare NHS Trust.

This source supports my fat question of how dementia affects the body and the

importance of caregivers, similar to the source by Brodaty. Connections are made between the

physical tolls’ dementia takes on a person and how badly those patients need assistance with

daily actions, especially if dementia has been affecting a patient for long periods of time.
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