Dementia Alzheimer (OWN) Ppt

7/28/2019 Dementia Alzheimer (OWN) Ppt

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Alzheimer Disease the most

common of Dementia

Kartika

030.08.134


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Introduction

Dementia describes progressive decline of cognitive function,

usually affecting the cortex as a whole, though sometimes

patchily.

Memory is especially affected, intellect gradually fails. There is

loss of emotional control, deterioration of social behavior and

loss of motivation.

There are many causes of this syndrome. Dementia is a

substantial cause of morbidity in any ageing population, with

profound social and economic effects.

Dementia affects some 10% of any population over 65, and

20% over 80. The commonest causes are Alzheimers

disease.(1)


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What is Dementia?

Dementia isn't a specific disease. Instead,

dementia describes a group of symptoms

affecting intellectual and social abilities

severely enough to interfere with daily

functioning.


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Etiology

Many cause of dementia, such us:

degenerative disease, vascular, metabolic,

vitamin deficiency, toxic, endocrine, infection,

trauma. And many more

But the most common of dementia is

Alzheimer disease that include the generative

disease about 60%


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Symptoms

The symptoms of dementia is divide into ABC

A : activity of daily living

B : behaviour/ behaviour psychologicalsyndrome of dementia (BPSD)

C : cognition or cognitive defisicits


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B/ Behaviour Psychological syndrome

of dementia (BPSD)

Paranoid: the people have taken his/hermoney, house in not oness home

Hallucination:

Depression:

Anxiety:

Social dysinhibition:

Wandering

Agitation


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C/Cognitive deficits

Memory: shortterm and longterm

Orientation: time,person, place

Language : Aphasia, anomian thingking,calculation, learning capacity

Personality

Judgement : ability to perform tasks insequence

Reduce activity daily living


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Risk factor

Risk factors that can not be changed

Age. The risk of Alzheimer's disease, vascular dementia andseveral other dementias increases significantly with age.However, dementia isn't a normal part of aging.

Family history. People with a family history of dementia areat greater risk of developing it. However, many people witha family history never develop symptoms, and many peoplewithout a family history do.

Down syndrome. By the time they reach middle age, most

people with Down syndrome develop the plaques andtangles characteristic of Alzheimer's disease, according tostudies. Many, but not all, also develop dementia.(6)


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Can be change Alcohol use. Consuming large amounts of alcohol appears to increase the risk

of dementia.

Atherosclerosis. This buildup of fats and other substances in and on your artery

walls (plaques) is a significant risk factor for vascular dementia because it

interferes with blood flow to your brain.

Blood pressure. Blood pressure that's too high, and also possibly too low, can

put you at risk of developing Alzheimer's disease and vascular dementia.

Cholesterol. High levels of low-density lipoprotein (LDL) cholesterol, the

"bad" cholesterol, can significantly increase your risk of developing vascular

dementia.

Depression. Although not yet well understood, late-life depression, may be an

indication for the development of Alzheimer's-related dementia.

Diabetes. If you have type 2 diabetes, you're at increased risk of developingboth Alzheimer's disease and vascular dementia.

High estrogen levels. High levels of total estrogen in women have been

associated with greater risk of developing dementia. This can be determined

through a blood test.

Smoking. Smoking likely increases the risk of developing dementia because itputs you at a higher risk of atherosclerosis and other types of vascular disease.(6)


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DSM-IV criteria for the diagnosis of Dementia of the Alzheimer's Type(4)

A. The development of multiple cognitive deficits manifested by both:

1.Memory impairment (impaired ability to learn new information or torecall previously

learned information)

2.One or more of the following cognitive disturbances:

(a) aphasia (language disturbance)

(b) apraxia (impaired ability to carry out motor activities depite intactmotor function)

(c) agnosia (failure to recognize or identify objects despite intactsensory function)

(d) disturbance in executive functioning (i.e., planning, organizing,sequencing, abstracting)

B. The cognitive deficits in criteria A1 and A2 each cause significantimpairment in social or

occupational functioning and represent a significant decline from aprevious level of functioning.

C. The course is characterized by gradual onset and continuing

cognitive decline.


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D. The cognitive deficits in Criteria A1 and A2 are not due to any

of the following:

(1) other central nervous system conditions that causeprogressive deficits in memory and cognition (e.g.,

cerebrovascular disease, Parkinson's disease, Huntington's

disease, subdural hematoma, normal-pressure hydrocephalus,

brain tumor)

(2) systemic conditions that are known to cause dementia (e.g.,

hypothyroidism, vitamin B or folic acid deficiency, niacin

deficiency, hypocalcaemia, neurosyphilis, HIV infection)

(3) substance-induced conditions

E. The deficits do not occur exclusively during the course of a

delirium.

F. the disturbance is do not better accounted for by another axis

I disorder (e.g., major depressive disorder, schizophrenia) (2)(4)


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Test in Dementia

Blood test: full blood count, ESR, C-reactiveprotein, urea, electrolytes, blood glucose, liverbiochemistry, serum calcium, vitamin B12, folate,T3 T4, HIV serology.

Imaging : Chest X-rays, CT scan, MRI brain Other: genetic studies, EEG, CSF, brain biopsy.

Psychiatric evaluation/neuropsychiatri:

MMSE(mini mental states examination)CDT (clock drawing test)

IADL


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What is Alzheimer Disease?

Alzheimers disease is an irreversible,

progressive brain disease that slowly destroys

memory and thinking skills.

This is the commonest dementia, a

degenerative disease of the cortex, accounting

for over 65% of dementia in any age group.(3)


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Etiology

AD develops when genetic, lifestyle, and

environmental factors work together to cause

the disease process to start.

In recent years, scientists have discovered

genetic links to AD. They are also investigating

other factors that may play a role in causing AD


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Genetic

The two main types of AD are early-onset and late-onset:

Early-onset AD is rare, usually affecting people aged 30to 60 and usually running in families. Researchers haveidentified mutations in three genes that cause early-onset AD.

Late-onset AD is more common. It usually affectspeople over age 65.

Researchers have identified a gene that produces aprotein called apolipoprotein E (ApoE). Scientistsbelieve this protein is involved in the formation of beta-amyloid plaques.


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To understand Alzheimers disease, its

important to know about the brain

Cerebellum in charge of balance and coordination

Brain Stem connects the spinal cord with the brain

relays and receives messages to and from muscles, skin, and

other organs

controls automatic functions such as heart rate, blood

pressure, and breathing.

Hippocampus: where short-term memories are converted to

long-term memories

Thalamus: receives sensory and limbic information and sends tocerebral cortex

Hypothalamus: monitors certain activities and controls bodys internalclock

Limbic system: controls emotions and instinctive behavior (includes

the hippocampus and parts of the cortex)


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Neuropathology

Amyloid plaque : which are dense deposits of

protein and cellular material that accumulate

outside and around nerve cells

Neurofibrillary tangles : which are twisted

fibers that build up inside the nerve cell


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Beta-amyloid PlaquesAmyloid precursor protein (APP) is theprecursor to amyloid plaque.

1. APP sticks through the neuronmembrane.

2. Enzymes cut the APP into fragmentsof protein, including beta-amyloid.

3. Beta-amyloid fragments cometogether in clumps to form plaques.

1.

2.

3.

AD and the Brain

In AD, many of these clumps form,

disrupting the work of neurons. This

affects the hippocampus and other areas

of the cerebral cortex.

Slide 17


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NeurofibrillaryTangles

Neurons have an internal support structure partly made up of

microtubules. A protein called tau helps stabilize microtubules. In AD,

tau changes, causing microtubules to collapse, and tau proteins clump

together to form neurofibrillary tangles.

AD and the Brain

Slide 18


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Amyloid accumulation and Neurofibrillary

tangles nerve cell death neurochemical

deficiency cognitive and behaviour changes


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Conclusion

Alzheimer's disease is the most common cause of dementiain people age 65 and older.

Symptoms usually appear after age 60, but early-onsetforms of the disease can occur, usually as the result of adefective gene.

Alzheimer's disease usually progresses slowly, over seven toten years, causing a gradual decline in cognitive abilities.

Caring for a person with Alzheimers disease can have highphysical, emotional, and financial costs.

The demands of day-to-day care, changing family roles, anddifficult decisions about placement in a care facility can behard to handle. (8)

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Dementia Alzheimer (OWN) Ppt