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Alzheimer's Disease

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alzheimer's disease

on 7 May 2013

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Transcript of Alzheimer's Disease

What are the causes of Alzheimer's? How is Alzheimer's diagnosed? How is Alzheimer's
treated? Can Alzheimer's be prevented? What is Alzheimer's? Alzheimer's Disease What is the cost of Alzheimer's disease to the NHS and society? Genes

66,697 for 40 months

Targeting risk factors may help delay onset and progression

- Cognitive and physical inactivity
- Malnourishment
- Smoking
- Midlife hypertension and obesity Distribution of dementia service cost Lack antioxidants and homocysteine lowering vitamins

Increased homocysteine levels are associated with the shrinkage of the hippocampus

Results in memory loss Nausea, headache, insomnia
(cholinesterase inhibitors)

Dizziness, constipation
(NMDA antagonist) Age Free radicals build up and react with proteins (process of aging)

Some of this damage has been linked to brains of AD patients Head Trauma Some brain injuries can lead to a deterioration of cells - Dementia Pugilistica

Similarity in symptoms

Often identical clinical presentation Phase 2 of clinical trials

Target copper and zinc ions in the brain, which drive the formation of plaques

Shown positive results - cognitive function appears to have improved over 12 weeks

Still being tested in larger clinical trials Uses electromagnetic stimulation of various parts of the brain

Non-invasive method

Reverse the symptoms of Alzheimer's Expected to undertake a defence mechanism to clear the plaques

Instead, there is a decrease in biological function - motility and ability to eliminate destructive material are lost

Still under researched Loss of productivity
- 690 million

Other social problems Treatment and care services

More likely to be hospitalised
longer

Aging society - more people are being diagnosed with Alzheimer's disease Direct Cost Indirect Cost What current research is
being carried out? Made using a series of criteria

Detailed history and examinations are of paramount importance

Other causes of cognition loss should be ruled out

Definite diagnosis cannot be made until after death

Mini-mental state examination
(MMSE) CSF biomarkers are measured MRI and FDG-PET scans can show degeneration of the brain "A chronic or persistent disorder
of the mental processes caused by
brain disease ...marked by memory disorders, personality changes and
impaired reasoning."
Alois Alzheimer (1907) Begins due to an accumulation of an insoluble fibrous protein called Beta-amyloid

Conformational changes make Beta-amyloid into large fibril structures, resulting in amyloid plaques

These plaques accumulate in the cortex, causing neurofibrillary tangles

This causes abnormal nutrient transportation, resulting in neuronal death Amyloid plaque surrounded by neurofibrillary tangles These plaques cause brain cell necrosis, leading to the atrophy of the frontal, parietal and temporal lobes

Abnormal neuroglia activation occurs, promoting inflammatory reactions in the brain that further disease progression Adapted from www.dementiaguide.com Pathophysiology 1 Pathophysiology 2 Free radical theory of aging:
Oxidative stress Environmental One monozygotic twin may develop AD; one may not

Some causation is environmental Vascular Disease Share many of the same risk factors

Eg.: High blood pressure
Diabetes
Hypertension
Heart disease
Current smoking Diagnosis Imaging Cholinesterase inhibitors
Memantine (Ebixa)

Block excessive amounts of glutamate from damaging brain cells NMDA receptor antagonists
Ronepezil hydrochloride (Aricept) Rivastagmine (Exelon)
Galantamine (Reminyl)

Inhibit cholinesterase from breaking down acetylcholine in brain Side effects Malnutrition Drugs PBT2 NeuroAD Microglia
Average total cost Questions? Cognitive and physical activity Staying physically fit - helps prevent other risk factors such as vascular disease

Staying mentally active - people that have been in life long education are less likely to develop Alzheimer's disease

Staying mentally active - Biomarkers are often less predictive in these patients
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