Alzheimer's Flashcards
AD is similar
dementia
AD
Chronic, progressive, neurodegenerative brain disease** = no cure
slow death
AD is One of the most feared disorders of modern times due to
catastrophic consequences
What gender has AD more and dies more?
women
AD is fatal in
8-10 years after dx
Etiology of AD
UNKNOWN but likely multiple factora
Risk Factors of AD
AGE >65 (not alone needs another factor)
Family Hx = 1st-degree relative with dementia
higher if more than 1 relative
HTN
Obesity
stroke
hyperlipidemia
DM
Head trauma
AD is not a normal part of
aging
Familian Alzheimer’s disease
clear inheritance pattern
onset before 60
rapid disease discourse
Sporadic Alzheimer’s disease
no familial connection
Genetic Link of AD
An increase in Beta-amyloid protein increases risk
Cardiovascular Risk Factors
health of brain closely related to health of the heart and blood vessels
HTN
Obesity
stroke
hyperlipidemia
Diabetes in relation to AD
Chronic high levels of insulin & glucose may be toxic to brain
Insulin resistance interfere with ability to breakdown amyloid
Patho of AD
Beta-amyloid protein production contain plagues that disable memory and cog functions
- neurofibrillary tangles
- loss of connections btw neurons
neuron death
Plagues of Beta-amyloid
consists of clusters of insoluble deposits of a protein
Neurofibrillary tangles
are abnormal collections of twisted protein threads inside nerve cells. The main component of these structures is a protein called tau.
Areas of the brain affected by Alzheimer’s
intelligence
judgment
behavior
memeory
language
10 Warning Signs of AD
- Memory loss*******
- Difficulty performing familiar tasks
- Problems with language
- Disorientation to time and place (silver alerts)
- Poor or decreased judgment
- Problems with abstract thinking
- Misplacing things (ex: put milk in pantry not refrigerator)
- Changes in mood or behavior (flat)
- Changes in personality
- Loss of initiative
AD Memory changes
forgets entire experience
rarely remembers later
gradually unable to follow direction
gradually unable to use notes as reminders
Unable to care for self
Normal Memory changes
forgets part of an experience
often remembers later
able to follow directions
able to use notes and reminders
able to care of self
Retrogenesis
Stop and go backward toward a kid with an older body
-brain deteriorates and stops the functioning of the body
AD is also known as
retrogenic
What is the definitive dx for AD?
No definitive diagnostic test exist for AD
Diagnosed by exclusion
Definitive diagnosis requires an autopsy
Brain Imaging Test
CT
MRI
PET
Neuropsychologic Testing
Mini-Cog: same thing over and over
Mini-Mental State Exam (MMSE): same test every visit and fewer the recognition the worse it gets (Orientation to time, registration, naming, reading)
PET scan shows
Hypometabolism in many areas of the brain in AD
AD Tx
NO CURE
exists to stop the deterioration of brain cells in AD
control undesirable s/s
provide support for caregiver
Memantine (Namenda)
NMDA receptor agonist: protects nerve cell against excess amounts of glutamate
Cholinesterase Inhibitors
Donepezil (Aricept), rivastigmine (Exelon)
Antidepressants
Sertraline (Zoloft), citalopram (celexa), fluoxetine (Prozac)
Antipsychotic drugs
Haloperidol (Haldol), risperidone (Risperdal)
goal of AD
maintain functional ability as lon as possible
dignity maintained
AD Nurse Mgmt
Rhythm
Safety
Autonomy
Reduce anxiety and agitation
Improve communication
Socialization
Nutrition
Balanced activity/rest
Educate home and community assistance
Sundowning
up and alert at night and fights
How do you communicate with AD pts?
play along with them
