ALZHEIMER’S DISEASE BY OLUFOLAKUNMI KEHINDE PRE-MD 1

DISEASE OVERVIEW :  INTRODUCTION TO ALZHEIMER’S  SIGNS AND SYMPTOMS  BRAIN ABNORMALITIES  RISK FACTORS  DIAGNOSIS  TREATMENT AND MANAGEMENT  PREVENTION 2

WHAT IS ALZHEIMER’S DISEASE? Alzheimer’s disease can be described as a progressive brain disorder characterized by an irreversible decline in mental activity such as memory, language skills, reasoning ability and perception of time and space. 3

WHAT REALLY HAPPENS?  Alzheimer’s disease is a neurodegenerative disease (a gradual process of brain cell death) that happens over a course of time.  Brain cells (neurons) meet at points known as synapses. Tiny burst of chemicals known as neurotransmitters (e.g. gaba, acetyl choline) travel across synapses to other cells carrying electrical signals.  Alzheimer’s disease is known to affect the function of the neurotransmitters (majorly the acetyl choline), leading to learning difficulties and memory problems. 4

DISCOVERY It was first described in 1906 by a German Psychiatrist Alois Alzheimer. It is the common cause of loss of mental function in those aged 65 and over (late-onset). Alzheimer’s disease in people in their 30s, 40s and 50s is referred to as early onset. It is usually as a result of genes or family history. 5

PREVALENCE OF ALZHEIMER’S DISEASE 6

ALZHEIMER'S VS. DEMENTIA  Alzheimer’s is often mistaken for Dementia. Although dementia is similar in effects to Alzheimer’s, but dementia is a symptom caused by Alzheimer’s disease. In a few cases, dementia is reversible if the cause is quickly detected and treated (thyroid causes or vitamin deficiencies) but Alzheimer’s is irreversible. 7

HOW DO YOU KNOW YOU HAVE ALZHEIMER’S DISEASE? 8

SIGNS AND SYMPTOMS OF ALZHEIMER'S DISEASE: Since Alzheimer’s disease is progressive, the symptoms diagnosed in early onset get worse as the individual ages.  Difficulty in taking in and remembering new information.  Impairments to reasoning, complex tasking and exercising judgment.  Impaired visuospatial abilities.  Impaired speaking, reading and writing.  Changes in personality and behavior e.g. loss of empathy and social withdrawal. 9

BRAIN ABNORMALITIES: 10

RISK FACTORS: Risk factors can generally be divided into two: unavoidable and potentially avoidable factors  Unavoidable factors Age : incidence is higher in older people than younger ones. Higher percentage in 85y and above than 65yrs and above. Family history: family history and inheritance of genes. Possession of the Apolipoprotein E gene or APOE increases the risk of Alzheimer's. Females are at risk of Alzheimer's compared to males. Children with Down’s syndrome are prone to early-onset Alzheimer’s. 11

RISK FACTORS:  Potentially avoidable factors Factors that cause increase in blood vessel e.g. hypertension and high cholesterol can lead to stroke (which can lead to another type of dementia). Prior head injury: traumatic brain injury can increase the risk for Alzheimer's. Chronic alcoholism 12

DIAGNOSIS OF ALZHEIMER'S 13

DIAGNOSIS OF ALZHEIMER'S  Alzheimer’s is positively diagnosed by viewing the brain tissue of a patient under a microscope after death (autopsy) :  Autopsy shows the build up of a protein called beta amyloid (amyloid plaques) found in between the dying cells causing a plaque formation.  Also, the disintegration of another protein called tau leads to tangles of the neurons. 14

DIAGNOSIS OF ALZHEIMER'S  Diagnosis of Alzheimer’s disease in a living patient involves the narrowing down of the possible diseases (differential diagnoses) by a physician to arrive at Alzheimer’s  Doctors can: take patient’s history check neurological function e.g. senses and reflexes performing brain scans like CT-scan and MRI carrying out blood and urine tests asking cognitive questions 15

DIAGNOSIS OF ALZHEIMER'S 16  Image showing the build up of amyloid plaques around on the neuron (white-coloured plaques).

TREATMENT OR MANAGEMENT:  Since Alzheimer’s cannot be treated the symptoms associated with it are rather managed e.g. by adult daycare programs  Drug therapy can also be adopted to manage the symptoms and improve the quality of life of the patient. Drugs like: o Donepezil (brand name Aricept) o Alantamine (Reminyl) o Rivastigmine (Exelon) o Tacrine (Cognex). 17

PREVENTION Decreasing the risk of Alzheimer’s by reducing the risk of cerebrovascular diseases like stroke. Stop smoking. Reduced alcohol consumption. Eating a healthy balanced diet. Constant monitoring of blood pressure. 18

REFERENCES Encarta premium

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