ALZHEIMER

1. Introduction

2. Characteristics

3. Cause

4. Diagnosis

5. Prevention

6. Management

• It is a chronic neurodegenerative disease which increase with time.

• Accounts for 60% to 70% of cases of dementia (brain disease)

• Most common early symptom: Short term memory loss

• Advances symptoms can include: problems with

language, disorientation, mood swings, loss of motivation, not

managing self care, and behavioral issues

• Cause of AD is poorly understood but mainly genetic, head injury,

hypertension or depression

• No treatments or medications can stop or reverse it progression

• Begins in people over 65 years of age

• Mental and physical exercise, and avoiding obesity may decrease the risk of

AD

• Divided into four stages, with a progressive patternof cognitive and functional impairment

CHARACTER Pre dementia

Early Moderate Advanced

DIAGNOSIS Mild cognitive

Increasingimpairment of learning and memory

Progressive deterioration

Complete deterioration

SYMPTOMS Short term memory loss, execution function or semantic memory

Language problem, executionfunction, perception, execution of movements

Paraphasias, inability to recall vocabulary, daily work, behaviouralissues

Loss of speech, aggressiveness, extreme apathy and exhaustion

• The cause for most Alzheimer's cases is still mostly unknown except for1% to 5% of cases where genetic differences have been identified.

• Several competing hypothesis exist trying to explain the cause of thedisease:

1. Genetics

2. Cholinergic hypothesis

3. Amyloid hypothesis

4. Tau hypothesis

5. Other hypotheses

Herpes simplex virus type 1

The cellular homeostasis of ionic copper, iron, and zinc is disrupted in A

Extremely low frequency electromagnetic fields

Age-related myelin breakdown

Oxidative stress and dys-homeostasis of biometal metabolism

Alzheimer's disease is usually diagnosed based on the person's medical

history, history from relatives, and behavioural observations

1. Cerebral pathology or subtypes of dementia-CT, MRI, SPECT, PET forgetting medical imaging

2. Cognitive impairment and a suspected dementia syndrome -Neuropsychological testing

3. Early AD - Neurological examination

1. Psychological tests

2. Analysis of cerebrospinal fluid

1. Supplemental testing - Blood tests, thyroid function tests, assess B12, ruleout syphilis, rule out metabolic problems (including tests for kidney function,electrolyte levels and for diabetes), assess levels of heavy metals (e.g. lead, mercury)and anaemia

At present, there is no definitive evidence to support that any

particular measure is effective in preventing AD

1. Medication

Statins, non-steroidal anti-inflammatory drugs (NSAIDs)

2. Lifestyle

People who engage in intellectual activities such as reading, playingboard games, completing crossword puzzles, playing musicalinstruments, or regular social interaction show a reduced risk forAlzheimer's disease

3. Diet

People who eat a healthy diet have a lower risk of AD.

Those who eat a diet high in saturated fats and simplecarbohydrates have a higher risk

• There is no cure for Alzheimer's disease; available treatments offer relatively small symptomatic benefit but remain palliative in nature

• Current treatments can be divided into pharmaceutical, psychosocial and caregiving.

1. Medications

Five medications are currently used to treat the cognitive problems of AD

acetylcholinesterase inhibitors (tacrine, rivastigmine, galantamine and donepezil) and the other (memantine) is an NMDA receptor antagonist

2. Psychosocial intervention

These are used as an adjunct to pharmaceutical treatment and can be classified within behaviour-, emotion-, cognition- or stimulation-oriented approaches

3. 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.