Mr ASHOK BISHNOI

Lecturer JINR

• First described by German psychiatrist ◦ Alois Alzheimer (1906)

Introduction:-

“is a slowly progressive disease of the brain that is characterized by impairment of memory and eventually by disturbances in reasoning, planning, language, & perception”

Definition:-

• Generally diagnosed in people over 65 years of age -Early-onset (before 65); only 5-10% of patients

• 4.5+ million Americans suffer from it

• 1 in 6 women over 55

• 1 in 10 men over 55

Incidence:-

Idiopathic

Cholinergic hypothesis◦ -Caused by reduced synthesis of acetylcholine◦ -Destruction of these neurons causes disruptions in distant

neuronal networks (perception, memory, judgment)

Amyloid hypothesis◦ -Abnormal breakdown; buildup of amyloid beta deposits ◦ -Damaged amyloid proteins build to toxic levels, causing call

damage and death

Genetics

Etiology:-

• Obesity• High blood pressure• Head trauma• High cholesterol• Depression• Lower rates in highly educated• Family history

Risk factors:-

Due to etiological factor

Amyloidosis ( Amyloid Decreased production

of acetylcholinepreserved protein

deposition in neurone)

Memory loss, Forgetfulness, Depression, Loss their familiar Phases, Place, Object & Environment

Pathophysiology:-

1.Mild AD:-

Memory disturbance

Poor judgement

Irritability

Agitation

Suspicious

Apathy

Cognitive impairment

Clinical Manifestations according to types:-

2.Moderate A D:-

Language disturbance Impaired word finding Spontaneous speech Paraphrasis (word used in the wrong context)

Motor disturbanceHyper orality (the desire to take everything in to

the mouth to suck, chew, taste)

Swallowing difficultyDepressionDelusion

3.Severe A D:-

Communication disturbance

Urinary, faecal incontinence

Pneumonia

Memory loss that disrupts daily life.

Challenges in planning or solving problems. Some people may

experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.

Difficulty completing familiar tasks at home, at work.

Confusion with time or place.

Trouble understanding visual images and spatial relationships.

New problems with words in speaking or writing.

Misplacing things and losing the ability to retrace steps.

Decreased or poor judgment.

Withdrawal from work or social activities.

Changes in mood and personality.

History

Physical examination

(MSE) Mental State Examination (used to evaluate the cognitive impairments)

C.T Scan

MRI

PET

Diagnostic evaluation:-

.

PET scan of the brain of a person with AD showing a loss of function in the temporal lobe.

Aricept Used to delay or slow the symptoms of ADDonepezil • Loses its effect over time

• Used for mild, moderate and severe AD• Does not prevent or cure AD

CelexaCitalopram Used to reduce depression and anxiety

• May take 4 to 6 weeks to work• Sometimes used to help people get to sleep

Depakote Used to treat severe aggressionSodium Valproate • Also used to treat depression and anxiety

Exelon Used to delay or slow the symptoms of ADRivastigmine • Loses its effect over time

• Used for mild to moderate AD• Can get in pill form or as a skin patch• Does not prevent or cure AD

Management of AD:-

Nursing management:-