ORAL PRESENTATION: BICYCLE, SPOON AND APPLE.

INTRODUCTION. In this oral presentation, I like to speak about these three words:
bicycle, spoon and apple. But, what is the meaning of these three words? A bicycle is a vehicle
consisting of two wheels held in a frame one behind the other, propelled by pedals and
steered with handlebars attached to the front of wheel. Secondly, a spoon is an implement
consisting of a small, shallow oval or round bowl on a long handle, used for eating, stirring, and
serving food. And finally, an apple is the rounded fruit of a tree of the rose family, with green
or red skin and crisp flesh. For me, this three united words mean Alzheimer disease.

WHAT IS THE ALZHEIMERS DISEASE? It is an irreversible neurodegenerative disease

whose cause is unknown, which attacks the brain producing critical deterioration of cognitive,
behavioral and motor functions thus condemning its sufferer to depend on a career all 24
hours. It is the most frequent form of dementia. It does not constitute a part of the regular
ageing process, nor is it contagious or hereditary (except for a small percentage of cases, less
than 5%). It is an illness that is linked to old age and there are about 800,000 sufferers in Spain
at present.

WHAT ARE THE SYMPTOMS? The disease course is divided in four levels: predementia, early, moderate and advanced. This disease is different for each person, but there
are many common symptoms. Some symptoms can be confused with age or stress. But, I can
explain some symptoms:

Aggression. Aggressive behaviors may be verbal (shouting, name-calling) or physical

(hitting, pushing).

Wandering. It is common for individuals with dementia to wander and become lost.

Anxiety or agitation. The person may feel anxious or agitated, or may become restless
and need to move around or pace.

Confusion. The person may not recognize familiar people, places or things. He or she
may forget relationships, call family members by other names or become confused
about where home is. The person may also forget the purpose of common items, such
as a pen or a fork.

Hallucinations. When individuals Alzheimer's disease have a hallucination, they see,

hear, smell, taste or feel something that isn't there.

Repetition. The person with Alzheimer's may do or say something over and over again
like repeating a word, question or activity.

Suspicion. Memory loss and confusion may cause the person with Alzheimer's to
perceive things in new, unusual ways. Individuals may become suspicious of those
around them, even accusing others of theft, infidelity or other improper behavior.
Sometimes the person may also misinterpret what he or she sees and hears.

DIAGNOSIS. The professionals who treat the Alzheimer disease are the neurologist,
psychiatrist and psychologist.
A. EVALUATING MOOD AND MENTAL STATUS. Mental status is tested to give the
doctor a general idea of how well the mind is working. This testing gives an overall
sense of whether a person:

Is aware of having symptoms.

Knows the date, time and where he or she is.

Can remember a short list of words, follow instructions and do simple

calculations.

The doctor may ask the person his or her address, what year it is or who is serving
as president. The individual may also be asked to spell a word backward, draw a
clock or copy a design.
B. PHYSICAL EXAM AND DIAGNOSTIC TESTS. The doctor will perform procedures to
assess the person's overall health like evaluating diet, checking blood pressure or
listening to the heart. Blood and urine samples will be collected, and other
laboratory tests may also be ordered. All these conditions may cause confused
thinking, memory problems or other symptoms similar to dementia.
C. NEUROLOGICAL EXAM. A doctor, sometimes a neurologist who specializes in
disorders of the brain and nervous system, will closely evaluate the person for
problems that may signal brain disorders other than Alzheimer's. The doctor will
also test the person's reflexes, balance, eye movement, speech and sensation. The
neurological examination may also include a magnetic resonance imaging (MRI) or
computer tomography (CT).

THE FAMILY. In the life, there are many events that change all our future existence.
One of them, which nobody expects, is someone reporting to you that a nearby and significant

person for you has Alzheimer. When we take care of our patient we dont think in the changes
that are going to take place in our life. Changes that can be developed are:
Changes in the familiar relationships.
Changes at work and in the economic situation.
Changes in our spare time.
Changes in health.
Changes in the state of mind.
At first moment, the patient needs supervision, but later he or she will need help 24
hours a day. The patient cannot continue carrying his or her previous responsibilities so
relatives will be taking new functions as: helping in the cleanliness, contributing with money
and taking care of the patient, among others.

Do you remember the three words that I have explained before? Normally, most
people who suffer this disease arent capable of remembering these words: spoon, bicycle and
apple.