The persons brain is dying

SO What is Dementia?

It is NOT part of normal aging! It is a disease!

It is more than just forgetfulness which is part of normal aging It makes independent life impossible

Dementia
What is Dementia? Acquired syndrome of decline in memory and at least one other cognitive function (e.g.apraxia, aphasia, agnosia) sufficient to affect daily life in an alert person.

Causes of primary dementia

DEMENTIA

AAlzheimers

Disease
Early onset Normal onset

Vascular (Multiinfarct) Dementia

Lewy Body Dementia

Fronto Temporal Lobe Dementias

Other Dementias Metabolic Drugs/toxic White matter disease Mass effects Depression Infections Parkinsons disease

Pathology of Alzheimers disease

A- Formation of amyloid plaques, neuritic tangles and brain atrophy. B- Reduced level of acetylcholine at hippocampus and other cortical areas for memory and learning

AD Pathology
neuritic tangles

Amyloid plaques (Ab)

Enzymes act on the APP (amyloid precursor protein) and cut it into fragments. The betaamyloid fragment is crucial in the formation of senile plaques in AD.

Tau proteins are proteins that stabilize microtubules

Latest Thinking About Prevention Help

Help

Mental activity Aerobic activity Vitamin E (low dose) & C Heart Smart Diet Omega 3 fatty acids (fish, canola, flaxseed oils) Lower weight Not smoking Enough sleep De-stressing Moderate alcohol intake

Keeping iron in limits Vitamin Bs Monitor thyroid function Staying socially active Getting depression treated Control diabetes better Control hypertension better Statins (if needed) Protect your head prevent head injuries

A study showed that Americans who followed the Mediterranean Diet (MeDi), consisting of lots of fruits and vegetables, legumes, cereals, some fish and dairy and meat, had a significantly reduced risk for Alzheimer's disease as they got older.

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Risk Factors for Alzheimers Disease

-Aging, History of head injury with loss of consciousness -Family history of AD or and Downs syndrome, -Mutations on presenilin1 & 2 genes (rare)
presenilin genes, called PSEN1 (located on chromosome 14) that encodes presenilin 1 (PS-1) and PSEN2 (on chromosome) that codes for presenilin 2 (PS-2) Presenilins are a family of related multi-pass transmembrane proteins that function as a part of the gamma-secretase intramembrane protease complex. They were first identified in screens for mutations causing early onset forms of familial Alzheimer's Disease

Aggravators of Apparent Dementia

D-Drugs E-Emotional illness including depression M-Metabolic/endocrine disorders E-Eyes/ear/environment T-Tumors/trauma I-Infection A-Alcoholism/anemia/atherosclerosis

CLINICAL FEATURES:
Amnesia: Memory loss for recent events
Progresses into dementia almost total memory loss Agnosia: naming and recognition problems Apraxia: difficulty with doing tasks such as dressing, bathing Aphasia: language difficulty, loss of language ability

Affective/personality disturbance:
(fatuous, hostile) Disorientation, getting lost, loss of hygeine, appetite

Death from opportunistic infections

How is AD Diagnosed?
Asking questions about the persons general health, any past medical problems, and the ability to do daily activities Memory tests, problem solving strategies, attention, counting, and language Tests of blood, urine, or spinal fluid

Brain scans as CT scan and MRI and PET

Positron Emission Tomography (PET) Alzheimers Disease Progression vs. Normal Brains
Normal Early Alzheimers Late Alzheimers Child

Treatment of Alzheimers disease

Early Cholinesterase Inhibitors Therapy May Slow Decline in Cognition, Function and Behavior.

Normal Brain Cells

Neurotransmitters (AChE) being sent message being communicated to the next cell

Normal Brain Cells

Once the message is sent, then enzymes lock onto the messenger chemicals and take them out of circulation so a new message can be sent

Brain Cells with Alzheimers

plaques tangles Less neurotransmitt er Further to go to get to the next cell

Enzymes (AChE inhibitors) get to them BEFORE they deliver their message

What do Alzheimers drugs DO?

Alzheimers drugs provide FAKE messenger chemicals that distract the enzymes. They attach to the Fake AChE & the message can get thru

Aricept, Exelon, Reminyl (Razadyne)

Keeps the cell from getting so much glutamate in it

Can use it with AChE inhibitors two actions

NIC5-15 is a safe and tolerable natural compound that may reduce the progression of Alzheimer's diseaserelated dementia by preventing the formation of beta-amyloid plaque. Vitamin E 2000 units per day Symptomatic therapy for specific behavioral/psychiatric disturbances.

The new treatment for Alzheimer, (IVIG):

of the drug : (IVIG) The new treatment, intravenous immunoglobulin, contains antibodies from blood donors. Clearing toxic proteins called beta amyloid from the brain, allowing brain cells to function properly. Side effects: no side effects.
Name

Caregiver education active participation of caregivers are critical optimal management of patients.

and the for AD

Over the past 5-10 years research and knowledge has increased dramatically

Where are we NOW

Over 90-95% accuracy on diagnosis Early diagnosis - best treatment & planning Drugs can help delay symptoms Strategies to improve care & quality of life 70-80 known causes of dementia Some causes are reversible We can reduce our risks New info each week

Strange finding

There is evidence showing improvement in cognitive performance in patients with Downs syndrome and Parkinsons disease when administered nicotine.

Studies state that nicotine can improve performance on a variety of tasks including learning, memory, and cognitive functioning.
Clinical observations show that long-term use of nicotine (i.e., smoking) is negatively correlated with risk for Alzheimers disease.