HISTORY OF ALZHEIMERS

DISEASE
-named after the
doctor who first
described it "Alois
Alzheimer", is a
physical disease
that affects brain.
 HISTORY OF ALZHEIMERS
DISEASE
The first Alzheimer
Patient in History
Auguste Deter
-51 y/o woman
Had a memory loss
Worsened psychological changes
like cognitive and language deficits
Delusions
 WHAT IS ALZHEIMERS DISEASE?

Progressive mental deterioration

that can occur in middle or old
age, due to generalized
degeneration of the brain. It is
the most common cause of
premature senility.
What really happens
inside the brain?
ALZHEIMER CHANGES THE
WHOLE BRAIN
 ALZHEIMER CHANGES THE
WHOLE BRAIN
CEREBRAL CORTEX -
damages the thinking,
planning and remembering

HIPPOCAMPUS

VENTRICLES- (fluid-filled
spaces within brain) grows
larger
 UNDER THE MICROSCOPE
FEWER NERVE CELLS AND
SYNAPSES
HALLMARKS OF DISEASE:
1.PLAQUES- abnormal
clusters of protein
Beta-amyloid clump
together
2. TANGLES- twisted
strands of another proteins
PROGRESSION THROUGH THE BRAIN
Earliest Alzheimer's-
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.
RISK FACTORS
Age
Family
history and
genetics
Down
syndrome
 RISK FACTORS
Sex
Mild cognitive impairment
Past head trauma
Lifestyle and heart health
Lifelong learning
and social engagement
 10 EARLY SIGNS AND
SYMPTOMS
1. Memory loss that disrupts daily life.
2. Challenges in planning or solving problems.
3. Difficulty completing familiar tasks at home, at work or at leisure
4. Confusion with time or place
5. Trouble understanding visual images and spatial relationships
6. New problems with words in speaking or writing
7. Misplacing things and losing the ability to retrace steps.
8. Decreased or poor judgment.
9. Withdrawal from work or social activities.
10. Changes in mood and personality.
 MAJOR NEUROCOGNITIVE DISORDER
DSM- V DOMAINS
A. Evidence of significant cognitive decline from a previous level of
performance in one or more area of cognitive domains ( complex
attention, executive function, learning and memory, language,
perceptual-motor or social cognition) based on:

1. Concern of the individual , a knowledgeable

informant or the clinician that there has been a
significant decline in cognitive function.
2. substantial impairment in cognitive performance,
preferably documented by standardized
neuropsychological testing or , in its absence , another
quantified clinical assessment.
 MAJOR NEUROCOGNITIVE DISORDER
DSM- V DOMAINS
B. The cognitive deficits interfere with independence in
everyday activities.

C. The cognitive deficits do not occur exclusively in the

context of a delirium.

D. The cognitive deficits are not better explained by

another mental disorder (e.g., major depressive disorder,
schizophrenia).
 Complex attention: patient has increased difficulty in
environments with multiple stimuli (TV, radio,
conversation). Has difficulty holding new information in
mind (recalling phone numbers, or addresses just given
or reporting what was just said).
Executive function: patient is not able to perform
complex projects. Needs to rely on others to plan
instrumental activities of daily living or make decisions.
Learning and memory: patient repeats self in
conversation, often within the same conversation.
Cannot keep track of short list of items when shopping or
of plans for the day. Requires frequent reminders to
orient task in hand.
 language: patient has significant difficulties with
expressive or receptive language. Often uses general
terms such as that thing and you know what I mean.
With severe impairment may not even recall names of
closer friends and family.
Perceptual Motor: Has significant difficulties with
previously familiar activities (using tools, driving motor
vehicle) , navigating in familiar environments.
social cognition: patient may change changes in behavior
(shows insensitivity to social standards). Makes decisions
without regard to safety. Patient usually has little insight
into these changes.
 MAJOR NEUROCOGNITIVE
DISORDER DUE TO ALZHEIMERS
DISEASE
A. The criteria are met for major neurocognitive disorder.

B. There is insidious onset and gradual progression of

impairment in one or more cognitive domains.

C. Criteria are met for either probable or possible

Alzheimers disease as follows:
 MAJOR NEUROCOGNITIVE DISORDER
DUE TO ALZHEIMERS DISEASE
For major neurocognitive disorder probable Alzheimers disease is
diagnosed if either of the following is present; otherwise, possible
Alzheimers disease should be diagnosed.
1.Evidence of a causative Alzheimers disease genetic mutation from
family history or genetic testing.
2.All 3 of the following are present:
Clear evidence of decline in memory and learning and at least one
other cognitive domain(based on detail history or serial
neuropsychological testing).
Steadily progressive, gradual decline in cognition, without extended
plateaus.
No evidence of mixed etiology( i.e., absence of other
neurodegenerative or cerebrovascular disease or another neurological
, mental or systemic disease likely contributing to cognitive decline).
 DIAGNOSTIC TESTS
Psychiatric assessments.
Mental status examination and neuro psychological assessment.
Laboratory tests.
Brain imaging
CT scan
MRI
PET
SPECT
CSF Examination
Electro-encephalogram (EEG)
Electromyogram
 SPECT SCAN
(single-photon
emission
computerized
tomography)

PET SCAN

CSF
(Cerebrospinal
fluid)
Examination
 PHARMACOLOGICAL
INTERVENTION
Acetylcholinesterase inhibitors -prevent the
breakdown of acetylcholine, a chemical messenger
important for learning and memory
eg.
Donepezil (Aricept)
Rivastigmine (Exelon)
Galantamine (Razadyne)
 PHARMACOLOGICAL
INTERVENTION
Antidepressants
Anxiolytics
Antipsychotics
Anticonvulsants
 PSYCHOSOCIAL INTERVENTION
Behavioral approach
Emotion oriented approach
-Reminiscence therapy
-Validation therapy
-supportive psychotherapy
-sensory integration
-stimulated presence therapy
Cognition oriented approach
Stimulation oriented approach
 CAREGIVING

Since Alzheimer's has no cure and it gradually

renders people incapable of tending for their own
needs, caregiving essentially is the treatment and
must be carefully managed over the course of the
disease.
 6 PILLARS OF ALZHEIMERS
PREVENTION
Pillar #1:
REGULAR EXERCISE

Exercise protects against

Alzheimers by stimulating
the brains ability to
maintain old connections
as well as make new ones.
 6 PILLARS OF ALZHEIMERS
PREVENTION
Pillar #2:
SOCIAL ENGAGEMENT

Staying socially engaged may

even protect against
Alzheimers disease and
dementia in later life, so make
developing and maintaining a
strong network of friends a
priority.
 6 PILLARS OF ALZHEIMERS
PREVENTION
Pillar #3:
HEALTHY DIET

In Alzheimers disease, inflammation

and insulin resistance injure neurons
and inhibit communication between
brain cells.By adjusting your eating
habits, however, you can help
reduce inflammation and protect
your brain.
 6 PILLARS OF ALZHEIMERS
PREVENTION
Pillar #4:
MENTAL STIMULATION

Those who continue learning new things

throughout life and challenging their brains
are less likely to develop Alzheimers
disease and dementia.
Learn something new
Practice memorization
Enjoy strategy games, puzzles, and
riddles
 6 PILLARS OF ALZHEIMERS
Pillar #5: PREVENTION
QUALITY SLEEP

Establish a regular sleep

schedule
Be smart about napping
Create a relaxing bedtime
ritual.
 6 PILLARS OF ALZHEIMERS
PREVENTION
Pillar #6:
STRESS MANAGEMENT

Breathe!
Schedule daily relaxation activities
Keep your sense of humor
Nourish inner peace
 OTHER TIPS TO REDUCE THE RISK
OF ALZHEIMER'S

Stop smoking
Control blood pressure and
cholesterol levels
Watch your weight
Drink only in moderation
THANK YOU!