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ALZHEIMER

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Nwakwu Chizuam

on 22 April 2015

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Transcript of ALZHEIMER

Content

What is Alzheimer's disease?
History
Prevalence of disease
Risk factors
The causes
Mechanisms
Stages
Symptoms
Prevention
Psychosocial aspects



What is Alzheimer's disease?

Alzheimer's disease is a progressive, degenerative disorder that attacks the brain's nerve cells or neurons. This results in loss of memory, thinking, language skills, and behavioral changes.
History
• Alois Alzheimer when, in November 1907, reported – an unusual illness of the cerebral cortex.
Genetic causes
Alzheimer's Disease
• His paper gives a brief description of the clinical history in a case of dementia with onset at age 51 and the unique pathological findings of plaques and tangles.
• The failure to pay much attention to this hallmark paper continued for a further seven decades.
Prevalence
Stage 1: No impairment (normal function)

Stages
Stage 2: Very mild cognitive decline (may be normal age-related changes or earliest signs of Alzheimer's disease)
Stage 3: Mild cognitive decline (early-stage Alzheimer's can be diagnosed in some, but not all, individuals with these symptoms)
Stage 4: Moderate cognitive decline (mild or early-stage Alzheimer's disease)
Stage 5: Moderately severe cognitive decline (moderate or mid-stage Alzheimer's disease)
Stage 6: Severe cognitive decline (moderately severe or mid-stage Alzheimer's disease)
Stage 7: Very severe cognitive decline (severe or late-stage Alzheimer's disease)
Early-onset (less than 60 years) of
familial AD

Mutations in the genes coding for:
Amyloid precursor protein (APP) on chromosome 21
Presenilin 1 (PSEN1)
on chromosome 14
Presenilin 2 (PSEN2)
on chromosome 1 
Late-onset or sporadic AD
The ϵ4 allele of the gene is the only polymorphism consistently found associated with LOAD
It has three major alleles (ϵ2, ϵ3, and ϵ4). The ϵ4 allele is a major risk for developing AD, while the ϵ2 allele confers protection.
Not everyone who has one or two APOE ϵ4 genes develops the disease.
Apolipoprotein E (APOE) gene
Neuropathologic causes
Amyloid plaques
Neurofibrillary tangles
Amyloid angiopathy
Diffuse loss of neurons and synapses in the neocortex, hippocampus, and other subcortical regions of the brain.
Plaques
Tangles
Risk factors
Genetic risks
Early onset
Late onset

Acquired risk factors
• Hypertension
• Lifestyle and physical inactivity
• Brain Trauma
• Hypercholesterolemia and vascular risk factor

Aging

Aging is the single most important risk factor for Alzheimer's disease (AD).
There is an increase prevalence of AD due to the increase in the human life span.

Symptoms of Alzheimer's disease
Memory loss
Challenges in planning or solving problems
Difficulty completing familiar tasks at home, at work or at leisure
New problems with words in speaking or writing
Misplacing things and losing the ability to retrace steps


Decreased or poor judgment
Withdrawal from work or social activities
Changes in mood and personality
Confusion with time or place
Trouble understanding visual images and spatial relationships

Prevention
Right now, there is no proven way to prevent Alzheimer’s disease. Research into prevention strategies is ongoing.
Regular exercise
Healthy diet
Mental stimulation
Quality sleep
Stress management
An active social life

However, lifestyle choices can protect your brain. The six pillars of a brain-healthy lifestyle are:

New programs targeted to people at high risk of the disease are being developed. These multicomponent programs encourage physical activity, cognitive stimulation, social engagement and a healthy diet.
They also teach memory compensation strategies that help optimise daily function even if brain changes progress. Keeping active — physically, mentally and socially — may make your life more enjoyable and may also help reduce the risk of Alzheimer's disease.
Psychosocial Aspects
The term behavioral and psychological disturbances refers to a syndrome or a pattern associated with subjective distress, functional disability, or impaired interactions with others or the environment.
Depression, psychosis, agitation...
Non aggressive
- physical (wandering)
- verbal (screaming)
Aggressive
- physical (hitting)
- verbal (cursing)
Social Challenges
Most Alzheimer patients depend on their family and natural support system for their intensive care. Caregiving for Alzheimer's patients is very taxing and exhausting.
The caregiver faces:
Lack of time for self
Social isolation
Unrelieved heavy physical labor in caregiving
Career interruption

Impact on family and friends
Guilt
— guilty for the way the person with dementia was treated in the past.
Grief and loss

— grief is a response to loss. If someone close develops dementia, we are faced with the loss of the person we used to know and the loss of a relationship.
Anger
— it is natural to feel frustrated and angry —angry at having to be a caregiver, angry with others who do not seem to be helping out, angry at the person with dementia
The decade between 1982 to 1992 was a ground breaking era for unreveling the misteries of AD.
Up to then, age was the only known risk factor. Below the age of 65, AD was found to be rare.
There was no explanation then, nor is there now , as to why
age
is so critical .
References

Jinnah University for Women
Alzheimer A. About a peculiar disease of the cerebral cortex (1907 article translated by Jarvik L, Greeson H).
Kumar, Vinay, Abul K. Abbas, Nelson Fausto, Stanley L. Robbins, and Ramzi S. Cotran. Robbins and Cotran Pathologic Basis of Disease. Philadelphia: Elsevier Saunders, 2005. Print.
http://www.cbsnews.com/news/new-clue-what-causes-alzheimers-disease/
http://www.webmd.com/alzheimers/guide/understanding-alzheimers-disease-basics

http://www.alz.org/facts/overview.asp
http://www.uptodate.com/contents/epidemiology-pathology-and-pathogenesis-of-alzheimer-disease?source=search_result&search=alzheimers+risk+factors&selectedTitle=1%7E150
http://accessmedicine.mhmedical.com/content.aspx?sectionid=41587679&bookid=371&jumpsectionID=41593841&Resultclick=2
Changes in the brain
Formation of plaques and tangles
Death of neurons (loss of cells)
Shrinkage
Formed when specific proteins in the neuron's cell membrane are processed differently.
Normally the enzyme Alpha secretase and Gamma secretase split APP.
In Alzheimer's, Alpha secretase is replaced by Beta secretase leading to release of shorter fragments of APP (beta-amyloid).
Clumps of beta-amyloid form plaque.
Block cell-to-cell signaling at synapses.
May also activate immune system cells that trigger inflammation and scavenge disabled cells.
The neuron transport system is organized in orderly parallel strands of microtubules
A protein called Tau helps the tracks stay straight and stabilize structures critical to the internal transport system.
In Alzheimer's disease, abnormal Tau separate from microtubules, causing them to disintegrate.
Strands of Tau combine to form tangles inside the neurons disabling the neuron transport system.
Shrinkage
Death of cells (neurons)
Loss of tissue and brain mass
Widening of sulcus and narrowing of gyrus
Shrinkage of the hippocampus
Enlargement of the ventricles
Progression through the brain
Earliest 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.
It can even occur without the APOE ϵ4 gene, suggesting that the APOE ϵ4 gene affects risk but is not a cause
Group 1
2014M001 - Sarfunissa Aisha
2014M002 - Ummu Salma
2014M003 - Mariam Hassan
2014M004 - Aisha Sani
2014M005 - Afnan Saleh
2014M006 - Zainab Ahmad Sani
2014M007 - Saamer
2014M008 - Varsha Raja
2014M009 - Saniya Jumani
2014M010 - Nwakwu Chizuam
2014M011 - Sara Jamal Alaali
2014M012 - Tandis Rastegar

"Fighting to Remember!"
THE BRAIN
Cerebrum
Cerebellum
Limbic System (hippocampus)
The neuron forest
Mechanism
Full transcript