1. Alzheimer’s disease & dementia
Psychology:
Alzheimer’s disease & dementia

2. Alzheimer’s disease & dementia
is a loss of mental functions that is severe enough to interfere with a person’s daily functioning
the loss of mental functions:
thinking
memory
reasoning
Change may also occur in:
Personality
Mood
Behavior

3. Alzheimer’s disease continued…
Dementia
is not a disease itself but rather a group of symptoms that go along with several different diseases or conditions
is irreversible when caused by disease, or injury, but “might” be reversible when caused by:
drugs, alcohol, hormone, vitamin imbalances, or depression

4. Alzheimer’s disease continued…
Dementia
Develops when the parts of the brain that are involved with learning, memory, decision-making, and language are affected by various infections of diseases
(the decline of intellectual functioning is not as wide spread as most people believe and it is not a normal part of aging but is in fact caused by disease)

5. Alzheimer’s disease continued…
Dementia cont…
old age dementia is not inevitable
in most cases, declines in intellectual functioning do not significantly impair people’s lives as they age
Most people retain the bulk of their mental abilities throughout their lives

6. Alzheimer’s disease continued…
Dementia cont…
some people do develop dementia in late adulthood
The most common cause of dementia is Alzheimer’s disease
Alzheimer’s disease is a degenerative brain disease and is NOT a normal part of aging

7. Alzheimer’s disease continued…
Other causes of dementia
There can be many causes of dementia other than Alzheimer’s disease
Example: vascular dementia- is caused by blood-flow-related problems
There are at least 51 different causes of dementia

8. Alzheimer’s disease continued…
Other causes of dementia continued…
Alzheimer’s, Parkinson’s and Huntington’s are degenerative neurological diseases in which neurons in the brain are being attacked by the disease
Huntington’s is caused by a single abnormal gene
It is a genetically inherited disease
Middle-aged people can have Huntington’s and Parkinson’s
Alzheimer’s is found among the elderly
In all of these diseases, the brain is slowly disintegrating

9. Alzheimer’s disease continued…
What is a stroke?
Example: multiple-infarct dementia is also caused by blood-flow-related problems
multiple-infarct dementia is caused by multiple strokes in the brain
A stroke is a serious medical condition that occurs if the brain does not receive an adequate supply of blood

10. Alzheimer’s disease continued…
What is a stroke? CONT…
the constant circulation of blood through the brain provides it with oxygen and nutrients
Permanent damage can occur if the brain lacks enough oxygen for 3 to 10 minutes
Strokes can be caused by blood clots, cerebral hemorrhages (bleeding in the brain), and other causes.
Strokes can cause dementia

11. Alzheimer’s disease continued…
Stroke symptoms
dizziness
tingling sensations in the skin (fingers, toes, arms, legs)
weakness or exhaustion
slurred speech
visual problems in one eye

13. Alzheimer’s disease continued…
This is a brain image from a 45 year-old woman who noticed the sudden onset of right body weakness and trouble speaking.
Stroke occurred on left side of the brain which caused right body weakness.
The Broca’s area was affected by the stroke since she was having trouble speaking.

14. Alzheimer’s disease continued…
This is a brain image from a fatal stroke
This patient died.

15. Alzheimer’s disease continued…
Other causes of dementia continued…
chronic drug use
prolonged Depression
fluid accumulation in the brain due to:
brain development problems
brain infections
brain injury
brain tumors

16. The discovery of Alzheimer’s disease
Dr. Alois Alzheimer (German neurologist)
Findings:
conducted a postmortem examination of the brain of a 56 year old woman who died after years of progressive mental deterioration and dementia
the examination disclosed that cells in her cerebral cortex were bunched up like a rope tied in knots
cellular debris (waste) had collected around the affected nerves

17. The discovery of Alzheimer’s disease continued….
Dr. Alois Alzheimer findings continued…
these destroyed areas of the brain came to be known plaques and tangles
Tangles are twisted fibers within neurons
Plaques are deposits of proteins and parts of dead cells found between neurons

18. Alzheimer’s disease Alzheimer’s disease
causes 50 to 70 percent of all dementia
Approximately 5.2 million Americans have Alzheimer’s disease
dementia has become even more common among the elderly in recent years

19. Alzheimer’s disease Alzheimer’s disease
Medical authorities estimate that by the year 2050 that 14 million Americans will be affected by Alzheimer’s disease
It is not clear if the “apparent” increased frequency of dementia reflects a greater awareness of the symptoms OR…
if people are living longer and thereby more likely to develop dementia in their older age

20. Alzheimer’s disease Cognitive abilities
as we age, all of us will experience changes in our cognitive abilities
our fluid intelligence begins to decline

21. Adult Cognitive Development
Fluid Intelligence
ones ability to reason speedily and abstractly
tends to decrease during late adulthood

22. Adult Cognitive Development
Fluid Intelligence declines
older people typically require more time to solve problems
they have greater difficulty with tasks that involve pattern recognition such as piecing together jigsaw puzzles
older people have more difficulty remembering new information such as people’s names

23. Adult Cognitive Development
Crystallized Intelligence
one’s accumulated knowledge and verbal skills
tends to increase with age
for instance, one’s vocabulary grows over the years as well as general knowledge and information

24. Adult Cognitive Development
Crystallized Intelligence cont…
one’s accumulated knowledge and verbal skills
tends to increase with age
for instance, one’s vocabulary grows over the years as well as general knowledge and information

25. Recognizing the symptoms of Alzheimer’s disease
People with mild Alzheimer’s disease may:
have difficulty learning & remembering new information
have difficulty managing their finances, planning meals, or taking medication on schedule
show symptoms of depression (sadness, decreased interest in usual activities, loss of energy)

26. Recognizing the symptoms of Alzheimer’s disease
People with moderate Alzheimer’s disease may:
forget old facts, such as past careers or the names of friends
seem agitated, restless, or anxious
Lack concern for their appearance, hygiene, or sleep

27. Recognizing the symptoms of Alzheimer’s disease
People with severe Alzheimer’s disease may:
refuse to eat
fail to recognize family or other familiar faces
have difficulty with essential activities of daily living, including toileting & walking

28. Alzheimer’s: neurotransmitters

29. Alzheimer’s disease: Brain structures affected
Hippocampus
brain structure located in the limbic system responsible for new learning and memories
damage to the hippocampus results in an inability to form new memories
cholinergic neurons are being destroyed by the Alzheimer’s disease
these neurons produce acetylcholine which is a neurotransmitter involved in new learning and memories

30. Alzheimer’s disease: Brain structures affected
Hippocampus continued…
the hippocampus of Alzheimer’s patients has been found to be smaller than in normal people
even a healthy person experiences a reduction in the size of their hippocampus as they age

31. Alzheimer’s disease: Brain structures affected
Hippocampus continued…
older healthy people, who did not have Alzheimer’s disease, experienced a decrease in volume of their hippocampus by about 4% over a two year period
during that same two year period, Alzheimer’s patients had a decrease in volume of their hippocampus by 10%
a smaller than average hippocampus in the elderly predicts the onset of the disease

32. Alzheimer’s disease: Brain structures affected
Cerebral cortex
outer layer of the brain; the body’s ultimate control and information center

33. Alzheimer’s disease: Brain structures affected
Cerebral cortex
interference with the cerebral cortex causes:
emotional outbursts
disorientation
aimless wandering
becoming lost
decline in judgment, reasoning, & decision-making
ability to recognize faces is lost

34. Alzheimer’s disease: Brain structures affected
Cerebral cortex
Alzheimer’s interferes with everyday tasks performed in this area of the brain such as:
balancing your checkbook
making a telephone call

35. Alzheimer’s disease: Brain structures affected
Ventricles
the chambers within the brain that contain cerebrospinal fluid
Sulcus
the grooves, or furrows, of the brain

36. Alzheimer’s disease & the brain there is an overall shrinkage of brain tissue in the Alzheimer’s brain
Alzheimer’s brain
normal brain

37. Alzheimer’s disease & the ventricles the ventricles, or chambers, within the brain that contain cerebrospinal fluid are noticeably enlarged
Alzheimer’s brain
normal brain

38. Alzheimer’s disease & the sulcus the grooves, or furrows, of the brain called the sulcus are noticeably widened and there is shrinkage of the brain tissue
Alzheimer’s brain
normal brain

39. Alzheimer’s SPECT scan

40. Alzheimer’s SPECT scan

41. Alzheimer’s SPECT scan

42. Alzheimer’s SPECT scan

43. Alzheimer’s disease: medications
Aricept
Tacrine
Exelon
Reminyl
Namenda

44. Alzheimer’s disease: medications
Aricept (acetylcholinesterase inhibitor)
a drug that can provide some relief from the symptoms of early Alzheimer’s disease
temporarily improves brain function in some Alzheimer’s sufferers
does not halt the progression of the underlying neural destruction
works by increasing the neurotransmitter acetylcholine which is used in learning and forming new memories

45. Alzheimer’s disease: medications
Namenda
a drug that can provide some relief from the symptoms of early Alzheimer’s disease
Slows the progression of symptoms
does not halt the progression of the underlying neural destruction
works by increasing the neurotransmitter glutamate which is also involved in memory

46. Alzheimer’s disease: Brain Reorganization
Synaptic Plasticity
The brain has a remarkable property called synaptic plasticity
Synaptic plasticity is the ability to strengthen neural connections at synapses as well as to establish new synapses
However, the brain’s plasticity is severely limited when it comes to repairing damage
Most brain damage leaves the victim permanently disabled in some way

47. Alzheimer’s disease: replacing brain tissue
One approach to helping people recover from brain damage is to replace lost brain tissue with tissue from another brain
Scientists have transplanted, or grafted, tissue from a still-developing fetal brain into the brain of an adult animal of the same species
If the receiving animal does not reject the tissue, the transplanted brain tissue sends axons out into the brain and makes some functional connections

48. Alzheimer’s disease: replacing brain tissue
Replacing brain tissue continued…
This treatment has reversed some animals learning difficulties, movement disorders, and other results of brain damage
The technique has also been used to treat a small number of people with Parkinson’s disease- a disorder characterized by tremors, rigidity of the arms and legs, difficulty in initiating movement, and poor balance

49. Alzheimer’s disease: replacing brain tissue
Replacing brain tissue continued…
The brain tissue transplant procedure is promising, but because its use with humans would require tissue from aborted fetuses, it has generated considerable controversy

50. Alzheimer’s disease: nerve growth factor
Another treatment uses “engineered” cells from rats to produce nerve growth factor- a substance that helps stimulate and guide the growth of newly sprouted axons in the central nervous system
When the “engineered cells” were implanted into the brains of rats with brain damage or disease, the cells secreted nerve growth factor

51. Alzheimer’s disease: nerve growth factor
Nerve growth factor continued…
Based on these animal studies, nerve growth factor- has been infused directly into the brain of a person with Alzheimer’s disease
The results were encouraging, and trials with other patients are in progress

52. Alzheimer’s disease: stem cells
scientists have been studying the formation of new neurons in the brain

53. Alzheimer’s disease: stem cells
the source of these new neurons has been recently been identified as “stem cells” which reside in the lining of the ventricles of the brain
The discovery of these stem cells, which have the ability to develop into many types of cells, including neurons, creates the exciting possibility that degenerative disorders such as Alzheimer’s disease may eventually be cured by actually replacing dying neurons with new neurons

54. Alzheimer’s disease: other possible preventative measures
blueberries (antioxidants may be linked to improved memory)
aspirin/ibuprofen (my decrease the rate of cognitive decline)
vitamin E
vitamin B12
estrogen replacement in women
testosterone replacement in men

55. Long-Term care :
Provision of a safe environment, control of aggressive or agitated behavior, and the ability to meet physiologic needs may require monitoring and assistance in the home or in an institutionalized setting.
This may include in-home care, boarding homes, adult day care, or convalescent homes.

56. Long-Term Treatment:
Family counseling may help in coping with the changes required for home care.
Visiting nurses or aides, volunteer services, homemakers, adult protective services, and other community resources may be helpful in caring for the person with Alzheimer’s disease (AD).