Alzheimer's disease is a degenerative brain disorder
of unknown etiology which is the most common
form of dementia, that usually starts in late middle
age or in old age, results in progressive memory
loss, impaired thinking, disorientation, and changes
in personality and mood. There is degeneration of
brain neurons especially in the cerebral cortex and
presence of neurofibrillary tangles and plaques
containing beta-amyloid cells
Alzheimer’s disease is a chronic, irreversible
disease that affects the cells of the brain and
causes impairment of intellectual functioning.
Alzheimer's disease is a brain disorder which
gradually destroys the ability to reason, remember,
imagine, and learn
First described by German psychiatrist
-Alois Alzheimer (1906)
Generally diagnosed in people over 65 years of age
-Early-onset (before 65); only 5-10% of patients
-Several genetic causes
4.5+ million Americans suffer from it
-5% of 65-74 years of age
-Nearly 50% of 85+
1 in 6 women over 55; 1 in 10 men over 55
Unknown
But advanced age
Female
Family history AD
Head trauma with loss of consciousness
Virus
Environmental toxin
Cerebrovascular disease
DUE TO THE ETIOLOGICAL FACTORS
CHANGES OCCUR IN THE PROTIENS OF THE NERVE CELLSOF THE
CEREBRAL CORTEX
ACCUMULATION OF NEUROFIBRILLARY TANGLES AND PLAQUES
GRANULO VASCULAR DEGENERATION
LOSS OF CHOLINERGIC NERVE CELLS
LOSS OF MEMORY, FUNCTION AND COGNITION
Mild Alzheimer’s Disease
Memory loss for recent events
hard time remembering newly learned information
Difficulty with problem solving, complex tasks and sound
judgments
tasks such as planning a family event or balancing a checkbook
become overwhelming, often experience lapses in judgment
Changes in personality
may become withdrawn, irritable, or angry when unexpected,
decreased attention span
Difficulty organizing and expressing thoughts
Getting lost or misplacing belongings
common to lose or misplace things, trouble finding way around
Showing increasingly poor judgment and deepening
confusion
lose track of where they are, confuse friends and family
members, and often wander
Experience even greater memory loss
may be unable to recall addresses, phone numbers, stories
Need help with some daily activities
Undergo significant changes in personality and behavior
not uncommon to develop unfounded suspicions, hear or
see things, grow restless and agitated, may bite, kick,
scream, etc.
• Lose the ability to communicate coherently
• Require daily assistance with personal care
total assistance with dressing, eating, etc.
• Experience a decline in physical abilities
unable to walk, get up, or hold up one’s head
Impairment of the ability to remember
information acquired in the past
Gradual impairment of memory
Short-long term memory
Apraxia
Aphasia
Depression
Inability to perform skilled motor activity
(dressing, walking)
Psychiatric assessments.
Mental status examination and neuro
psychological assessment.
Laboratory tests
Brain imaging.
• CT scan
• MRI
• PET
• SPECT
CSF Examination
Electro-encephalogram (EEG)
Electromyogram
Pharmacological intervention
Acetylcholinesterase inhibitors -prevent the
breakdown of acetylcholine, a chemical
messenger important for learning and memory
eg. Donepezil (Aricept)
Rivastigmine (Exelon)
Galantamine (Razadyne
N-Methyl d-aspartate Receptor Antagonist
(NMDA)
Eg:Memantine – blocks the NMDA
receptor and inhibit their overstimulation
by glutamate (neurotransmitter)
Antidepressents.
Anxiolytics.
Antipsychotics.
Anticonvulsants
Psychosocial intervention
Behavioral approach
Emotion oriented approach
Reminiscence therapy
Validation therapy
supportive psychotherapy
sensory integration
stimulated presence therapy
Cognition oriented approach
Stimulation oriented approach
Care giving
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
Disturbed thought processes related to
physiologic disease process
Risk for injury due to loss of cognitive
abilities
Insomnia secondary to disease process
Caregiver role stain related to physical
needs and behavioral manifestations of the
disease process
Improving cognitive response
Reduce noise and social interaction to a level tolerable for
the patient
Provide physical activity
Preventing injury
Avoid restraints but maintain observation
Provide adequate lighting to avoid misinterpretation of
the environment
Remove unneeded furniture and euipment from the room
Ensuring adequate rest
Supporting care
Encourage caregiver to discuss feeling
Assess caregivers stress and refer for counseling
Stress the need for relaxation time or respite care
