Introduction
Alzheimer's disease is a progressive neurodegenerative disorder that affects memory, thinking, and behavior. It is the most common cause of dementia, accounting for up to 80% of all dementia cases (Rayathala et al., 2022). While Alzheimer's disease affects both men and women, research has shown that women are disproportionately affected by the disease (Rabipour et al., 2021). Women have a higher risk of developing Alzheimer's disease than men, and they also tend to experience more rapid cognitive decline once they develop the disease (Duarte-Guterman et al., 2021).
Background
The challenges of making an early diagnosis of Alzheimer's disease have been documented (Pais et al., 2020). However, why these challenges exist is not particularly well understood (Dubois et al., 2021). Early diagnosis is crucial because it allows for early intervention and treatment, which can slow the progression of the disease and improve quality of life for patients and their families (Rasmussen & Langerman, 2019). However, making an early diagnosis of Alzheimer's disease can be particularly challenging for women (Ferretti et al., 2020).
It is unclear why early diagnosis of Alzheimers for women is challenging for physicians, but a challenge it certainly is (Dubois et al., 2021). Researchers have, however, presented different theories as to why this challenge exists, including atypical presentation, delayed presentation, bias in research, and differences in brain structure and function (Duara & Barker, 2022; Lopez et al., 2020).
Duara and Barker (2022) argue that women may present with atypical symptoms that are not always recognized as being related to Alzheimer's disease. For example, women may be more likely to experience mood changes, anxiety, and sleep disturbances than men, which could be mistaken for other conditions. Or, women may be more likely to delay seeking medical attention for cognitive symptoms or may not report them at all due to social stigma or shame. This can delay the diagnosis and treatment of Alzheimer's disease (Lopez et al., 2020). Also, historically, Alzheimer's disease research has been biased towards studying men, leading to a lack of understanding of how the disease manifests in women (Ferretti et al., 2020). This can result in misdiagnosis or delayed diagnosis of Alzheimer's in women. Finally, studies have shown that women's brains may be more resilient to the effects of Alzheimer's disease, making it harder to detect the disease in its early stages (Veitch et al., 2022). Plus, women may have a higher burden of certain types of Alzheimer's-related brain changes, such as tau tangles, which can be harder to detect with current diagnostic tools (Veitch et al., 2022).
Relevance and Importance
The topic of the challenges of making an early diagnosis of Alzheimer's disease in women is both relevant and important for several reasons. First, as the population ages, the number of cases of Alzheimer's disease is expected to increase significantly, and women will be disproportionately affected (Dubois et al., 2021). Second, early diagnosis is crucial for effective treatment and care, and the challenges of making an early diagnosis in women must be addressed to improve outcomes for patients and their families (Dubois et al., 2021; Rasmussen & Langerman, 2019). Third, the topic is of theoretical importance because it highlights the complex interplay between gender, health, and aging, and raises important questions about how healthcare systems can address these issues. More can be said, however, on the value of this research in terms of practical, empirical, and theoretical importance.
Practical Importance
Practically, the ability to accurately diagnose Alzheimer's disease is critical to providing appropriate treatment and care to patients. If physicians are not able to accurately diagnose Alzheimer's disease in women, this can result in delayed treatment, misdiagnosis, and suboptimal care. Accurate diagnosis can also help patients and their families plan for the future and make informed decisions about their care.
Empirical Importance
Empirically, understanding the factors that contribute to diagnostic challenges in women with Alzheimer's disease can help inform the development of more effective diagnostic tools and strategies (Duarte-Guterman et al., 20210. It can also help improve our understanding of the disease itself, including its presentation and progression in different populations. This can lead to better treatment options and improved outcomes for patients.
Theoretical Importance
Theoretically, the topic of diagnosing Alzheimer's disease in women is important because it sheds light on broader issues related to health disparities and gender bias in medicine (Lopez et al., 2020). It highlights the need fo more research and attention to be paid to how diseases present differently in different populations, and the need for more inclusive research practices that account for diversity and inclusivity in medical research.
Prior Research
Prior research has shown that women are more likely than men to develop Alzheimer's disease, and that they experience more rapid cognitive decline once they develop the disease (Duarte-Guterman et al., 2021). Some studies have also suggested that women may be more sensitive to the effects of Alzheimer's disease pathology in the brain (Duara & Barker, 2022; Lopez et al., 2020). However, research on the challenges of making an early diagnosis of Alzheimer's disease in women is limited (Dubois et al., 2021).
The challenges of making an early diagnosis of Alzheimer's disease in women are significant and multifaceted. There is a need for more research to understand the specific challenges that women face in receiving an early diagnosis of Alzheimer's disease, and to develop effective strategies for addressing these challenges. This study seeks to address this need by exploring the challenges of making an early diagnosis of Alzheimer's disease in women, and through that exploration making inroads into potentially developing new strategies that can improve early diagnosis and treatment for this population.
The purpose of this qualitative study is to focus on the need to further investigate why many women with AD are not diagnosed. The aim will be to conduct a descriptive qualitative study to examine physicians experiences diagnosing AD in women in order to identify why women go undiagnosed.
The research questions that will be used to guide this study are: 1) How do physicians describe barriers to diagnosing Alzheimer's disease (AD) in women? 2) What factors do physicians perceive limit their ability to identify symptoms of AD for women?
Hypotheses
For exploratory research such as this, hypotheses are not necessarily applicable, as nothing is being tested. However, the following hypotheses, null hypotheses, and alternative hypotheses are included for the sake of identifying possible scenarios or outcomes of the exploration.
Research Question 1: How do physicians describe barriers to diagnosing Alzheimer's disease (AD) in women?
Hypothesis: Physicians will describe various barriers to diagnosing AD in women, including lack of education, stigma, and communication difficulties.
Null Hypothesis: Physicians will not describe any barriers to diagnosing AD in women, and will perceive the process as straightforward and uncomplicated.
Alternative Hypothesis: Physicians will describe different barriers to diagnosing AD in women, and will have varying perceptions of the complexity of the diagnosis process.
Research Question 2: What factors do physicians perceive limit their ability to identify symptoms of AD for women?
Hypothesis: Physicians will perceive various factors that limit their ability to identify symptoms of AD in women, including atypical symptom presentation and comorbidities.
Null Hypothesis: Physicians will not perceive any factors that limit their ability to identify symptoms of AD in women, and will feel confident in their ability to identify the disease.
Alternative Hypothesis: Physicians will perceive different factors that limit their ability to identify symptoms of AD in women, and will have varying levels of confidence in their diagnostic abilities.
Research Method and Design
Based on the research questions, a qualitative research method and design would be appropriate for this study.
Qualitative research methods aim to understand the meaning and interpretation of experiences, attitudes, and beliefs of individuals. This approach is ideal for exploring complex phenomena such as barriers to diagnosing Alzheimer's disease in women, which is potentially influenced by subjective experiences, beliefs, and opinions of physicians.
The research design that would be suitable for this study is descriptive qualitative research. The purpose of this research design is to describe and explore a phenomenon or a group of individuals' experiences or attitudes. In this study, the research design will focus...
…stages of the disorder. Based on these findings, the authors recommend additional research to identify efficacious preventative and management strategies for women experiencing the early stages of Alzheimers disease. Although not a weakness per se, this study used Japanese women only, meaning that there may be unidentified cultural issues involved that may also play a role in the onset of Alzheimers disease and that the above findings may not be generalizable to other populations.Majoka, M. A. & Schimming, C. (2022, June). Effect of Social Determinants of Health on Cognition and Risk of Alzheimer Disease and Related Dementias. Clinical Therapeutics, 43(6), 922-929.
The problem of interest to this study using a systematic literature review was the risk of developing Alzheimers disease as well as associated disorders. The overarching purpose of this study was to examine the various social determinants of health that affect cognitive function and the risk of Alzheimer's and related dementias (ADRDs). The authors note that the term Alzheimer disease and related dementias refers to the combined effects of the most common types of neurodegenerative illnesses that include cognitive impairment and dementia. The key findings that emerged from this study included factors such as lower socioeconomic status, less education, manual labor, high body mass index in midlife, low food security, poor neighborhoods, and stress are clearly associated with an elevated risk of developing ADRDs. Conversely, higher levels of education, higher socioeconomic status, social engagement, and experiences with early-life adversity have a protective effect. The authors conclude that the future direction for this research should focus on reducing ADRDs in the future which could be achieved by enhancing education, improving socioeconomic conditions, and eliminating racial discrimination. The main weakness of this study was is broad focus on ADRDs (an umbrella term that includes Alzheimers disease but dementia with Lewy bodies. frontotemporal lobar degeneration, vascular dementia, and multifactorial dementias as well, which limited its applicability and generalizability to Alzheimers. The main strength of this study was the authors systematic discussion of the various ADRDs and how they affect the likelihood of developing one of the ADRDs discussed, including Alzheimers disease.
Schacter, A. S. & Davis, K. L. (2022, April). Alzheimer's disease. Dialogues in Clinical Neuroscience, 2(2), 1-100.
This study used a systematic review of the relevant literature concerning Alzheimer's disease in the context of it representing a significant public health concern. Despite growing recognition f the problem, Alzheimers disease remains undiagnosed and undertreated in far too many cases. The purpose of this study was to identify the causes of the disease and what progress is being made in developing innovative treatments. The authors note that advances have been made in diagnostic methods and treatments for both cognitive and behavioral symptoms. The main treatment for cognitive symptoms includes drugs such as donepezil, tacrine, rivastigmine, and galantamine. In addition, the use of estrogen replacement for women as well as anti-inflammatory agents, and antioxidants is still being studied. Behavioral symptoms are often treated with antidepressants, antipsychotics, mood stabilizers, anxiolytics, and hypnotics.
A particularly interesting finding from this study was that because women have an increased risk of developing Alzheimers and they tend to live longer than men with this disorder, there are currently twice as many women and men suffering from this disorder. The future directions for research identified in this study included techniques for diagnosing and treating Alzheimer's disease using functional brain imaging for early detection and evaluating the effectiveness of treatments.
Vega, I. E. et al. (2017). Alzheimers Disease in the Latino Community: Intersection of Genetics and Social Determinants of Health. Journal of Alzheimers Disease, 58(4), 979-992.
This study cites the effects of various social determinants of health on the Latino community in the U.S. developed Alzheimers disease at some point in their life as the problem of interest and examines these determinants using a review of the quantitative and qualitative data. The problem of interest is the estimated dramatic increase in diagnosed cases of Alzheimers by 2050. The purpose of the study was to what steps can be taken today to…
Bibliography
Andrew, M. K. & Tierney, M. C. (2018). The puzzle of sex, gender and Alzheimer’s disease: Why are women more often affected than men? Women’s Health, 14, 1-8.
Kimura, A. et al. (2019). Malnutrition is Associated with Behavioral and Psychiatric Symptoms of Dementia in Older Women with Mild Cognitive Impairment and Early-Stage Alzheimer’s Disease. Nutrients, 11(8), 1951-1966.
Majoka, M. A. & Schimming, C. (2022, June). Effect of Social Determinants of Health on Cognition and Risk of Alzheimer Disease and Related Dementias. Clinical Therapeutics, 43(6), 922-929.
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