Alzheimer's disease referred to as Alzheimer's, is a chronic neurodegenerative disease that starts and worsens over time. It is the cause of 60–70% of cases of dementia; the most common early symptom is difficulty in remembering recent events. As the disease advances, symptoms can include problems with language, mood swings, loss of motivation, not managing self-care, behavioural issues; as a person's condition declines, they withdraw from family and society. Bodily functions are lost leading to death. Although the speed of progression can vary, the typical life expectancy following diagnosis is three to nine years; the cause of Alzheimer's disease is poorly understood. About 70% of the risk is believed to be inherited from a person's parents with many genes involved. Other risk factors include a history of head injuries and hypertension; the disease process is associated with plaques and neurofibrillary tangles in the brain. A probable diagnosis is based on the history of the illness and cognitive testing with medical imaging and blood tests to rule out other possible causes.
Initial symptoms are mistaken for normal ageing. Examination of brain tissue is needed for a definite diagnosis. Mental and physical exercise, avoiding obesity may decrease the risk of AD. There are no supplements that have been shown to decrease risk. No treatments reverse its progression, though some may temporarily improve symptoms. Affected people rely on others for assistance placing a burden on the caregiver; the pressures can include social, psychological and economic elements. Exercise programs may be beneficial with respect to activities of daily living and can improve outcomes. Behavioural problems or psychosis due to dementia are treated with antipsychotics, but this is not recommended, as there is little benefit with an increased risk of early death. In 2015, there were 29.8 million people worldwide with AD. It most begins in people over 65 years of age, although 4–5% of cases are early-onset Alzheimer's, it affects about 6% of people 65 years and older. In 2015, dementia resulted in about 1.9 million deaths.
It was first described by, named after, German psychiatrist and pathologist Alois Alzheimer in 1906. In developed countries, AD is one of the most financially costly diseases; the disease course is divided into four stages, with a progressive pattern of cognitive and functional impairment. The first symptoms are mistakenly attributed to ageing or stress. Detailed neuropsychological testing can reveal mild cognitive difficulties up to eight years before a person fulfills the clinical criteria for diagnosis of AD; these early symptoms can affect the most complex activities of daily living. The most noticeable deficit is short term memory loss, which shows up as difficulty in remembering learned facts and inability to acquire new information. Subtle problems with the executive functions of attentiveness, planning and abstract thinking, or impairments in semantic memory can be symptomatic of the early stages of AD. Apathy can be observed at this stage, remains the most persistent neuropsychiatric symptom throughout the course of the disease.
Depressive symptoms and reduced awareness of subtle memory difficulties are common. The preclinical stage of the disease has been termed mild cognitive impairment; this is found to be a transitional stage between normal ageing and dementia. MCI can present with a variety of symptoms, when memory loss is the predominant symptom, it is termed "amnestic MCI" and is seen as a prodromal stage of Alzheimer's disease. In people with AD, the increasing impairment of learning and memory leads to a definitive diagnosis. In a small percentage, difficulties with language, executive functions, perception, or execution of movements are more prominent than memory problems. AD does not affect all memory capacities equally. Older memories of the person's life, facts learned, implicit memory are affected to a lesser degree than new facts or memories. Language problems are characterised by a shrinking vocabulary and decreased word fluency, leading to a general impoverishment of oral and written language. In this stage, the person with Alzheimer's is capable of communicating basic ideas adequately.
While performing fine motor tasks such as writing, drawing, or dressing, certain movement coordination and planning difficulties may be present, but they are unnoticed. As the disease progresses, people with AD can continue to perform many tasks independently, but may need assistance or supervision with the most cognitively demanding activities. Progressive deterioration hinders independence, with subjects being unable to perform most common activities of daily living. Speech difficulties become evident due to an inability to recall vocabulary, which leads to frequent incorrect word substitutions. Reading and writing skills are progressively lost. Complex motor sequences become less coordinated as time passes and AD progresses, so the risk of falling increases. During this phase, memory problems worsen, the person may fail to recognise close relatives. Long-term memory, intact, becomes impaired. Behavioural and neuropsychiatric changes become more prevalent. Common manifestation
York was a federal electoral district in New Brunswick, represented in the House of Commons of Canada from 1867 to 1917. It was created as part of the British North America Act of 1867, it consisted of the County of York. It was abolished in 1914 when it was merged into York—Sunbury riding; this riding elected the following Members of Parliament: By-election: On Mr. Fisher's resignation, 3 October 1868 to become Judge of the Supreme Court of New Brunswick By-election: On Mr. Pickard's death, 17 December 1883 By-election: On election being declared void by a Court decision, 11 June 1901 By-election: On Mr. Crocket being appointed judge, 11 December 1913 List of Canadian federal electoral districts Past Canadian electoral districts Riding history from the Library of Parliament
Shane Shackleton is an Australian former professional rugby league footballer who played as a prop and second-row forward who played for the Sydney Roosters, Parramatta Eels and the Penrith Panthers in the NRL. He played twice for NSW City between 2009 and 2011. Shackleton made his first grade debut for the Sydney Roosters in 2005. Shackleton's last season at the club ended with a wooden spoon in 2009. In total, Shackleton made 65 appearances for the club. Shackleton was selected for City in the City vs Country match on 8 May 2009. Shackleton was eligible to play for Malta in the same year. Shackleton signed for the Parramatta Eels for a reported three-year deal starting from 2010, he made his debut for the Parramatta Eels coming of the bench in round 1 up against St. George Illawarra, but only to suffer a horrific hamstring injury ending his season. After suffering one of the worst hamstring injuries seen by doctors, Shackleton had worked hard to get back into the side and was a regular off the bench for Parramatta.
In early 2011 when Parramatta played the Gold Coast, Shackleton scored a try after pouncing on a bomb, the match winner for Parramatta. In 2012, Shackleton was dropped to the Eels NRL feeder team; when asked on Facebook why he was not playing first grade, he replies, because, "Kearney's a fucker."Soon after, Shackleton signed a two-year deal to link up with the Penrith Panthers prior to the 30 June trade deadline, resulting in an immediate switch to the new club. In 2013, Shackleton was working part time as a labourer and a comedian while playing for the Mount Pritchard Mounties in the Intrust Super Premiership NSW competition. In 2016, Shackleton while playing for the Guildford Owls, was named in the Ron Massey Cup representative side to play the Queensland Rangers. In November 2018, Shackleton played for Parramatta in the Legends of League tournament, staged at the Central Coast Stadium in Gosford. First grade debut: Sydney Roosters v Brisbane, Suncorp Stadium, 26/08/05 NRL profile Shane Shackleton's Parramatta Eels Profile