ABSTRACT
BACKGROUND: General relationships between dotage and infancy and childhood have been acknowledged for more than two millennia. Recent findings indicate precise relationships between functional, praxic, and feeding changes in the course of the degenerative dementia of Alzheimer's disease (AD) and inverse corresponding developmental sequences. Similar inverse relationships between AD and human development can be described for cognition and language skills; for physiologic measures of electroencephalographic activity, brain glucose metabolism, and developmental neurologic reflex changes; and for the neuropathologic and neuroanatomic progression of these processes. In AD, these processes may be termed "retrogenesis." The relevance of the retrogenesis model for AD management is explored. METHOD: The functional stages of AD can be translated into developmental age equivalents that can be utilized to explicate observed changes in the disease. RESULTS: The retrogenesis-based developmental age model can usefully inform an understanding of the general care needs, emotional and behavioral changes, and activity needs of the AD patient. This model must be amended by necessary caveats regarding physical differences, variations in age-associated pathology, differences in social and societal reactions, and differences in background between AD patients and their developmental age "peers." CONCLUSIONS: Knowledge of retrogenesis and the developmental age of the AD patient can form a nidus for the development of a nascent science of disease management. Such a science must ultimately incorporate not only appropriate caveats but also relevant universal human needs, such as those for dignity, love, and movement.
Subject(s)
Aging/psychology , Alzheimer Disease/nursing , Alzheimer Disease/psychology , Health Knowledge, Attitudes, Practice , Mental Competency , Patient Care/methods , Adolescent , Aged , Child , Child Development/physiology , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Models, Nursing , Models, PsychologicalABSTRACT
Data from clinical, electrophysiologic, neurophysiologic, neuroimaging and neuropathologic sources indicates that the progression of brain aging and Alzheimer's disease (AD) deterioration proceeds inversely to human ontogenic acquisition patterns. A word for this process of degenerative developmental recapitulation, "retrogenesis", has been proposed. These retrogenic processes provide new insights into the pathologic mechanism of AD deterioration. An understanding of retrogenic phenonmena can also result in insights into the applicability of retrogenic pathologic mechanisms for non-AD dementing disorders. Management strategies based upon retrogenesis have recently been proposed. Retrogenic pathophysiology also points to previously unexplored pharmacologic approaches to dementia prevention and treatment.
Subject(s)
Aging/physiology , Alzheimer Disease/pathology , Alzheimer Disease/physiopathology , Brain/pathology , Brain/physiopathology , Cognition Disorders/diagnosis , Aged , Disease Progression , Humans , Nerve Degeneration/pathology , Neuropsychological Tests , Psychomotor Disorders/diagnosis , Psychomotor Disorders/physiopathology , Reflex, Abnormal/physiology , Severity of Illness IndexABSTRACT
Much has been learned about the clinical symptomatology of Alzheimer's disease (AD) and ontogenic reciprocal relationships in the past few decades. It is now possible to describe and verify inexorable symptomatic sequences and corresponding temporal relationships. It is also possible to identify more variable symptoms in AD. Ontogenic models can be useful in providing a clearer understanding of the nature of AD symptomatology in terms of both consistency and variability. These models can also be informative in explicating the management needs of AD patients and the treatment possibilities of AD symptoms as well as the etiology of variability in AD symptoms.
