ALZHEIMER’S DISEASE

Dr. Shantel Anderson, DHEdLeadership and Organizational Management

MPH 543Jill Marshall and Tara Sheets

February 18, 2014

Alzheimer’s Disease

Alzheimer’s Disease is: a type of dementia that causes problems with

memory, thinking, and Behavior.

Dementia results in the loss of skills: Intellectual, and Social.

Alzheimer’s Disease

Alzheimer’s Disease: is irreversible and progressive; slowly destroys

Memory, Cognitive (thinking) skills, and ability to complete activities of daily living;

causes the brain cells and the connections between them to degenerate and die; and

causes a decline in memory and mental function.

Risk Factors

Risk Factors include: Age

65 and older. Risk doubles with every 5 years. After age 85 risk increases to 50 percent.

Family History Immediate family member with Alzheimer’s increases risk. Risk is increased if there is more than one relative with

the illness. Genetics

Three Deterministic genes directly cause Alzheimer’s Disease including

Amyloid precursor protein (APP), Presenilin-1 (PS-1), and Presenilin-2 (PS-2).

Risk FactorsRisk Factors: Head trauma

Seat belts, safety helmets Head-Heart connection (high blood pressure, stroke, diabetes,

etc.) Healthy eating, and exercise Monitor heart health with a physician

General Health Maintain a healthy weight, limit tobacco and excess alcohol

Myths Aluminum Aspartame (equal, nutrasweet) Flu Shots Silver dental fillings

Stages The stages of Alzheimer’s disease

include pre-clinical (mild cognitive

impairment), mild, moderate, and severe.

Symptoms and Impact Preclinical: No Major symptoms

toxic changes are taking place in the brain; abnormal deposits of proteins; Forming of plaques and tangles throughout the brain; and neurons begin to work less efficiently.

Mild: Changes aren’t significant enough to affect work or relationships.

May be changes or issues with: memory, personality, thinking, organizing, expressing

thoughts; and misplacing belongings, problem solving, and ability to

complete complex tasks and make sound judgments Neurons lose ability to function and communicate with each

other and die.

Symptoms and Impact Moderate: Increased confusion and significant changes in

personality and behavior. May need assistance with activities of daily living and

self-care. Damage spreads to a nearby structure in the brain,

more neurons die, and affected brain regions begin to shrink.

Severe: Impact now includes movement and physical capabilities

Require daily assistance with activities of daily living, and self-care;

Loss of ability to communicate coherently; Damage is widespread; and Brain tissue has shrunk significantly.

Prevalence and Forecast In 2013:

5.2 million people had Alzheimer’s Someone develops Alzheimer’s every 68

seconds One in every three seniors died with

Alzheimer’s or other dementia By 2030 it is estimated:

8.6 million will have Alzheimer’s By 2050 it is estimated

16.0 million will have Alzheimer’s

Direct Costs

In 2013: $203 billion was spent on health care, long-

term care, and hospice $142 billion of that was paid by Medicare and

Medicaid By 2050:

Those with Alzheimer’s is projected to triple Costs are projected to increase to $1.2 trillion

Indirect Costs $216 billion is spent by the 5 million family and friends

that provide 17 billion hours of unpaid care every year. Many caregivers have to travel away from their

families. Emotional stress, depression, and physical exhaustion. $9.1 billion is spent on the health care costs of these

caregivers. 65 percent of caregivers take time off, come in late, or

leave early. 20 percent take leaves of absence. 13 percent switched from full-time to part-time jobs. 11 percent gave up their jobs.

Cholinesterase InhibitorsBenefits: Cholinesterase inhibitors slow the progression, Helps brain cells function better, and May provide improvements in memory and functioning. Common Cholinesterase inhibitors share these similar

benefits to the brain: Donepezil (Aricept)—treats mild, moderate, and severe

stages Rivastigmine (Exelon)—treats mild and moderate stages Galantamine (Razadyne)—treats mild and moderate

stages

Concerns: Improvements last 6-12 months, Improvements found in only about half of the

participants, and No current method to identify who will respond to the

medications

Side EffectsSide Effects with medications: nausea and vomiting, loss of appetite, indigestion and Increased frequency of bowel movement, pain and headaches, and shakiness and tremors (Rivastigmine only).

Less common side effects: Insomnia, Fatigue, Muscle cramps, and Stomach ulcers (donepezil only).

  

Side EffectsUncommon but more serious side effects: seizures, bloody coughs, stools, or vomiting, Painful urination, Irregular heart rate and Depression (Galantamine only)

NOTE: Currently research has indicated that Donepezil may have less adverse effects than Rivastigmine.

  

Research Project AgendaInclude Cholinesterase Inhibitors as a treatment option for

upcoming five year strategic research project agenda to determine:

Long term care costs can be reduced by 30 percent over a five year period.

Methodology Treatment options are:

effective in 50 percent of participants prolongs deterioration by approximately six months to one

year It is cost effective:

Average annual cost for long-term care $6,833/month. Stay in long-term care for Alzheimer’s is at least 17

months. Saves approximately or $81, 996 per year ($40,998 every

six months), per person. Dignity:

Allowing more to age in place for a longer period of time.

  

References

  

Alzheimer’s Association (2014a). What is Alzheimer’s? Retrieved February 9, 2014 from http://www.alz.org/alzheimers_disease_what_is_alzheimers.asp

Alzheimer’s Association (2014b). Alzheimer’s Disease: Risk Factors. Retrieved February 9, 2014 from https://www.alz.org/alzheimers_disease_causes_risk_factors.asp

Alzheimer’s Association (2014c). Alzheimer’s Disease: Alzheimer’s Facts and Figures. Retrieved February 9, 2014 from https://www.alz.org/alzheimers_disease_facts_and_figures.asp

Alzheimer’s Association (2014d). Alzheimer’s Disease: Treatments: Medications for Memory Loss. Retrieved February 10, 2014 from http://www.alz.org/alzheimers_disease_standard_prescriptions.asp

Ammons Scientific LTD. (2013). Image. Retrieved February 16, 2014 from http://www.amsci.com/about

Birks, J (2006, Jan 25). Cholinesterase inhibitors for Alzheimer's disease. The Cochrane Library, DOI: 10.1002/14651858.CD005593. Retrieved February 10, 2014 from http://www.ncbi.nlm.nih.gov/pubmed/16437532

Health Media Ventures (2014). 25 Signs and Symptoms of Alzheimer’s Disease. Image. Retrieved February 15, 2014 fromhttp://www.health.com/health/gallery/0,,20416288_4,00.html

HMBD Insurance Services. (n.d.). Long-term care is the assistance your employees will need for an extended period of time if they develop a chronic illness, disability, or cognitive impairment, such as Alzheimer's disease. Image. Retrieved February 11, 2014 from http://www.hmbd.com/group-long-term-care.html

Centers for Disease Control and Prevention (CDC). (2010). Cholinesterase Inhibitors. Agency for Toxic Substances and Diseases Registry. Image. Retrieved February 16, 2014 from http://www.atsdr.cdc.gov/csem/csem.asp?csem=11&po=5

Mayo Clinic (2013). Diseases and Conditions. Alzheimer’s Disease. Retrieved February 9, 2014 From http://www.mayoclinic.org/diseases-conditions/alzheimers-disease/basics/definition/con-20023871

  

ReferencesMedical Care Corporation. (2014). Education: Progression of Alzheimer’s Disease. Image. Retrieved February 9, 2014 from https://www.mccare.com/education/alzprogression.html

MedicineNet.com. Donepezil, Aricept, Aricept ODT. Retrieved February 12, 2014 from http://www.medicinenet.com/donepezil/article.htm

MedicineNet.com. Galantamine, Razadyne, Razadyne ER. Retrieved February 12, 2014 from http://www.medicinenet.com/galantamine/article.htm

MedicineNet.com. Rivastigmine - oral, Exelon (cont.). Retrieved February 12, 2014 from http://www.medicinenet.com/rivastigmine-oral/page2.htm#SideEffects

National Institute on Aging (n.d.). Alzheimer’s Disease Education and Referral Center. Retrieved February 13, 2014 From http://www.nia.nih.gov/alzheimers/topics/alzheimers-basics

National Institutes of Health (NIH). (2013). Science-Based Health And Wellness Resources for your Community. Image. Retrieved February 15, 2014 from http://www.nih.gov/health/wellness/

National Institutes of Health (NIH). (n.d.). Alzheimer’s Disease: Symptoms and Diagnosis. Senior Health. Image. Retrieved February 16, 2014 from http://nihseniorhealth.gov/alzheimersdisease/symptomsanddiagnosis/meal_bed_popup.html

Orestis, C. (2013). Life Expectancy Compression: The Impact of moving into a long term care facility on length of life. Life Care funding. White Papers. Retrieved February 17, 2014 from http://www.lifecarefunding.com/white-papers/moving-into-long-term-care-facility

Park, Alice (2012, March 8). Cost of Alzheimer's Care in the U.S. in 2012: $200 Billion. Time: Health and Family. Retrieved February 12, 2014 February 9, 2014 from http://healthland.time.com/2012/03/08/cost-of-alzheimers-care-in-the-u-s-in-2012-200-billion/

Puiu, T. (2012). Synthetic DNA and RNA that mimics chemistry of live can encode genetic information and evolve. ZME Science. Image. Retrieved February 10, 2014 from http://www.zmescience.com/medicine/genetic/xna-synthetic-dna-rna-nucleic-acids-20042012/

  

ReferencesQuick, D. (2012). Maintaining a brain protein’s sugar levels could prevent development of Alzheimer’s. Gizmag. Image. Retrieved February 9, 2014 from http://www.gizmag.com/brain-protein-sugar-alzheimers-treatment/21660/

Resnic, M. (2011). New! SANDWICH: Stuck Between Two Generations. Jen Singer’s Mommasaid.net. Image. Retrieved February 9, 2014 from http://mommasaid.net/2011/04/11/sandwich-two-generations/

Rudolph, M. (2013). Laughter Yoga at Alzheimer’s Conference. Laughter Yoga International. Image. Retrieved February 13, 2014 from http://www.laughteryoga.org/english/blog/blog_detail/473

Rush University Medical Center. (2013). Rush Scientists Identify Buphenyl as a Possible Drug form Alzheimer’s disease. Image. Retrieved February 15, 2014 from http://medresearch.tumblr.com/post/63474246677/rush-scientists-identify-buphenyl-as-a-possible

Sandhaus, R.A. (2009). Pass the Turkey, Pie, Football,…and Family Health History. Fantastic Voyage: A journey through my DNA and Personal Genomics. Image. Retrieved February 14, 2014 from http://exploringmygenes.blogspot.com/2009/11/pass-turkey-pie-football-and-family.html

Seniorhomes.com (2014). Alzheimer’s Care Costs. Retrieved February 11, 2014 from http://www.seniorhomes.com/p/alzheimers-care-costs/

Walji, P. (2013). Alzheimer’s and Dementia on the Decline, Study Finds. Liberty Voice. Image. Retrieved February 13, 2014 from http://guardianlv.com/2013/07/alzheimers-and-dementia-on-the-decline-study-finds/   WebMD. Alzheimer's Disease Health Center. Retrieved February 10, 2014 from http://www.webmd.com/alzheimers/cholinesterase-inhibitors-for-alzheimers-disease