30. Alzheimer's disease

Question 1

What is Alzheimer’s disease?

Answer 1

A neurodegenerative disorder, plaques develop in the hippocampus and other cerebral cortex (inv. thinking and decision making). Results in cognitive and behavioral impairment.

Question 2

Causes

Answer 2

UNKNOWN
Genetic: Mostly sporadic, APP on chromosome 21, PS1 on chromosome 14, PS2 on chromosome 1, APOE on chromosome 19
Infection, depression, head trauma

Question 3

Diagnosis

Answer 3

Gradually worsening. Preclinical may be perfectly fine in physical examination & mental status.

Clinical exam.: During the mild stage of the disease
Lumbar puncture: Levels of tau and phosphorylated tau in CSF, amyloid levels are usually low; but only for research settings
Imaging studies: To rule out potentially treatable causes of progressive cognitive decline

Question 4

Treatment

Answer 4

Treat the 2ndary symptoms; depression, agitation, aggression, hallucinations, delusions, and sleep disorders
Cholinesterase inhibitors, antidepressants, anxiolytics, antiparkinsonian agents, beta-blockers, antiepileptic drugs, neuroleptics