Alzheimer’s

DiseaseBy: Reagen Dozier,

Evette Lara, Antonio Alfaro,

Jo Acosta, Sandra Zamora, Sylvia Reyes,

Emmanuel Gomez, Elena Baez, Natalie Castanon,

Maria Logue

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After our presentation on Alzheimer’s Disease, please work on the exercise passed out. The exercise is meant to keep the mind active and can be a preventative measure against Alzheimer’s Disease.

Through the eyes of

Someone with

Alzheimers

https://www.youtube.com/watch?v=BUrR6BTx6Mk

Description of the Problem

According to The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Alzheimer’s Disease (AD) is an age-related, progressive, and irreversible

neurodegenerative disorder characterized by cognitive and memory impairment.

AD affects...

5.4 million peoplehave Alzheimer’s Disease

6th Leading Cause of Death

In the USA, Alzheimer’s Disease is the

13.8 million people

will have Alzheimer’s Disease

Description of the Problem (cont.)

By mid-century

In the USA,

(Alzheimer’s Association, 2016)

Review of Literature▧ AD was first identified in 1906 by a German

doctor, Alois Alzheimer through a clinical visit with his patient (Pete, B.J. 2016).

▧ According to a review article titled “ Therapies for Prevention and Treatment of Alzheimer’s Disease” by the University of Queretaro, Mexico, the prevalence of Alzheimer patients around the world in 2015 was about 44 million people.

▧ The U.S census data states that 7% of individuals diagnosed with AD are between ages 65 & 74 years, 53% are between 75 & 84 years , and 40% are 85 years and older. There has been a few rare cases of individuals diagnosed at age 30 (DSM-5).

▧ Estimates to double by 2050.

▧ Over 95% of AD patients have environmental factors and genetic inclinations as their major contributor to the disease.

▧ In less than 5% of the patients, AD is caused by mutation in the following genes:

➢ APP: chromosome 21 (Down Syndrome).

➢ PSEN-1: chromosome 14 ( building material of DNA).

➢ PSEN-2: chromosome 1 {3-5} (largest building block-249 million pairs).

Diagnosis - medical history, physical examination, laboratory tests, neuroimaging & neuropsychological evaluation.

● Time frame in new medical developments.

● Quality of life● Cost of care

● Exact causes of Alzheimer's Disease still unclear.

● No diagnostic tool

Why isResearch

Important?

Literature Review (cont.)

Key People in Alzheimer’s:Alois Alzheimer Emil Kraepelin

Max Knoll and Ernst Ruska Robert KatzmanJerome H. Stone George Glenner and Cai’ne WongNational Institutes of Aging Food and Drug Administration (FDA)Warner-Lambert Pharmaceutical Company (now Pfizer)Major Milestones in

Alzheimer’s:

1906-1960:: First Discovery 1970-1979: Modern Research1980-1989: Awareness

1990-1999: Treatments Emerge2000-2009: Progress and Hope2010-2019: Setting a National Agenda

Resource retrieved from: http://www.alz.org

A lack of public awarenessUnprepared caregiversInsufficient research funding Mounting costsInadequate treatments Poor dementia careSpecific challenges facing diverse Difficulties with detection & diagnosisCommunities & those with younger-Onset Alzheimer’s

Major Advancements:

EPPS - destroys the characteristics toxic amyloid plaques that build in the brain.SOLANEZUMAB - this drug slowed the rate of decline in Alzheimer’s patients.ULTRASOUND TECHNOLOGY - can break up the brain-clogging amyloid plaques.ADUCANUMAB - brain scans of patients treated with this experimental antibody showed a reduction in amyloid plaque in patients who were in the earliest stages of Alzheimers.

Literature Review (cont.)

Major Challenges/Obstacles:

Resource retrieved from: http://www.alz.org

Risk Factors:

● Memory loss that affects job skills

● Difficulty performing familiar tasks

● Often forgetting simple words

● Disorientation to time and place

● Poor or decreased judgement

● Problems with abstract thinking

● Misplace things

● Changes in mood or behavior

● Change in personality and loss of initiative

Age

Family history ( first degree relative with dementia)

Heredity (genetic risk Apolipoprotein E-e4 gene)

Lower educational attainment

Chronic Conditions

Parkinson’s Disease

Heart disease and stroke

Diabetes

High blood pressure

High Cholesterol

Head Injury

Warning Signs:

Relevance to Minority Populations

Almost ⅔ of AD patients

are women

Older African

Americans 2X as likely to have AD

& other dementias as older whites

Hispanics are

about 1 and

1..5X as likely to have AD as older whites

👩

Currently, there is not enough research to determine if there is a prevalence in other ethnicities or races.

(Alzheimer’s Association, 2016)

▧ According to Ayalon and Arean (2004), there is a misunderstanding about Alzheimer’s disease among Asian, Hispanic, and African Americans.

▧ There are beliefs associated with Alzheimer’s disease.

○ These minority groups believe the beginning signs of Alzheimer’s disease are the beginning stages of aging.

○ Alzheimer’s disease may be seen as a form of psychosis by these minority groups.

○ Asian and Hispanics see Alzheimer’s disease as transmittable and could be improved or eradicated from one’s health (Ayalon & Arean, 2004).

Minorities Education on Disease

● Not all minorities know enough about Alzheimer’s disease.

■ In the study from Liat Ayalon (2013) of Caucasian, African American, and Hispanic individuals, the Caucasian minority had the greatest knowledge about Alzheimer’s disease.

○ Misunderstandings about the disease can halt diagnosis (Ayalon, 2013):

■ Stress causes Alzheimer’s disease.

● Likely to come from African American and Hispanic ethnic groups.

■ Exercising the mind will not help Alzheimer’s disease.

● Likely to come from Hispanics.

■ There is a magic pill to prevent Alzheimer’s disease.

● The three ethnic groups believed a pharmaceutical drug is available.

■ Genetics has nothing to do with Alzheimer’s disease.

● Likely to come from African American ethnic groups.

● With education, minorities would be able to understand and know the signs of Alzheimer’s disease.

Minorities Education on Disease

▧ Reduce potential risk

▧ Make time to be physically active

▧ Eat a healthy diet

▧ Maintain healthy blood pressure, cholesterol, and blood sugar levels

▧ Learn new things and keep your mind active by reading, dancing, and puzzles

▧ Stay socially active by engaging in classes that stimulate the mind and body or community groups

Prevention

Stretch Break

Alzheimer’s

Prevention in

ACTION

!

The Day Dream:

Gently pull each elbow to the opposite side overhead. Just pretend you’re under a Tahitian waterfall and need to scrub your shoulder blades.

The Half-Bear Hug:

Hug one knee at a time, pulling it toward your chest. Tell passers-by you need a mini childhood flashback, or that “this is how you roll.”

Educate:● Promote awareness and educate the public, to

help reduce stigma

● Raise awareness among health professionals about the importance of early detection

● Promote standard post-diagnostic care among clinicians using the California Guidelines for Alzheimer’s Disease Management

● Promote effective practices in caregiving and make caregiver training more widely available

● Provide access to basic information about the responsibilities caregivers face and the resources they may need

Group Counseling1) Facilitating group counseling

sessions so patients can pick up on others non-verbal cues

2) Group counseling also may help with depression associated with Alzheimer's patients

Counseling for Alzheimer’s Disease

Three Stages of Counseling:1) Helping the individual

cope with decreased cognitive abilities

2) Addressing the emotional feelings that are associated with having a serious illness

3) Improving cognitive function and performance

Structure1) Providing structural

cues in their environment makes it easier for them to function

2) Too much stimulation or larger living spaces promotes confusion

3) Changing their environment to better suit their needs

1. Intentional Interventions for children

2. Providing Information

3. Group counseling or family counseling

Forgotten Victims

1) The memory loss associated with the Alzheimer's disease is difficult to diagnose due to the natural signs of aging

2) Not much research done on counseling techniques with Alzheimer's patients

3) Difficulty in counseling patients whose verbal and cognitive skills are declining

4) Healthcare companies do not cover much of the cost of counseling because they believe this is a disease medication is more effective for

Challenges With Counseling Alzheimer's

Patients

Treatment Options

Memory Loss Behavioral Changes

Sleep Changes

Treatment

options are

limited and are

not able to cure

AD.

Medication Medication

Triggering Situations

Cope Medication

Schedule

Looking Forward:

● New developments in medication and treatment

○ Mercks & Co.

■ Verubecestat

■ New trail development data expected in late 2017.

■ If approved, will be first new treatment in over a decade.

● Awareness

○ Fundraising

○ Charitable Foundations

○ Counseling groups

● Research

○ Global

■ Cure Alzheimers - 6 Billion in grants.

○ Local Impact

Summary:Statistics

Risk factors

Minorities

Prevention/Education

Counseling

Conclusions:Personal Perspectives

Alzheimer’s disease is a progressive and irreversible disorder that affects more and more people year after year. For that reason, spreading awareness is crucial. It is necessary to reach out to minorities and educate them on the importance of early detection. Early detection may help individuals acquire better coping skills, and thus may lead to a better quality of life.

Early detection is crucial to start treatment however, early memory loss is sometimes linked to natural signs of aging.

Although there’s no cure for Alzheimer’s disease having an early detection helps with giving individuals treatment that prolong their awareness and slow down memory loss.

Future of Alzheimer’s Disease

Further research on the brain is essential in finding a cure and alternative treatments.

Verubecestat is a drug that’s still in the early stages of trials, but if approved will be treatment for Alzheimer’s.

Continuing to use lab rat for research.

Advances in therapy and care for patients suffering from Alzheimer’s Disease is necessary

Any Questions?

https://www.youtube.com/watch?v=tkIg-SxPzTA

ResourcesAlzheimer’s Disease Education and Referral (ADEAR) Center

www.nia.nih.gov/alzheimers

Alzheimer’s Association

www.alz.org

Alzheimer’s Foundation of America

www.alzfdn.org

Area Agencies on Aging

www.c4aging.org

Eldercare Locator

www.eldercare.gov

Family Caregiver Alliance

www.caregiver.org

Medline Plus

www.nlm.nih.gov/medlineplus/alzheimersdisease.html

References

Ayalon, L. (2013). Re-examining ethnic differences in concerns, knowledge, and beliefs about Alzheimer’s disease: Results from a

national sample. International Journal Of Geriatric Psychiatry, 28(12), 1288-1295. doi:10.1002/gps.3959

Ayalon, L., & Areán, P. A. (2004). Knowledge of Alzheimer’s disease in four ethnic groups of older adults. International Journal Of

Geriatric Psychiatry, 19(1), 52-57. doi:10.1002/gps.1037

Alzheimer’s Association. (2016). 2016 Alzheimer’s Disease Facts and Figures. In Living with Alzheimer’s. Retrieved from

http://alz.org/documents_custom/2016-facts-and-figures.pdf

California Department of Public Health's Alzheimer's Disease Program. (2014). California Alzheimer’s Disease Centers (CADCs) New

Patient Demographics 2013-2014. In California Department of Public Health. Retrieved from

http://www.cdph.ca.gov/programs/cdcb/Documents/CADCPatientDemographicInfographic-2013-2014.pdf

Granello, P.F., & Fleming, M.S. (2008). Providing Counseling for Individuals With Alzheimer’s Disease and Their Caregivers. Adultspan Journal, 7(1), 13-25.

Heckler, M.M. (1985). The fight against Alzheimer’s disease. American Psychologist, 40(11), 1240-1244.

doi:10.1037/0003-066x.40.11.1240Magnuson, Sandy; Strategies to help students whose grandparents have Alzheimer’s disease. Professional School Counseling, Vol 2(4),

Apr, 1999 pp. 327-333. Publisher: American School Counselor

Mendiola-Precoma, J., Berumen, L. C., Padilla, K., & Garcia-Alcocer, G. (2016). Therapies for Prevention and Treatment of Alzheimer’s Disease. Biomed Research International, 20161-17.doi:10.1155/2016/2589276.

Pete, B.J. (2016). Alzheimer’s Disease. AMT Events, 33(2),72-74.

The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013).

References

Sperling RA, Aisen PS, Beckett LA, Bennett DA, Craft S, Fagan AM, et al. Toward defining the preclinical stages of Alzheimer’s disease: Recommendations from the

National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement

Ortman JM, Velkoff VA, Hogan H. An Aging Nation: The Older Population in the United States, Current Population Reports, P25-1140. U.S. Census Bureau,

Washington, D.C. 2014. Available at: http://www.census.gov/content/dam/Census/library/publications/2014/demo/p25-1140.pdf. Accessed November 6, 2015.

Hebert LE, Bienias JL, Aggarwal NT, Wilson RS, Bennett DA, Shah RC, et al. Change in risk of Alzheimer disease over time.

Neurology 2010;75:786-91.

Hebert LE, Weuve J, Scherr PA, Evans DA. Alzheimer disease in the United States (2010-2050) estimated using the 2010 Census.Neurology 2013;80(19):1778-83.

Saunders AM, Strittmatter WJ, Schmechel D, George-Hyslop PH, Pericak-Vance MA, Joo SH, et al. Association of apolipoprotein E allele epsilon 4 with late-onset

familial and sporadic Alzheimer’s disease. Neurology 1993;43:1467-72.

Farrer LA, Cupples LA, Haines JL, Hyman B, Kukull WA, Mayeux R, et al. Effects of age, sex, and ethnicity on the association between apolipoprotein E genotype

and Alzheimer disease: Ameta-analysis. JAMA 1997;278:1349-56

Jack CR, Albert MS, Knopman DS, McKhann GM, Sperling RA, Carrillo MC, et al. Introduction to the recommendations from the National Institute on Aging-

Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011;7(3):257-62.