Progressive, degenerative disorder Attacks the brain's neurons Results in loss of memory, thinking and language skills, and behavioral changes Confusion over time and place

 Early Onset Familial Alzheimer's Disease (FAD) genetic link Age 30 to 60  Late Onset Diagnosed when a person has cognitive decline Genetic link suspected  Emerging evidence epigenetic mechanisms contribute to Alzheimer's disease ~NIH 2012

1. Educate yourself about the disease 2. Learn caregiving techniques. 3. Understand the experience of your loved one 4. Avoid caregiver burnout 5. Maintain your own physical and mental health. 6. Discuss the situation with family and friends. 7. Do cognitive stimulation activities with your loved one. 8. Foster communication with physicians 9. Take care of financial, legal and long-term care planning issue 10. Smile 11. Think positive 12. Reach out for care.

1.Increasing forgetfulness and mild confusion. 2.Inability to speak and write coherently 3.Impaired judgment and problem solving ~Mayo 2012

Evidence indicates  Use the sense of smell to determine if someone may get Alzheimer’s disease  Use changes in sense of smell to begin treatments, instead of waiting until someone has issues learning and remembering  Determine if therapies are working The Journal of Neuroscience, Nov. 2, 2011 Case Western Reserve Medical School

 Starts in the olfactory – loss of smell one of the first signs  Short-term memory fails when Alzheimer's disease first destroys nerve cells in the hippocampus  Language skills and judgment decline when neurons die in the cerebral cortex

Atrophy and clinical stage of AD. Coronal three-dimensional T1-weighted volume MR images (repetition time msec/echo time msec/inversion time msec, 7/900/2.8/900) in three individuals in their 70s are shown. Jack C R Radiology 2012;263: ©2012 by Radiological Society of North America

cross-section of the brain as seen from the front

 1906  Dr. Alois Alzheimer, German physician  Presented a case history of a 51-year-old woman who suffered from mental illness  He identified through autopsy plaques and tangles in her brain

These plaques and tangles characterize Alzheimer's Disease

Plaques and tangles. Jack C R Radiology 2012;263: ©2012 by Radiological Society of North America

Integral membrane protein concentrated in the synapses of neurons. Its primary function is not known, though it has been implicated as a regulator of synapse formation, neural plasticity and iron export

Mu YMu Y, Gage FH. Mol Neurodegener. 2011; 6: 85Gage FHMol Neurodegener. 2011; 6: 85 PMID PMID

Main component of deposits found in the brains of patients with Alzheimer's disease

Stabilizes microtubules

Reddy 2011 hyperphosphorylation of tau

In Alzheimer travels down the microtubule and tangles

reddy

Hypothetical model of the dynamic biomarkers of the AD cascade. Jack C R Radiology 2012;263: ©2012 by Radiological Society of North America

Reddy

Nothing prevents Some interventions don’t hurt  Coffee  Aspirin April 28, 2010 by NIH

 Anti –inflammatory Properties  Aged mice bred to develop symptoms of Alzheimer's Given caffeine - the equivalent of 5 cups of coffee/day Memory impairment was reversed University of South Florida Florida Alzheimer's Disease Research Centre 2009  Aspirin? Doesn’t hurt? Increases the risk of serious bleeding

 Jan Dubinsky, PhD  Alzheimer Foundation  Mayo Clinic  NIH  University of Minnesota  Dr. Ravinder Reddy  Dr. Clifford Jack