Alzheimer’s Disease Edwin Onattu P. 3

Basics… Alzheimer's is a type of dementia that causes problems with memory, thinking and behavior. Alzheimer's is the most common form of dementia. Alzheimer's is not a normal part of aging. Alzheimer's worsens over time. NO Cure No tests, but Physician may perform neurological exam, mental status test, brain Imaging. The most common early symptom of Alzheimer's is difficulty remembering newly learned information. Fairly new avenue Risk factors The risk gene with the strongest influence is called apolipoprotein E-e4 (APOE-e4). Everyone inherits a copy of some form of APOE from each parent. Deterministic genes Other Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks. Dementia, is a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. Alzheimer's disease accounts for 50 to 80 percent of dementia cases. although the greatest known risk factor is increasing age, and the majority of people with Alzheimer's are 65 and older. But Alzheimer's is not just a disease of old age. Up to 5 percent of people with the disease have early-onset Alzheimer's (also known as younger-onset), which often appears when someone is in their 40s or 50s. Alzheimer's is a progressive disease, where dementia symptoms gradually worsen over a number of years. In its early stages, memory loss is mild, but with late-stage Alzheimer's, individuals lose the ability to carry on a conversation and respond to their environment. Alzheimer's is the sixth leading cause of death in the United States. Those with Alzheimer's live an average of eight years after their symptoms become noticeable to others, but survival can range from four to 20 years, depending on age and other health conditions. Alzheimer's has no current cure, but treatments for symptoms are available and research continues. Although current Alzheimer's treatments cannot stop Alzheimer's from progressing, they can temporarily slow the worsening of dementia symptoms and improve quality of life. Today, there is a worldwide effort under way to find better ways to treat the disease, delay its onset, and prevent it from developing. One out of every eight baby boomers are likely to develop Alzheimer’s at some point, and the disease is now the sixth deadliest in the country. By 2050, there will be a million new cases of Alzheimer’s each year. Alzheimer's disease can be diagnosed with complete accuracy only after death, when microscopic examination of the brain reveals the characteristic plaques and tangles. As we age, our brains do slow down, but major changes suggest failing cells. Alzheimer's changes typically begin in the part of the brain that affects learning As Alzheimer's advances through the brain it leads to increasingly severe symptoms, including disorientation, mood and behavior changes; deepening confusion about events, time and place; unfounded suspicions about family, friends and professional caregivers; more serious memory loss and behavior changes; and difficulty speaking, swallowing and walking. People affected have a hard time realizing they have a problem, it’s normally their family members that see symptoms first. 90% of what we know was discovered in the last 15 years. Risk Factors Age most with disease are 65 or older Risk doubles every 5 years after 65 After 85, the risk is nearly 50% BIG MYSTERY, risk rises so dramatically? Family history relatives hereditary or environmental factors Genetics Risk genes Increase likelihood, but no guarantee of disease Strongest influence APOE-e4 Deterministic Alzheimer’s directly cause a disease, guaranteeing that anyone who inherits them will develop the disorder. When Alzheimer’s disease is caused by these deterministic variations, it is called “autosomal dominant Alzheimer’s disease (ADAD)” rue familial Alzheimer’s accounts for less than 5 percent of cases. Head Trauma Heart to head connection The risk of developing Alzheimer’s appears to be increased by many conditions that damage the heart or blood vessels. These include high blood pressure, heart disease, stroke, diabetes and high cholesterol

The Brain 3 lbs. ; 3 Parts Cerebrum Cerebellum Brain Stem Your brain is your most powerful organ, yet weighs only about three pounds. It has a texture similar to firm jelly. It has three main parts: The cerebrum fills up most of your skull. It is involved in remembering, problem solving, thinking, and feeling. It also controls movement. The cerebellum sits at the back of your head, under the cerebrum. It controls coordination and balance. The brain stem sits beneath your cerebrum in front of your cerebellum. It connects the brain to the spinal cord and controls automatic functions such as breathing, digestion, heart rate and blood pressure.

The Supply Lines Rich network of blood vessels nourishes the Brain. With each heartbeat, arteries carry about 20 to 25 percent of your blood to your brain, where billions of cells use about 20 percent of the oxygen and fuel your blood carries. When you are thinking hard, your brain may use up to 50 percent of the fuel and oxygen.

The whole vessel network This includes the veins and capillaries

The Cortex a.k.a “Wrinkles” Your brain’s wrinkled surface is a specialized outer layer of the cerebrum called the cortex. Scientists have “mapped” the cortex by identifying areas strongly linked to certain functions. Interpret sensations from your body (RED) Sights(Orange) Sounds(Green) Smells from the outside world(Teal) General thoughts, problem solving and making plans.(Blue) Forms and stores memories(Yellow) Control voluntary movement(Black)

Left vs. right Your brain is divided into right and left halves. Many interpretations on difference in functions of right and left brain. However, it is accepted that Left controls right, Right controls left Language area is usually left

The Neuron Forest real work of your brain goes on in individual cells. An adult brain contains about 100 billion nerve cells, or neurons, with branches that connect at more than 100 trillion points. Scientists call this dense, branching network a "neuron forest.“ Signals traveling through the neuron forest form the basis of memories, thoughts, and feelings. Neurons are the chief type of cell destroyed by Alzheimer's disease.

Signals that form memories and thoughts move through an individual nerve cell as a tiny electrical charge.

Nerve cells connect to one another at synapses. When a charge reaches a synapse, it triggers a release of tiny bursts of chemicals called neurotransmitters. The neurotransmitters travel across the synapse, carrying signals to other cells. Ex. Of Nuerotransmitters Dopamine; Epinephrine(Adrenaline) Seratonin Alzheimer's disease disrupts both the way electrical charges travel within cells and the activity of neurotransmitters.

Over time, our experiences create patterns in signal type and strength Over time, our experiences create patterns in signal type and strength. These patterns of activity explain how, at the cellular level, our brains code our thoughts, memories, skills and sense of who we are. The positron emission tomography (PET) scan shows typical patterns of brain activity Reading words Hearing words Thinking about words Saying words Activity is highest in red areas and then decreases through the other colors of the rainbow from yellow to blue-violet Specific activity patterns change throughout life as we meet new people, have new experiences and acquire new skills. The patterns also change when Alzheimer’s disease or a related disorder disrupts nerve cells and their connections to one another.

The Demented brain Alzheimer’s disease leads to nerve cell death and tissue loss throughout the brain. Over time, the brain shrinks dramatically, affecting nearly all its functions.

Here is another view of the massive cell loss The whole brain changes in advanced Alzheimer's disease. This slide shows a crosswise "slice" through the middle of the brain between the ears. The cortex shrivels up, damaging areas involved in thinking, planning and remembering.(BLUE) Shrinkage is especially severe in the hippocampus, an area of the cortex that plays a key role in formation of new memories.(Red) Ventricles (fluid-filled spaces within the brain) grow larger. (Yellow)

So what’s going on? Alzheimer's tissue has many fewer nerve cells and synapses than a healthy brain. Plaques, abnormal clusters of protein fragments, build up between nerve cells.(Red) Dead and dying nerve cells contain tangles, which are made up of twisted strands of another protein.(Blue) Scientists are not 100% sure what causes cell death and tissue loss in the Alzheimer's brain, but plaques and tangles are the primary suspects for now.

Plaques Plaques form when protein pieces called beta-amyloid (BAY-tuh AM-uh-loyd) clump together. Beta-amyloid comes from a larger protein found in the fatty membrane surrounding nerve cells. Beta-amyloid is chemically "sticky" and gradually builds up into plaques. The most damaging form of beta-amyloid may be groups of a few pieces rather than the plaques themselves. The small clumps may block cell-to-cell signaling at synapses. They may also activate immune system cells that trigger inflammation and devour disabled cells. On a side note, this idea, that inflammation could be big cause has led some people to believe that simple NSAIDs Or Nonsteroidal anti-inflammatory drugs, like Aspirin, Ibuprofen, could be a treatment for early stages of Alzheimer’s.

Tangles destroy a vital cell transport system made of proteins. This is an electron microscope image that shows a cell with some healthy areas and other areas where tangles are forming. The transport system is organized in orderly parallel strands somewhat like railroad tracks. Food molecules, cell parts and other key materials travel along the “tracks.” A protein called tau (rhymes with wow) helps the tracks stay straight. Tau collapses into twisted strands called tangles. The tracks can no longer stay straight. They fall apart and disintegrate. Nutrients and other essential supplies can no longer move through the cells, which eventually die. “Tangled”

Progression Plaques and tangles spread through the cortex in a predictable pattern as Alzheimer's progresses. Rate of progression varies People with Alzheimer's live an average of eight years, but some people may survive up to 20 years. The course of the disease depends in part on age at diagnosis and whether a person has other health conditions. You’re going to die either way haha Earliest Alzheimer's - changes may begin 20 years or more before diagnosis. Mild to moderate Alzheimer's stages - generally last from 2 - 10 years. Severe Alzheimer's - may last from 1 - 5 years.

Onset In the earliest stages, before symptoms can be detected tests, plaques and tangles begin to form in brain areas involved in Learning and Memory Thinking and planning

Mild to moderate In mild to moderate stages, brain regions important in memory and thinking and planning develop more plaques and tangles than were present in early stages. As a result, individuals develop problems with memory or thinking serious enough to interfere with work or social life. They may also get confused and have trouble handling money, expressing themselves and organizing their thoughts. Many people with Alzheimer’s are first diagnosed in these stages. Plaques and tangles spread to other areas that control: Speaking and understanding speech (black) Sense of where objects are in relation to your body (red) As this goes on, individuals may experience changes in personality and behavior and have trouble recognizing friends and family members.

Severe Alzheimer’s In advanced Alzheimer’s disease, most of the cortex is seriously damaged. The brain shrinks dramatically due to widespread cell death. Individuals lose their ability to communicate, to recognize family and loved ones and to care for themselves.

Future treatment plans Cell phone radiation reverses Alzheimer’s and boosts memory in mice Drugs that target Beta-Amyloid Drugs that keep Tau proteins from tangling Anti-inflammatory drugs Study to find how electromagnetic radiation affected memory function. Not only boosted memory in mice, but reversed Alzheimer’s symptoms. How you ask? The EM waves erase the Beta-Amyloid protein cells, which we know is the primary contributor of plaques. Most mice were genetically engineered to develop Alzheirmer’s There were non-demented mice that saw benefits from the exposure through increased blood flow and energy metabolism in the brain. That improved brain activity actually boosted the memory of the mice to above-normal levels. No mice had cancer realted growths in their brains. World Health Organization, the American Cancer Society, and the National Institutes of Health, all concluded that no scientific evidence points to bad health effects from cell phone use.

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