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Alzheimer's Disease

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Travis Fisher

on 25 July 2013

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Transcript of Alzheimer's Disease

Alzheimer's Disease
By Travis Fisher

6th Leading Cause of Death in U.S.
In 2010: 83, 494 U.S. Alzheimer's Deaths (Underlying Cause)
26,488 Deaths from Alzheimer's as Contributing Cause In 2010

Disease Burden:
Estimated 5.4 Million In U.S. With Alzheimer's Disease
Among High Income Countries Alzheimer's and Other Dementia Accounts For 4.4 Million Disability Adjusted Life Years Annually
Cost of Alzheimer's On U.S. Health Care Was Estimated At 200 Billion Dollars For 2012
70% of Those Costs Went To Medicare/Medicaid

Alzheimer's Disease Leads To:
Nerve Cell Death and Tissue Loss
Brain Shrinkage
Continued Build Up of Plaques and Tangles
Early Onset (<65 Years)
Late Onset
Familial AD
Pathophysiology Continued:
Early Stage:
Learning and Memory Abilities Affected
Thinking and Planning Skills Hindered
Changes May Begin 20 Years Prior To Diagnosis
Difficulty To Detect In This Period
Pathophysiology Continued:
Mild To Moderate Stage:
Plaques and Tangles Move To Speech and Understanding Brain Areas
Motor Coordination Skills Affected
Significant Change In Behavior
Stage Generally Lasts From 2 To 10 Years
Pathophysiology Continued:
Severe Stage:
Dramatic Brain Shrinkage
Widespread Cell Death
Loss Of Communication And Recognition Skills
Unable To Care For Self
Stage Generally Lasts From 1 To 5 Years
Descriptive Epidemiology:
2000-2010: 38.7% Increase In Age-Adjusted Death Rate For AD
In 2000 U.S.Age-Adjusted Death Rate Was 18.1 For AD
In 2010 It Increased To 25.1
Continued Increase In Mortality Rate While Other Major Causes For Death Decrease
Risk Factors:
Descriptive Epidemiology:
In 2010: Women Had A 30% Greater Mortality Rate Than Males
When Looking At Racial Differences, Non-Hispanic White Women Have The Highest Mortality Rates From Alzheimer's Disease
Amongst Males, Non-Hispanic Whites Have Highest Mortality Rates
Descriptive Epidemiology:
Age Adjusted Death Rates
Wide Variation Across The States
No Clear Pattern
Risk Factors:
Familial History
Those With An Immediate Family Member With Alzheimer's At Greater Risk
More Than One Family Member With AD Increases Risk
When Disease Runs In Family, Genetics And/Or Environment Can Be Factors
Risk Factors:
Risk Genes
Increase The Likelihood
Deterministic Genes
Directly Results In AD
Also Referred To As Familial AD
Accounts For Less Than 5% Of AD Cases
Risk Factors:
Vascular Risk Factors:
Blood Pressure
Low Diastolic Pressure Associated With A Multiadjusted Hazard Ratio Of 2.16 For AD, (Chenxuan et al., 2009)
Systolic Pressure Did Not Show A Significant Association In The Chenxuan et al. Study
Type 2 Diabetes Has Been Believed To Have An Association With Late Onset AD
A Hazard Ratio Of 2.04 (95% CI) According To Reitz And Colleagues, (Reitz et al., 2010)
Other Studies Have Found Risk Ratios From 1.20 To 1.90 For Dementia Association, (Lu et al., 2009).
Hypertension Showed A HR Of 1.41(95% CI) In The Reitz et al. Study
Burden Will Increase With Aging Population
Improved Genetic Testing Investigations Needed
Preventive Screenings In Early To Midlife Stages Couple With Vascular Disease Prevention Behaviors May Decrease AD Rates
Aging Process
APOE-e4 genome
Familial AD In Family
Vascular Risk Factors
Low Diastolic Blood Pressure
Type 2 Diabetes
Elevated Hypertension
Brain Injury
Alzheimer's Disease
High Risk Populations
Older Adults
Family History Of AD
High Income Status
Cognitive Abilities Impaired
Brain Cell Death
Brain Shrinkage
Loss In Ability To Communicate And Care For Self
Financial And Emotional Burden On Caretakers
Centers for Disease Control and Prevention, (2013). National Center for Health Statistics Brief. Retrieved from: www.cdc.gov/nchs/data/databriefs/db116.pdf

Chengxuan, Q., Winblad, B., & Fratiglioni, L. (2009). Low Diastolic Pressure and Risk of Dementia in Very Old People: A Longitudinal Study. Dementia & Geriatric Cognitive Disorders, 28(3), 213-219. doi:10.1159/000236913

European Commission, (2013). European Month of the Brain. Image Retrieved from:

Ferraz Alves, T., Ferreira, L., Wajngarten, M., & Busatto, G. F. (2010). Cardiac Disorders as Risk Factors for Alzheimer's Disease. Journal Of Alzheimer's Disease, 20(3), 749-763. doi:10.3233/JAD-2010-091561

Knopman DS, Mosley TH, Catellier DJ, Coker LH (2009)
Fourteen-year longitudinal study of vascular risk factors,
APOE genotype, and cognition: the ARIC MRI Study.
Alzheimers Dement 5, 207-214.

Lu, F. P., Lin, K. P., & Kuo, H. K. (2009). Diabetes and the risk of multi-system aging phenotypes: A systematic review and meta-analysis. PLoS One, 4. doi:10.1371/journal.pone.0004144

National Center for Health Statistics, (2010). National Vital Statistics System. Multiple cause-of-death files. Available from: http://www.cdc.gov/nchs/data_access/Vitalstatsonline.htm

Reitz C, Tang MX, Schupf N, Manly JJ, Mayeux R, Luchsinger JA. A summary risk score for the prediction of Alzheimer disease in elderly persons. Archives of Neurology. 2010;67:835–841. doi: 10.1001/archneurol.2010.136

Rye, P. D., Booij, B., Grave, G., Lindahl, T., Kristiansen, L., Andersen, H., & ... Lönneborg, A. (2011). A Novel Blood Test for the Early Detection of Alzheimer's Disease. Journal Of Alzheimer's Disease, 23(1), 121-129. doi:10.3233/JAD-2010-101521

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

Sivanandam, T., & Thakur, M. (2012). Traumatic brain injury: A risk factor for Alzheimer's disease. Neuroscience & Biobehavioral Reviews, 36(5), 1376-1381. doi:10.1016/j.neubiorev.2012.02.013

Risk Factors
Vascular Risk Factors Continued
Researchers Have Argued Stroke May Be Independently Associated With AD And Cognitive Decline, (Knopman et al., 2009).
Stroke May Also Alter The Clinical Expression Of AD

Brain Injury
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