alzheimer disease

When is old age considered old?
1. The United Nations has agreed that 65+ years may be usually denoted as old age
  1. the World Health Organization (WHO) set 55 as the beginning of old age. At the same time, defines old age, not by years, but by new roles, loss of previous roles, or inability to make active contributions to society.
3. confusion aka deliruum
  1. types
Dementia
1. types
2. factors effecting memory
3. Physiology of memory
Anatomy of the limbic system
sign and symptoms
1. At first, increasing forgetfulness or mild confusion may be the only symptoms of Alzheimer's disease that the patient notice. But over time, the disease robs more of the memory, especially recent memories.
  1. The patient may be the first to notice having unusual difficulty remembering things and organizing thoughts. Or may not recognize that anything is wrong, even when changes are noticeable to family members, close friends or co-workers.
    1. Forget conversations, appointments or events, and not remember them later. Routinely misplace possessions, often putting them in illogical locations. Repeat statements and questions over and over, not realizing that they've asked the question before
      1. Have trouble finding the right words to identify objects, express thoughts or take part in conversations
        Changes in personality and behavior
        Depression... Apathy... Social withdrawal... Mood swings... Distrust in others Irritability and aggressiveness... Delusions, such as believing something has been stolen
2. causes
  1. Scientists believe that for most people, Alzheimer's disease is caused by a combination of genetic, lifestyle and environmental factors that affect the brain over time.
  2. hallmarks
    1. beta amyloid plaques
      1. These clumps of a protein called beta-amyloid may damage and destroy brain cells in several ways, including interfering with cell-to-cell communication. Although the ultimate cause of brain-cell death in Alzheimer's isn't known, the collection of beta-amyloid on the outside of brain cells is a prime suspec
    2. tau tangles
      1. Brain cells depend on an internal support and transport system to carry nutrients and other essential materials throughout their long extensions. This system requires the normal structure and functioning of a protein called tau
Investigations
1. Blood work up
  1. Anemia...B12 deficiency... HYPOthyroidism...nfection.... HYPOglycemia
2. Genetic:
  1. Apo-epsilon-4 allele
3. Mental status tests
  1. Mini-Mental state examination
  2. Imaging
    1. ct scan
treatment
1. Pharmacology
  1. Acetylcholinesterase Inhibitors
    1. Donepezil, Rivastigmine, & Galantamine Improve cholinergic transmission within the CNS
    2. Galantamine has nicotinic action.
  2. NMDA-glutamate Antagonist
    1. Memantine blocks excess Glutamate transmission, limiting Ca2+ influx.
      1. Adverse Effects
        Nausea & Vomiting Bradycardia & Hypotension Miosis
Epidemiology
1. Worldwide, nearly 47 million people have Alzheimer’s or a related dementia.
  1. Only 1-in-4 people with Alzheimer’s disease have been diagnosed. Alzheimer’s and dementia is most common in Western Europe.
Prognosis
1. Most patients die within 8 to 10 years, some live as long as 25 years.
  1. An accurate, early diagnosis gives affected individuals a greater chance of benefiting from existing treatments
    1. Complications
      1. Infections mainly (UTI & pneumonia... Injuries from falls... Bedsores... Loss of ability to move joints.. Loss of ability to care for self... Malnutrition & dehydration... Harmful or violent behavior.

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alzheimer disease

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