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Alzheimers Disease

By Frances Chang

What is Alzheimers disease?


degenerative brain disease a form of dementia decline in mental and social function impairs memory, thinking, judgment and the ability to learn affect personality and the ability to make decisions risk factors: old age, women, family history

Areas of the brain affected by Alzheimers disease

What cause Alzheimers disease?


the exact cause is unknown lower level of acetylcholine in certain areas of the brain link to specific gene abnormalities (people with SORL1 and ApoE4 has the highest risk of developing the disease) development of senile plaques and neurofibrillary tangles

The two main forms of nerve damage:

senile plaques (clumps of dead nerve cells containing amyloid) neurofibrillary tangles (twisted strands of insoluble proteins in the nerve cell)

Disease Progression

Early Phase

Early Phase

gets lost easily unable to start task on his own avoid new and unfamiliar situations delayed reactions and slowed learning speaks more slowly than before difficulty in handling money poor judgment mood swings, depressed or irritable

Disease Progression

Middle Phase

Middle Phase

problems recognizing friends and family restless and wanders problems in reading, writing, and dealing with numbers problems organizing thoughts problems finding the right words to say trouble dressing gets upset easily delusions, paranoia, agitation loses recognition of time

Disease Progression

Late Phase

Late Phage

cant remember how to bathe, eat, or dress lose ability to chew and swallow trouble with balance and walking confused in the evening trouble sleeping cant communicate using words loses bowel and bladder controls

How is it diagnosed?

medical history and physical exam evaluation of mental and functional status Verbal tests and interviews with family lab tests and imaging tests (CT,MRI ) Analysis of spinal fluid and positron emission tomography (PET)

PET scans of Alzheimers brain


decline in metabolic activity in Alzheimers brain (right) as compared to normal brain (left)

Treatment Overview

currently no cure for Alzheimers, medications used to slow progression of symptoms in its early stages and help with mood changes and behavior problems cholinesterase inhibitors are prescribed for initial treatment memantine can also be used alone or in combinatin with the above drugs

Cholinesterase Inhibitors
DRUGS: donepezil, galantamine, and rivastigmine
MOA:slows the breakdown of acetylcholine that helps nerve cells in the brain communicate INDICATION:people with mild to moderate disease, use temporarily to improve cognitive functions SIDE EFFECTS:nausea, vomiting, weight loss, and abdominal pain or cramps

Memantine
MOA:block a substance called glutamate which may be overactive in someone with Alzheimers disease INDICATION:people with moderate to severe symptoms of confusion and memory loss caused by the disease SIDE EFFECTS:fatigue, pain, increase in blood pressure, dizziness, headache, constipation, vomiting, back pain, confusion, hallucination, coughing, and difficulty in breathing

Prevention

no sure way to prevent Alzheimers, some activities can help delay the onset of disease physical exercise mentally stimulating activites diet rich in antioxidants and omega-3 fatty acids Stay at a healthy body weight

Conclusion

average amount of time a person lives after developing symptoms is 8 to 10 years Medicare pays one-third of all its health-care funds for 4.5 million Alzheimer's patients within the next 5 years, nearly a half-million new Alzheimer's cases will be diagnosed annually vaccine against Alzheimer's disease could be available for high-risk patients within 6 to 10 years

References:

www.medicinenet.com www.horizon-bcbsnj.com www.news.yahoo.com www.mercksource.com www.images.search.yahoo.com

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