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Alzheimer's Disease

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brittany watters

on 26 November 2013

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Transcript of Alzheimer's Disease

Alzheimer's Disease
By: Brittany, Shelby and Breanne
What is Alzheimer's?
Neurological disorder that affects the brain
Incurable, degenerative and possibly terminal disease
Most common form of dementia
Described as 'loss of the ability to think'
Usually worsen over 5 to 20 years
More prevalent in older people
Diagnosis
A brain autopsy of the deceased patient is the only way to get a definitive diagnosis of Alzheimer's - the brain would posses microscopic abnormalities
Without a brain autopsy it is still possible to diagnose Alzheimers correctly based on mental and behavioral symptoms, a physical examination, neuropsychological tests and laboratory tests
General
Cell
Biology

Cause
The exact cause is not known
Some people have genes that put them at higher risk
It is usually purely due to genetics for people who get the disease when they are 40 or 50
In people who get it at 60 or older, genetics might play a role but there are usually other factors
Such as: type 2 diabetes, heart disease or high blood pressure
Symptoms
Stock Photo - Reminder Sticky Notes on a stainless steel refrigerator. (n.d.). 123RF Stock
Photos. Retrieved October 23, 2013, from http://www.123rf.com/photo_7890252_reminder-sticky-notes-on-a-stainless-steel-refrigerator.html
How To Stop Paying Your Bills Late And Start Paying Your Bills On Time.
(n.d.). Personal Finance. Retrieved October 23, 2013, from http://personal-finance.thefuntimesguide.com/2008/05/tips_for_paying_bills_on_time.php
Nullification Confusion. (n.d.). <i>Tenth Amendment
Center</i>. Retrieved October 23, 2013, from http://tenthamendmentcenter.com/2013/09/03/nullification-confusion/
Memory
Memory loss is the most common sign of Alzheimer's
Recently learned information is forgotten
For example: dates, events, names
Tend to repeat questions
Relying on memory aids and other people
For example: sticky notes, electronic devices
Difficulty problem solving and planning
Change in their ability to develop or follow a plan
Difficulties working with numbers
Following a recipe or keeping track of monthly bills
Difficulty concentrating
Taking longer to do simple tasks
Confusion
Lose track of dates, seasons and passage of time
Trouble understanding immediate situations
May forget where they are and how they got there
Problems with words, speaking and writing
Troubles following a conversation
Stopping midway through sentences and not be able to finish
Very repetitive
Calling things and people by the wrong names
Struggle with vocabulary or finding the proper words
They may start to remove themselves from hobbies, social activities, work projects or sports
Forgetting how to play sports or accomplish usual hobbies
Avoid social gatherings
Feeling iffy about work, family and social obligations
Nerve Cell
Mitochondrion Theory:
Visual Impairment
Vision problems
Difficulty reading, judging distance and determining color and contrast
Perception is distorted
Confusion with peripheral vision
Changes in old age. (n.d.). Health Insurance India, Medical Health Insurance India, Mediclaim Policy India. Retrieved November 4, 2013, from http://www.medimanage.com/my-parents-health/articles/Changes-in-old-age.aspx
Microsoft can't talk about Live's status. (n.d.). <i>Joystiq</i>. Retrieved November 4, 2013, from http://www.joystiq.com/2008/01/14/microsoft-cant-talk-about-lives-status/
Withdrawals from daily activities
Emotions and Aftermaths. (n.d.). <i>Emotions and Aftermaths</i>. Retrieved November 4, 2013, from http://koushikblogs.blogspot.ca/2012/11/being-loner.html
Treatment
There is no real cure for Alzheimer's yet
Treatments are being developed to slow or stop the progression of the disease
Medications can maintain thinking, speaking and memory skills
Only 5 known drugs have been approved
Medications work best when started early since most patients live 4 to 7 years from diagnosis to death
Alzheimer's occurs because brain cells are slowly dying
Leads to disease because as the cells die parts of the brain shrink and stop working
Brain
3 main signs
Amyloid plaques
: material build up between brain cells (neurons)
Tangles
: build up of proteins inside brain cells
Loss of synapses
: connections between brain cells
Dawn On The Horizon. (n.d.). A fresh approach to dementia care. Retrieved
November 8, 2013, from http://www.dawnonthehorizon.com/learningcenter.html
Amyloid Plaques & Neurofibrillary Tangles. (n.d.). <i>Amyloid Plaques &
Neurofibrillary Tangles</i>. Retrieved November 8, 2013, from http://www.brightfocus.org/alzheimers/about/understanding/plaques-and-tangles.html
Genes Involved in Alzheimer's
Amyloid-Beta precursor protein gene (APP gene)
APP gene initiates the making of the protein called amyloid precursor protein
The protein is found in the brain and spinal cord
Found on chromosome 21 at position 21.3

From base pair 27,252,860 to base pair 27,243,445
APP gene
Mutation to APP gene
Over 50 mutations to APP gene can lead to early onset Alzheimer's
The most common mutation:
Mutation to the amino acid chain in the amyloid precursor protein replacing valine with isoleucine at position 717
Isoleucine makes longer and stickier peptide chains
When released they form clumps called amyloid plaques which build up in the brain
Build up of toxic AB peptides and amyloid plaques leads to death of the neuron
Fisioterapeuta Brasão Gouveia. (n.d.). : Demencia Alzheimer. Retrieved November 8, 2013, from http://
fisiobrasaogouveia.blogspot.ca/2011/05/demencia-alzheimer.html
The nerve cell is composed of 3 parts:
Dendrite
: Receives information and relays it to the cell body
Cell body
: coordinates information processing
Axon
: sends information to other neurons, muscles or glands
How exactly do neurons pass signals through your nervous system?. (n.d.). io9. Retrieved November 8, 2013, from http://io9.com/5877531/how-exactly-do-neurons-pass-signals-through-your-nervous-system
Where the mitochondria and the ER touch is called the mitochondria associated membranes (MAM)
Inside the MAM:
Amyloid precursor protein is made which plays a role in plaque formation in neurons
Location of cholesterol and phospholipid metabolism - as obesity is a risk factor of Alzheimer's
Amyloid Positron Emission Tomography (PET) Imaging
Helps with the diagnosis of Alzheimer's disease
Candidates:
People who are under the age of 65
People who demonstrate impairment on cognitive tests such as MMSE
People with progressive dementia
Primary Research Article
"Four Components Describe Behavioral Symptoms in 1,120 Individuals With Late-Onset Alzheimer's Disease"
Objective

To investigate behavior of Alzheimer's disease
To analyze the behavior of different Alzheimer's patients to link disease severity with factors such as;
Apolipoprotein E genotype (APOE)
Gender
Years of education
Age at onset
Mental impairment

Design
They performed a cross-sectional analysis

A type of study that involves observing a chosen group of people at one time without manipulating the environment
Setting
Data was collected from community residents and those living in nursing homes
Participants

1,120 individuals were chosen
In order to be chosen they must meet the "National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer’s Disease and Related Disorders Association Criteria" for late-onset probable AD.
Measurements
Behavioural symptoms were assessed using the Neuropsychiatric Inventory
Neuropsychiatric Inventory
(NPI): a questionnaire that assesses changes in behavioral and psychological instabilities in a patient diagnosed with dementia
The impact of these symptoms on the caregiver is also evaluated
The correlations of the
disease severity
and the
estimated scores
were analyzed
Results
Based on four components:
1. The inability to control ones
behaviour
:
• euphoria
• lack of inhibition
• aberrant motor behavior
• disruption of sleep and appetite
2.
Psychosis
:
• delusions
• hallucinations
3.
Mood
:
• Depression
• Anxiety
• Apathy
4.
Agitation
:
aggression
irritability

Conclusion
Future analysis of these components will strengthen understanding of the underlying pathology of behavioral symptoms and Alzheimer’s disease

Alzheimer's Disease Pathogenesis - Steven G. Younkin. (n.d.). <i>Overview</i>.
Retrieved November 8, 2013, from http://www.mayo.edu/research/labs/alzheimers-disease-pathogenesis/overview
Stem Cell Therapy
The New York Stem Cell Foundation Research Institute was able to make the forebrain neurons involved in Alzheimer's disease by using patients stem cells
They found that cells mature, get sick and die off, just like the would in a patient
This allows them to see what goes wrong at a cellular level in Alzheimer's disease
How they did it
They took patients stem cells
They reverted the cells back to their embryonic state
Now these cells can be turned into any desired cell
They can use these cells to make healthy neurons
Citations
Hollingworth, P., Hamshere, M., Moskvina, V., Dowzell, K., Moore, P., Foy, C., & Williams, J. (2006). Four components describe
behavioral symptoms in 1,120 individuals with late-onset Alzheimer's disease. Journal Of The American Geriatrics Society, 54(9), 1348-1354. doi:10.1111/j.1532-5415.2006.00854.x

The New York Stem Cell Foundation. (n.d.). Alzheimer's Disease. Retrieved November 15, 2013, from http://www.nyscf.org/
alzheimers-disease

Shan, Y. (2013). Treatment of Alzheimer's disease. Primary Health Care, 23(6), 32-38.

Memory Loss & 10 Early Signs of Alzheimer's | Alzheimer's Association. Retrieved November 8, 2013, from http://www.alz.org/
alzheimers_disease_10_signs_of_alzheimers.asp

Genetics Home Reference. Retrieved November 8, 2013, from http://ghr.nlm.nih.gov/gene/APP



Glaucoma
Increased pressure in the eye
It is the leading cause of blindness
Is a commons sign of Alzheimer's
Blue areas indicate reduced brain activity
due to shrinkage of the brain
Does anyone know what cell is affected by Alzheimer's?
Neuron
This is a picture of a
healthy normal neuron
The neuron when Alzheimer's is present
Loss of hippocampal and cerebrocortical neurons
These neurons are responsiable for memory, thoughts, attention, language and consciousness
What happens to neurons when Alzheimer's is present?

A build up of a protein called amyloid-beta (AB) peptides forms plaques in the extracellular space
The AB peptide is a major factor in characterizing Alzheimer's disease
Neurofibrillary tangles build up inside the neuron
Amyloid Plaques & Neurofibrillary Tangles. (n.d.).
<i>Amyloid Plaques &
Neurofibrillary Tangles</i>. Retrieved November 8, 2013, from http://www.brightfocus.org/alzheimers/about/understanding/plaques-and-tangles.html
Neurofibrillary tangles
inside the neuron
Amyloid plaques in the extracellular space, made of Amyloid-Beta peptide
Shrinkage of the brain
due to dying neurons, leads to loss of language and memory
Possibility of the mitochondria being involved in Alzheimer's?
APP gene
A recent finding, that may help find a treatment for Alzheimer's
Did you know....

That 36 million people in the world are living with Alzheimer's Disease

More women have Alzheimer's than men
Normal
Alpha-secretase snips APP releasing one fragment followed by a gamma-secretase snips APP in another place releasing a seperate fragment
Alpha-secretase is replaced by another enzyme such as beta-secretase followed by gamma-secretase producing short fragments of amyloid-beta (AB) peptide
These AB peptide fragments clump together to form toxic plaques
Alzheimer's
Formation of Tangles
Protein Tau stabilizes structures critical for internal transport system, such as microtubules, inside the neuron
Formation of Plaques
Abnormal Tau separates from microtubules causing them to fall apart
Stands of the Tau that fell off the microtubules come together to form tangles
Normal
Alzheimer's
If no cure is found by 2030 there will be 66 million people living with Alzheimer's and by 2050 there 115 million people
Every 33 seconds someone is diagnosed with Alzheimer's in the world
By the end of 2013, Alzheimer's will have cost America $203 billion. If no treatment is found by 2050 it is expected to cost $1.2 trillion
There are 5 times as many people living with Alzheimer's than HIV
"Latest Facts & Figures Report | Alzheimer's Association." Latest Facts &
Figures Report | Alzheimer's Association. N.p., n.d. Web. 21 Nov. 2013. <http://www.alz.org/alzheimers_disease_facts_and_figures.asp>.
The scores of these components were linked to severity of cognitive impairment
Higher behavioral dysfunction, agitation, and mood component scores were associated with lower age at onset
Behavioral dysfunction and mood component scores were associated with sex
None of the components were associated with age at assessment, years of education, or number of APOE e4 alleles.
Cont..
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