ALZHEIMER

Dra Maria Caecilia NS,M.Sc,Apt

 Demensia adalah penurunan
kemampuan mental yang biasanya
berkembang secara perlahan,
dimana terjadi gangguan ingatan,
fikiran, penilaian dan kemampuan
untuk memusatkan perhatian, dan
bisa terjadi kemunduran
kepribadian., timbul perlahan,
menyerang usia > 60 tahun

 Alzheimer merupakan sejenis

penyakit penurunan fungsi saraf
otak yang kompleks dan progresif
yang di sebabkan karena
berkurangnya gizi di otak. Penyakit
Alzheimer bukannya sejenis
penyakit menular. Penyakit
Alzheimer adalah keadaan di mana
daya ingatan seseorang merosot
dengan parahnya sehingga
pengidapnya tidak mampu
mengurus diri sendiri.
www.alz.org
Definisi

Penyakit alzheimer

sindrom demensia yang ditandai dgn

penurunan ingatan dan kemampuan
kognitif pasien secara progresif
 In 1906, Dr. Alzheimer noticed changes in the
brain tissue of a woman who had died of an
unusual mental illness. Her symptoms
included memory loss, language problems,
and unpredictable behavior.
 After she died, he examined her brain and
found many abnormal clumps (now called
amyloid plaques) and tangled bundles of
fibers (now called neurofibrillary tangles).
Plaques and tangles in the brain are two of
the main features of AD. The third is the loss
of connections between nerve cells (neurons)
in the brain
www.alz.org
www.alz.org
Patogenesis
• Pasien mengalami atrofi kortikal dan
berkurangnya neuron secara signifikan,
terutama saraf kolinergik (limbik otak dan
korteks)
• Terjadi penurunan jumlah enzim kolin
asetiltransferase di korteks serebral dan
hippocampus
• Di otak, dijumpai amyloid plaques dan
neurofibrillary yg terpusat pd daerah yg
sama
nejm.org
Gejala dan Tanda
• Memory loss
• Difficulty performing familiar tasks
• Problems with language
• Disorientation to time and place
• Poor or decreased judgment
• Problems with abstract thinking
• Misplacing things
• Changes in mood or behavior
• Changes in personality
• Loss of initiative www.alz.org
Penyebab dan Faktor Resiko
• Age
• Family history
• Genetics (heredity)
Penyebab dan Faktor Resiko Lain yg
Mungkin mempengaruhi
•Head injury
•General healthy aging

www.alz.org
Diagnosis

• ask questions about the person’s overall

health, past medical problems, ability to
carry out daily activities, and changes in
behavior and personality
• conduct tests of memory, problem solving,
attention, counting, and language
• carry out medical tests, such as tests of
blood, urine, or spinal fluid
• perform brain scans, such as a computerized
tomography (CT) scan or a magnetic
resonance imaging (MRI) test

www.nia.niv.gov
Stage Of Alzheimer
• Stage 1:No impairment (normal function)
• Stage 2:Very mild cognitive decline (may be
normal age-related changes or earliest signs
of Alzheimer's disease)
• Stage 3:Mild cognitive decline
• Stage 4:Moderate cognitive decline
(Mild or early-stage Alzheimer's disease)
• Stage 5:Moderately severe cognitive decline
(Moderate or mid-stage Alzheimer's disease)
• Stage 6:Severe cognitive decline
(Moderately severe or mid-stage Alzheimer's
disease)
• Stage 7:Very severe cognitive decline
(Severe or late-stage Alzheimer's disease)
www.alz.org
Terapi
1. Non farmakologi
Melibatkan pasien, keluarga, atau
pengasuh khusus untuk mensupport,
menghadapi, dan memahami kondisi
pasien.
2. Farmakologi
 Terapi untuk mengatasi gejala penurunan
kognisi atau menunda progresivitas
penyakit
 Terapi simptomatik
Terapi Menunda Progresivitas Penyakit

• Inhibitor kolinesterase ↑↑ Asetilkolin

contoh : takrin, donepezil, rivastigmin,
galantamin.
• Antagonis reseptor NMDA : memantine
• Antioksidan, contoh : vitamin E, selegilin
www.nejm.org
Terapi simptomatik

• Pasien yg disertai depresi : antidepresan

(SSRI, TCA)
• Insomnia hipnotik atau antidepresan
yg bersifat sedatif
• Delusion antipsikotik (klozapin,
quetiapin, risperidon)
www.nejm.org