Diana Vizoso

Samantha Concepcion

Melissa Sirolli

Sean Faria

William Lopez Jr.

Prof. Bidot

BSC2085

M & W 7:05pm

Alzheimer’s disease:
 A Deeper Look

Diana Vizoso

Samantha Concepcion

Melissa Sirolli

Sean Faria

William Lopez Jr.

BSC2085

M & W 7:05pm

Professor Bidot

December 07, 2009

Table of Contents

Page(s) #
Title Page.........................................................................................................................................2
Table of Contents.............................................................................................................................2

Reason and Concept.........................................................................................................................3

Causes..............................................................................................................................................4

Sign and symptoms..........................................................................................................................6

Diagnosis..........................................................................................................................................9

Treatments......................................................................................................................................11

Index..............................................................................................................................................19

Bibliography..................................................................................................................................23

Reason

The reason my group choose this topic for our research paper is for three reasons. One

reason was the availability of information; it is easy to find information on the topic. Secondly

was the topic seemed very interesting because from the research we have collected at least two
people from this group will have Alzheimer’s disease as we age. Lastly was at least three of us

from the group have relatives with this disease and would like to know what at least is going on

so we may be some use to them. From this research paper we have learned a lot and this

information we have learned is irreplaceable.

Concept

Alzheimer’s disease is a brain disorder named for German physician Alois Alzheimer, who first

described it in 1906. Alzheimer's destroys brain cells, causing memory loss and problems

with thinking and behavior severe enough to affect work, lifelong hobbies or social

life. Alzheimer’s disease accounts for 50 to 70 percent of dementia cases. Other types of

dementia include vascular dementia, mixed dementia, dementia with Lewy bodies and front

temporal dementia. The brain has 100 billion nerve cells (neurons). Nerve cell networks have

special jobs. In Alzheimer’s disease, as in other types of dementia, increasing numbers of brain

cells deteriorate and die. Plaques build up between nerve cells. Tangles form inside dying cells.

Scientists are not absolutely sure what role plaques and tangles play in Alzheimer’s disease.

Causes

Scientists are still trying to fully understand the cause or causes of Alzheimer’s disease.

In the meantime, it’s said to be helpful that we understand the hallmarks of Alzheimer’s plaques

and tangles and the risk factors that affect a person’s likelihood of developing the disease.

Alzheimer's disease is characterized by a build-up of proteins in the brain. Though this cannot be
measured in a living person, extensive autopsy studies have revealed this circumstance. The

build-up manifests in two ways. Plaques which are deposits of the protein beta-amyloid that

accumulates in the spaces between nerve cells. Another way this build up can occur is through

tangles, which are deposits of the protein tau that accumulate inside of nerve cells. Scientists are

still studying how plaques and tangles are related to Alzheimer’s disease.

One theory is that they block nerve cells’ ability to communicate with each other, making

it difficult for the cells to survive. It is likely that the causes include genetic, environmental, and

lifestyle factors, because people differ in their genetic make-up and lifestyle, the importance of

these factors for preventing or delaying AD differs from person to person. Autopsies have shown

that most people develop some plaques and tangles as they age, but people with Alzheimer’s

develop far more than those who do not develop the disease.

Scientists still don’t know why some people develop so many compared to others.

However, several risk factors for Alzheimer’s disease have been uncovered. Genetics play a role

in some people with AD. A rare type of AD, called early-onset AD, affects people ages 30 to 60.

Some cases of early-onset AD, called familial AD, are inherited. Familial AD is caused by

mutations (permanent changes) in three genes. Offspring in the same generation have a 50-50

chance of developing familial AD if one of their parents had it.

  Advancing age is the number one risk factor for developing Alzheimer’s disease. One out

of eight people over the age of 65 have Alzheimer’s disease, and almost one out of every two

people over the age of 85 has Alzheimer’s. Facts and studies show that the probability of being

diagnosed with Alzheimer’s nearly doubles every five years after age 65. People who have a

parent or sibling that developed Alzheimer’s disease are two to three times more likely to
develop the disease than those with no family history of Alzheimer’s. If more than one close

relative has been affected, the risk increases even more.

Scientists have identified two kinds of genes that are associated with this familial risk

factor. The first is thought to be a “risk gene,” ApoE 4, that increases the likelihood of

developing Alzheimer’s, but does not guarantee it. In addition to ApoE 4, scientists think there

could be up to a dozen more risk genes yet to be discovered. The second kind of gene is a

“deterministic gene” and is much rarer than risk genes. Deterministic genes are only found in a

few hundred extended families around the world.

  If a deterministic gene is inherited, the person will undoubtedly develop Alzheimer’s, but

probably at a much earlier age. Although age and family history are out of our control, scientists

have also identified several lifestyle factors that can influence a person’s risk of developing

Alzheimer’s disease. A connection has been found between serious head injury and future

development of Alzheimer’s, so those who practice safety measures such as wearing seat belts

and not engaging in activities where there is a high risk of falling are at an advantage. Evidence

states that there should be a greater promotion of exercise and a healthy diet, to help reduce

Alzheimer’s risk.

Avoiding tobacco, limiting alcohol consumption, staying socially active, and engaging in

intellectually stimulating activities, have also been shown to have a protective effect against

Alzheimer’s disease. Finally, there is a strong link between heart health and brain health. Those

who are free of heart disease or related conditions are at a lower risk of developing Alzheimer’s

or another kind of disease than those who have cardiovascular problems.

Signs and Symptoms of Alzheimer’s disease

 Alzheimer’s disease is the most common forms of Dementia. Alzheimer’s disease is a

serious brain disorder that impacts daily living through memory loss and cognitive changes.

Some common signs of Alzheimer’s disease can be mixed up with normal everyday normality of

forgetfulness. Early stages of Alzheimer’s can be detected mainly by memory loss regarding

recent conversations and events. It can start off as routinely placing important items in odd

places, forgetting names of family members and common objects. It also is a result of, repeated

questions, forgetting the way to get to a frequent visited place and even the inability to following

simple directions for a recipe. This stage can usually last from 2-4 years.

Moderate to middle stage Alzheimer’s disease is usually discovered when they can no

longer cover up problems, have rambling speech, unusual reasoning, and have problems with

places and times. Constant reminders are needed; assistance is needed with daily living activities,

mood and behavioral changes start to occur and about 80% of patients show evidence of

emotional and behavioral problems which are aggravated by stress and change that they are not

used to. This Stage can last from 2-10 years.

Severe to Late stage Alzheimer’s is the result of confusion of the past and present.

Another sign is severe to total loss of verbal skills, they forget to speak or how to speak or write. 

The person becomes completely incapable to care for self.  They become very high risk to falling

due to gait dysfunction, and become bedridden. Patients begin to hallucinate, have severe mood

swings and behavioral issues. They tend moan and cry when unable to express what they are

feeling at the moment. They become totally dependent on others and need total support and care.

They can end up with issues such as the inability to swallow, incontinence, and illness. Illness is

the result of the body systems shutting down usually resulting in death. To sum up the basic

important information about Alzheimer’s disease one should the top ten basic signs to detect
Alzheimer’s.

First Sign is memory loss. We all experience it one way or another; it is just a matter of

knowing the difference between a slip-up and long-term forgetfulness. It is natural to forget an

appointment and/or a person’s name but to later remember it. Second basic sign of Alzheimer’s is

challenges arising when planning or solving problems. We can easily make a mistake while

balancing our check book every once in awhile but forgetting to pay monthly bills can be a sign

to a serious condition. Third sign of possible Alzheimer’s disease is difficulty in completing

familiar tasks at home. Of course we forget what button to press when wanting to TiVo

something but forgetting the rules to your all time favorite board game, there’s obviously a

problem.

The fourth simple sign to detect Alzheimer’s disease is confusion time and place.

Obviously we can occasionally forget what day of the week it is but we always remember in the

end, whereas forgetting where we are and having no clue how we got there. These situations can

be very stressful. The fifth sign of Alzheimer’s is trouble understanding. Alzheimer’s prospect

begins having visual problems creating difficulty with reading. Over the years, with age, it is

common to be diagnosed with cataracts, which at this time would be natural to have difficulty

reading or seeing.

The sixth sign of Alzheimer’s is having trouble with speech i.e. speaking and writing. It

creates difficulty in joining in on conversations happening around them and or even while

they’re speaking they stop because they do not recall the subject of the conversation. We can be

in the middle of a conversation and be distracted by something but as long as we are reminded by

just a simple word. The seventh sign of Alzheimer’s is misplacing things and the inability to

retrace ones steps to remember. It’s normal for us to misplace the remote or even our car keys
time to time but to place our common everyday items in awkward places is a little sign of

Alzheimer’s.

The eighth sign of Alzheimer’s disease is decreased or poor judgment. It is normal for us

to every once in a while make bad decisions and Alzheimer’s prospects pay less attention to their

personal hygiene or can even pay people such as telemarketers large sum of money due to poor

judgment with money. The ninth sign of Alzheimer’s disease is withdrawal from work or social

activities. We are always at fault for feeling weary from work and wanting to be alone not having

to go social gatherings or family gatherings from time to time. It is perfectly normal. An

Alzheimer’s prospect will begin to withdraw from their favorite hobbies and forget how their

favorite teams play. They can begin to feel that they don’t want to participate in anything

anymore and become lonely.

The final sign of Alzheimer’s is the change in mood and/or personality. The prospect can

become depressed, confused and even suspicious. We can usually create a routine of how we do

things and when they get interrupted we can become irritated and frustrated and it is perfectly

normal on occasion.

Diagnosis

Alzheimer’s disease causes physical change in a person’s brain that cannot be properly

diagnosed until being closely examined. Physicians are able to diagnose Alzheimer’s with 90%

accuracy due to thorough examination. Several of these medical examinations include the

patient’s history, a mini-mental state exam, specific laboratory testing, and certain neuro-imaging

examinations (Beers and Berkow). By gathering certain information from these exams, a doctor

can identify if a patient suffers from Alzheimer’s and what stage of Alzheimer’s the patient is
currently in.

For further explanation, a doctor will ask a series of questions to compose a medical

evaluation of the patient. The questions asked as part of the patients history includes information

of the problem occurring, a history of current illnesses, and any family history in regards to the

occurring problem. Physicians perform mini-mental exams that focus on the patient’s attention

span, memory and other types of mental moods. For instances, the doctor performing the exam

will try to interpret the different mood swings the patients undergoes. Another example would be

the attitude, behavior and appearance towards other people. Specialists evaluate patients on the

following statuses: Cognition, Insight judgment, Speech and language, Thought content, and

Thought processes.

After the physician has performed several mental tests, they usually send the patient to a

laboratory to have blood work done. Even though there is not a specific lab test that can identify

Alzheimer’s, the physician tries to rule out the possibility of other diseases by checking the

levels of certain chemicals in the body. Specialist analyze the levels of Vitamin B12, TSH (for

the thyroids), CBC (for anemia), and HIV. Furthermore, depending on the conditions of the

patient, the next step to evaluate if the patient has Alzheimer is to perform several neuro-imaging

exams. One of the main exams that a patient undergoes is a CT scan. A CT scan takes multiple

X-ray pictures of a certain body part to analyze any major changes. Patients with possible

Alzheimer’s carry out a CT scan of the brain, where specialist can observe changes in the size of

the brain. A size reduction of the brain may be a result of Alzheimer’s. Another imaging exam

will be an MRI, which shows the functional changes of the brain. MRI’s also rule out the

possibility of Alzheimer’s by observing if any tumors are present (Kasper, Braunwald and
Fauci). As stated previously, a patient cannot be properly diagnosed with Alzheimer’s until

further studies are done after the patient’s death. These are some of the methods to determine the

possibility of a patient suffering Alzheimer’s. There is only one method that has been recently

discovered to diagnose Alzheimer’s at 100% accuracy which is an autopsy on the brain.

Treatments

Although no cure for Alzheimer’s disease is yet available, medical and behavioral

treatments for the disease may ease symptoms for the individual with Alzheimer's. The

symptoms that can be treated are the cognitive and behavioral symptoms. There is only three

ways for treating symptoms of Alzheimer’s. They are the Standard Treatments, Sleep Treatments

and lastly Alternative Therapy.

Standard Treatments consist of two types of medications that have been approved by the

U.S. Food and Drug Administration (FDA). The two types of drugs are cholinesterase inhibitors

and Memanatine. Cholinesterase inhibitors are prescribed to treat symptoms related to memory,

thinking, language, judgment and other thought processes. Three different cholinesterase

inhibitors are commonly prescribed. Donepezil also called Aricept, which is used to treat all

stages of Alzheimer’s disease. Galantamine also called Razadyne, used to treat mild to moderate

stages of Alzheimer’s. Rivastigmine also called Exelon, usually used to treat mild to moderate

Alzheimer’s. Tacrine also called Cognex, the first cholinesterase inhibitor, was approved in 1993

but is rarely prescribed today because of associated side effects, including possible liver damage.

Cholinesterase inhibitors work by increasing the levels of a chemical messenger involved

with memory, judgment and other thought processes called acetylcholine. There are certain cells

in the brain that produce or release this chemical messenger acetylcholine, which in fact actually
help communicate between other cells. Upon this messenger reaching the receiving cell various

other chemicals as well as an enzyme called acetyl cholinesterase appear. This enzyme acetyl

cholinesterase breaks down acetylcholine so it can be recycled.

However Alzheimer’s disease damages or worst yet destroys the cells that produce or use

acetylcholine. As a result of this process reduces the amount of acetylcholine to carry messages.

Cholinesterase inhibitor is actually an enzyme created to slow down the process of breaking

down the acetylcholine. Cholinesterase inhibitor accomplishes this by blocking the activity

acetyl cholinesterase. This process saves some acetylcholine from being destroyed by the

Alzheimer’s disease. These medications help the brain work better but it doesn’t stop or reverse

the destruction of the brain cells. Cholinesterase inhibitors do not prevent Alzheimer’s from

getting worst this is just a method to slow the progression down.

Cholinesterase inhibitors seem to offer other benefits, as well. For example,

Galantamine appears to stimulate the release of acetylcholine and to strengthen the way certain

message-receiving nerve cells respond to it. Rivastigmine may block the activity of another

enzyme involved in breaking down acetylcholine. In contrast if side effects occur, they

commonly include nausea, vomiting, loss of appetite and increased frequency of bowel

movements. It is strongly recommended that a physician who is experienced in using these

medications monitor patients who are taking them, and that the recommended guidelines be

strictly observed.

Memantine also called Namenda is prescribed to improve memory, attention, reason,

language and the ability to perform simple tasks. This was the first Alzheimer drug of the NMDA

receptor antagonist type. Memanatine is used to treat moderate to severe Alzheimer’s only.
 Memantine works by regulating the activity of a chemical involved in information

processing, storage and retrieval called glutamate. Perceptibly Glutamate triggers NMDA

receptors to let a controlled amount of calcium into a nerve cell as a result of this process it

significantly helps with learning and memory. The calcium helps creates the chemical

environment required for information storage. In the same way Glutamate can be helpful it can

be damaging. If there is excess Glutamate it over stimulates NMDA receptors so that they allow

too much calcium into nerve cells. In a nut shell excess glutamate causes disruption and death of

cells.

However Memantine may protect cells by partially blocking NMDA receptors. Adverse

side effects include headache, constipation, confusion and dizziness. Scientists have made

remarkable progress in understanding how Alzheimer’s affects the brain. Their insights point

toward promising new treatments to slow or stop the disease. Ultimately, the path to effective

therapies is through clinical studies.

The second treatment to help Alzheimer’s is sleep treatment. This is a significant factor

of Alzheimer’s because doctors have not found the exact reason why this happens. Many people

with Alzheimer’s experience changes in their sleep patterns. Similarly how Alzheimer’s affect

memory and behavior, sleep changes also occur to Alzheimer’s patients. There have been cases

of this in older adults without dementia who notice this as well. These conflicts occur more

frequently and tend to be more brutal in Alzheimer’s patients. This is common in later stages of

Alzheimer’s yet there have been reports and studies show to be found in the early stages as well.

This seems hard to believe that such a thing as difficulty sleeping can be caused by

Alzheimer’s. There are several patients with Alzheimer’s that wake up more often and stay
awake longer during the night. Brain wave studies have shown to have a decrease in both

dreaming and non-dreaming sleep stages. Sometimes those who can’t sleep may be unable to lie

still, or yell or call out, disturbing the sleep of their caregivers.

Alzheimer’s patients have tendency for daytime napping and other shifts in the sleep-

wake cycle. Individuals may feel very drowsy during the day and then be unable to sleep at

night. Experts estimate that in late stages of Alzheimer’s, individuals spend about 40 percent of

their time in bed at night awake and a significant part of their daytime sleeping. Patients should

have a thorough medical examination to identify any treatable illnesses that may be contributing

to the sleeplessness. Some conditions are Depression, Restless legs syndrome, Sleep apnea.

Most doctors mostly try the non-drug treatment first due to the amount of medications

patients usually are taking. This treatment aspires to build a sleep routine, to decrease daytime

napping and to create the sleep environment necessary. The structure of this treatment consists of

Maintaining a schedule for regular times for meals and for going to bed and getting up,

Encourage regular daily exercise includes seeking morning sunlight exposure, Treat any pain,

Avoid alcohol, caffeine and nicotine, If the person is taking a cholinesterase inhibitor avoid

giving the medicine before bed, Make sure the bedroom temperature is comfortable, If the person

awakens, discourage staying in bed while awake; use the bed only for sleep, Discourage

watching television during periods of wakefulness.

The second Sleep treatment is obliviously medications. This is for the cases that non-

drug fails help the sleeplessness. There is one rule for delivering sleep medications all experts

agree on begin low and go slow. This rule came about because of the risk of sleep inducing

medication on older adults who are cognitively impaired are significant. The risks are increased
risk for falls and fractures, confusion, and a decline in the ability to care for oneself. However

once a sleep pattern has been established patients are too slowly discontinue them.

The most common used sleep medications are Tricyclic antidepressants, such as

nortriptyline and trazodone. Another is Benzodiazepines which common names are lorazepam,

oxazepam and temazepam. Sleeping pills also called zolpidem, zaleplon and chloral hydrate.

Lastly are antipsychotics such as haloperidol, risperidone, onlanzapine and quetiapine.

The final treatment is alternative therapy which consists of several herbal remedies,

vitamins and other dietary supplements. The safety and capability of these products are based

fundamentally on testimonials, tradition, and a rather small body of scientific research. The

reason this is called alternative therapy is due to the unknown. The effectiveness, safety, purity

are all unknown. The claims do not present enough evidence of effectiveness for FDA, as well as

FDA has no authority over supplement production. The safety of this therapy is also not

regulated. The safety precautions are actually given by healthcare professionals to the

manufacturers. Not to mention the risk of these products can have serious or serve interactions

with prescribed medications.

Vitamin E is used to treat Alzheimer’s because it is an antioxidant, a substance that may

protect nerve cells from certain kinds of chemical wear and tear. There is one large federally

funded study that shows that vitamin E can slightly slow down the loss of ability to carry out

daily life. Patients should not take vitamin E to treat Alzheimer’s unless supervised by physician.

The Vitamin E doses in these cases are relatively high. This high dose is why vitamin E should

never been taken without proper supervision. Vitamin E can interact with other medications,

including those prescribed to keep blood from clotting.

Coenzyme Q10 or ubiquinone is another antioxidant that is used in Alzheimer’s patients.

This usually naturally produced in the body and is necessary for ordinary cell reactions. There

was a synthetic version of this compound called idebenone, which was studied with Alzheimer’s

but produced complimentary results. There is also no information on an adequate dose to be

taken and considered safe. Consequently there can be harmful effects due to the lack of study.

Coral Calcium which is advertised as a cure for Alzheimer’s, cancer and other illnesses.

This is a form of calcium carbonate that is derived from shells of formerly living organisms that

made up coral reef. In June 2003, the Federal Trade Commission (FTC) and the Food and Drug

Administration (FDA) filed a formal complaint against the promoters and distributors of coral

calcium. Coral calcium differs from ordinary calcium supplements only in that it contains traces

of some additional minerals incorporated into the shells by the metabolic processes of the

animals that formed them. It contains no amazing health benefits.

Ginkgo biloba is a plant extract containing several compounds. Ginkgo biloba is thought

to have antioxidant and anti-inflammatory benefits that may have positive effects on cells within

the brain and the body. However, multicenter Phase III study published in the Journal of the

American Medical Association  (November 19, 2008) proved that gingko was acting as a placebo

in delaying changes in memory, thinking and personality and had no impact on the development

of Alzheimer’s.

Huperzine-A is a moss extract usually used in traditional Chinese medicine. The

properties of Huperzine-A is very similar to those of cholinesterase inhibitors. As a result, it is

promoted as a treatment for Alzheimer's disease also may be comparable to approved drugs for

Alzheimer’s. There was a study for this drug launched in spring 2004 by no results has been

mentioned. This is also another drug that has been regulated as a dietary supplement with no

uniform standards. It is recommended not to be taken with prescribed medication due its
similarity to cholinesterase inhibitors and increase side effects of prescribed drug.

Last form of alternative therapy is Omega-3 fatty acids. Omega-3 is a type of

polyunsaturated fatty acid it has been more linked to heart disease and stroke than Alzheimer’s.

There are only two types of Omega-3’s qualified for use. Docosahexaenoic acid (DHA) and

Eicosapentaenoic acid (EPA) recently added to 75% of prenatal vitamins for develop of brain in

babies. This fatty acid cannot be made in the body this is fatty acid primarily use from fish oil or

flax oil. The reason why this was linked to the reduction of brain decline was that DHA is the

chief omega-3 in the brain. There are theories that Omega-3’s are might influence dementia risk

include their benefit for the heart and blood vessels, anti-inflammatory properties, and support

while protecting the nerve cell membranes. These findings are still under study and are in the

preliminary stage.
 Index

1. Alzheimer’s disease - a common form of dementia of unknown cause, usually beginning

in late middle age, characterized by memory lapses, confusion, emotional instability, and

progressive loss of mental ability. Named after Alois Alzheimer (1864–1915), German

neurologist, who described it in 1907.

2. Antidepressants- of or pertaining to a substance that is used in the treatment of mood

disorders, as characterized by various manic or depressive affects.

3. Anti-inflammatory- acting to reduce certain signs of inflammation, as swelling,

tenderness, fever, and pain.

4. Autopsy- inspection and dissection of a body after death, as for determination of the

cause of death; postmortem examination.

5. Cholinesterase inhibitors- is an enzyme that increases the levels of a chemical

messenger involved with memory, judgment and other thought processes called

acetylcholine.

6. Coenzyme Q10- a naturally occurring, fat-soluble, vitamin like enzyme found in a

variety of foods and synthesized in the body: sold as a dietary supplement for its

antioxidant properties.

7. Confusion- lack of clearness or distinctness: a confusion in his mind between right and

wrong.
8. Coral Calcium- This is a form of calcium carbonate that is derived from shells of

formerly living organisms that made up coral reef.

9. Dementia- severe impairment or loss of intellectual capacity and personality integration,

due to the loss of or damage to neurons in the brain.

10. Depression- condition of general emotional dejection and withdrawal; sadness greater

and more prolonged than that warranted by any objective reason.

11. Diagnose- to determine the identity of (a disease, illness, etc.) by a medical examination:

The doctor diagnosed the illness as influenza.

12. Dietary supplement- product taken orally that contains one or more ingredients that are

intended to supplement one's diet and are not considered food.

13. Docosahexaenoic acid (DHA)- an omega-3 fatty acid found especially in cold-water

fish.

14. Eicosapentaenoic acid (EPA)-An omega-3 fatty acid found in fish oils.

15. Fatty acid- any of a class of aliphatic acids, esp. palmitic, stearic, or oleic acid,

consisting of a long hydrocarbon chain ending in a carboxyl group that bonds to glycerol

to form a fat.

16. Federal Trade Commission (FTC)- A federal agency responsible for maintaining the

competitive markets, thereby discouraging restraint of trade and monopoly. The clout and

aggressiveness of the FTC vary greatly depending on its membership and the incumbent

Presidential administration.
17. Food and Drug Administration (FDA) - The FDA is responsible for protecting the

public health by assuring the safety, efficacy, and security of human and veterinary drugs,

biological products, medical devices, our nation’s food supply, cosmetics, and products

that emit radiation.

18. Ginkgo biloba- is a plant extract containing several compounds.

19. herbal remedies- a plant or plant part or an extract or mixture of these used to prevent,

alleviate, or cure disease called also herbal, herbal medicine.

20. Huperzine-A - is a moss extract usually used in traditional Chinese medicine. The

properties of Huperzine-A is very similar to those of cholinesterase inhibitors. 

21. medical examinations- thorough physical examination; includes a variety of tests

depending on the age and sex and health of the person.

22. Memory- the mental capacity or faculty of retaining and reviving facts, events,

impressions, etc., or of recalling or recognizing previous experiences.

23. mild stages of Alzheimer’s- progress from mild forgetfulness to widespread neurological

impairment and ultimately death.

24. moderate stages of Alzheimer’s- progress from moderate forgetfulness to widespread

neurological impairment and ultimately death.

25. Omega-3 - a polyunsaturated fatty acid, essential for normal retinal function, that

influences various metabolic pathways, resulting in lowered cholesterol and triglyceride

levels, inhibited platelet clotting, and reduced inflammatory and immune reactions.
26. Polyunsaturated fatty acid - an unsaturated fatty acid whose carbon chain has more

than one double or triple valence bond per molecule; found chiefly in fish and corn and

soybean oil and safflower oil.

27. Restless legs syndrome- a nervous disorder of uncertain patho-physiology that is

characterized by restlessness of the legs usually as evidenced by aching, crawling, or

creeping sensations in them especially at night or when lying down and that is often

accompanied by insomnia and by involuntary twitching of the legs during sleep called

also restless legs.

28.  Serve stages of Alzheimer’s- is the result of confusion of the past and present. Another

sign is severe to total loss of verbal skills, they forget to speak or how to speak or write. 

The person becomes completely incapable to care for self.

29. Sleep apnea- a temporary suspension of breathing, occurring in some newborns (infant

apnea) and in some adults during sleep

30. Supplements- something added to complete a thing, supply a deficiency, or reinforce or

extend a whole.

31. Vitamin- any of a group of organic substances essential in small quantities to normal

metabolism, found in minute amounts in natural foodstuffs or sometimes produced

synthetically: deficiencies of vitamins produce specific disorders.

32. Vitamin E- a pale-yellow viscous fluid, abundant in vegetable oils, whole-grain cereals,

butter, and eggs, and important as an antioxidant in the deactivation of free radicals and

in maintenance of the body's cell membranes: deficiency is rare.

 Bibliography

Alzheimer’s Association. Early Onset Dementia: A National Challenge, A Future Crisis.

(Washington, D.C.: Alzheimer’s Association, June 2006) Accessible at www.alz.org

Alzheimer’s Association. Professionals & Researchers, Alzheimer's disease, Treating

Alzheimer’s: Cognitive Symptoms. Accessible at www.alz.org

Beers, Mark H. and Robert Berkow. "The Merck Manual of Diagnosis and Therapy, 17th

Edition." Delirium and Dementia. Whitehouse Station, New Jersey: Merck Research

Laboratories, 1999. Chapter 40.

Lon S. Schneider MD, (University of Southern California) reflects in the Journal of the
 American Medical Association (JAMA. 2008;300[19] “Ginkgo Biloba and Alzheimer's

Disease” Online article accessible http://www.audiology.org/news/Pages/20081119a.aspx

Kasper, Dennis L., et al. "Harrison's Principles of Internal Medicine, 16th Edition." Bird,

Thomas D. and Bruce L. Miller. Dementia. New York: McGraw-Hill Professional, 2004.

Chapter 365.

Appendix
A.1 – During the presymptomatic stage of Alzheimer's disease (A), a beta accumulates in diffuse plaques. Axons
and dendrites within and near the plaque appear structurally normal. By the symptomatic stage (B), many
plaques appear "mature”. Nearby microglia and astrocytes are activated, and axons and dendrites are
degenerating.

A.2 – This illustration demonstrates a CT scan of the brain.

Physicians are able to notice any changes of the brain to
distinguish Alzheimer’s.