The decline in cognitive function and physical health is rapid. The average survival time after the diagnosis of Alzheimer’s disease is 8 to 12 years.64,65 It is the sixth leading cause of death in the United States.8 The brains of patients with Alzheimer’s disease have 3 signs of damage. The first is an accumulation of a protein called beta-amyloid, which forms plaques in the spaces between neurons (Figure 1-9). The second is the development of neurofibrillary tangles inside the neurons that stop communication with other neurons (see Figure 1-9). Lastly, the presence of the plaques and tangles is believed to cause the neurons to degenerate and die. This results in atrophy of the brain; the mass of the brain decreases dramatically (Figure 1-10). Brain cells are highly specialized and conduct messages for thoughts, memories, motor skills, and emotional control. Persons with Alzheimer’s disease do not regenerate nerve cells at a high enough rate to maintain this complex network and experience more and more symptoms as time passes.
There are 2 forms of the disease, including early and late onset. Early-onset occurs before age 60 and is rare.66 This form is strongly linked to a family history of Alzheimer’s disease and mutations of a chromosomes that have a role in developing the precursor to beta-amyloid.61 Much
Although risk factors, such as advanced age (older than 85 years), family history, or the APOE e4 gene are not changeable, there are modifiable risk factors for Alzheimer’s disease, including hypertension, obesity, smoking, depression, cognitive inactivity, and physical inactivity.68 The precise mechanisms by which each risk factor impacts brain cells is not known, but there is strong epidemiological evidence that people who had less CVD69 at mid-life remain socially and cognitively engaged70 and physically active71,72 as older adults experience less dementia even if they are genetically susceptible.73
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Smoking is the greatest risk factor for lung cancer, but it is also linked to mortality from many other diseases. Create a list of diseases that would have reduced mortality if the smoking rates in the United States continue to decline. Use the following article as a resource: www.cdc.gov/ pcd/issues/2012/11_0295.htm. How do attributable risk statistics improve our understanding of what health behaviors need to change.
Exercise is a specific type of leisure-time physical activity that maintains or improves physical fitness. To qualify as exercise, a physical activity has to be sustained long enough or be demanding enough to cause the body to improve how it makes energy and delivers oxygen.4 Leisure-time physical activity can be further divided into lifestyle physical activity and active transportation. Daily tasks that require movement, such as shopping, house cleaning, and yardwork, make up lifestyle physical activity.5 Commuting places by walking or biking are examples of active transport.6 Sports are another type of leisure-time physical activity. Sports are more competitive than exercise, and the amount of physical activity required varies greatly depending on the sport and the level of play.7 In general, athletes are considered highly physically active.
Activities of daily living (ADLs) include lifestyle physical activity and basic self-care, such as bathing and cooking.8 Ability to do these daily physical tasks without assistance is a measure of one’s physical function. Higher levels of physical function are related to greater amounts of physical activity,9 and for older adults, physical function is associated with greater independence.10 A step beyond physical function is physical fitness. Being physically fit means that one can complete his or her “daily tasks with vigor and alertness, without undue fatigue and ample energy. .”n Physical fitness includes naturally occurring and acquired abilities.2 Exercise training can improve physical fitness, especially the health-related components.12
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