alzheimer's disease 1/2

Question 1

What is Alzheimer’s disease?

Answer 1

• chronic, Progressive neurological disorder
• resulting in cerebral atrophy, deterioration and irreversible damage within cerebral cortex and sub cortical areas of the brain
• especially neurons involved in Acetylcholine transmission
• Lose of neurons because breakdown of process that would normally sustain brain cells

Question 2

Symptoms of Alzheimer’s disease

Answer 2

Changes in higher cortical functions – memory, impaired concentration, difficulty with new learning

Question 3

Alzheimer’s disease prognosis

Answer 3

7-11 years, Death resulting from infection or dehydration
chronic and progressive
4th leading cause of death in adults

Question 4

what are found in the brain during post-mortem biopsies of Alzheimer’s disease patients?

Answer 4

neurfibrillary tangles in cytoplasm
Amyloid plaques
cerebral atrophy

Question 5

what are amyloid plaques contents?

Answer 5

fragmented axons
altered glial cells
cellular waste
causing inflammatory response and atrophy of smooth muscles of brain arteries

Question 6

cause of alzheimer’s disease?

Answer 6

unknown, possibly:
abnormal processing of protein amyloid
automimmune disease
genetics
higher levels aluminum in brain
lower level NT
virus

Question 7

prevalence, gender preference of alzheimer’s disease?

Answer 7

4.5 million in US
risk increases with age, higher in women
6% in >65yo
20% in >80yo

Question 8

What are early stage symptoms of Alzheimer’s disease?

Answer 8

Loss of orientation
poor judgment
word finding difficulties
Emotional lability, depression
impaired ability to perform self-care skills

Question 9

What are middle stage symptoms of Alzheimer’s disease?

Answer 9

Behavioral and motor problems including
Aphasia
Apraxia
Perseveration
Agitation, violent or socially unacceptable behavior including wandering

Question 10

What are end stage symptoms of Alzheimer’s disease?

Answer 10

Unable to learn
Lose long-term memory
Severe intellectual and physical destruction
Vegetative symptoms – incontinence, functional dependence, inability to speak, seizure activity

Question 11

What is the only way to definitively diagnose Alzheimer’s disease?

Answer 11

Postmortem biopsy shows neurofibrillary tangles and amyloid plaques

Question 12

What imaging studies can be used to rule out other medical conditions and suspect Alzheimer’s disease?

Answer 12

MRI- show abnormalities or brain atrophy, rule out other medical conditions
SPECT Single photon emission computed tomography- shows brain activity
Bloodwork, urine, spinal fluid – rules out other disease that caused dementia

Question 13

What exam results would cause suspect of Alzheimer’s disease?

Answer 13

physical, neurological, and neuropsychological testing
patient has at least 2 deficits of cognition, memory, and related cognitive functioning
absences of all other brain disease

Question 14

what are end-stage Alzheimer’s disease patients are at high risk for?

Answer 14

infection, pneumonia

Question 15

Medications for Alzheimer’s disease?

Answer 15

Short term, lasts 6 to 9 months

Focus on inhibiting acetylcholinesterase, alleviate cognitive symptoms, control behavioral change

Question 16

Is physical therapy constant or intermittent? What is the PT focus?

Answer 16

Intermittent
early stage- maximize function, safety with functional mobility and gait, family and caregiver training
as progress - caregiver training, daily exercise program, compensatory strategies like setting up the environment for success and memory book
long-term care facility that specializes in Alzheimer’s disease

Question 17

what medication is commonly use for Alzheimer’s disease, MOA is reversible cholinesterase inhibitor?

Answer 17

tacrine (Cognex)

Question 18

what medication is commonly use for Alzheimer’s disease for confusion (dementia), may improve memory, awareness, and the ability to function?

Answer 18

donezepil (Aricept)

Question 19

what medication is commonly use for Alzheimer’s disease for cognition-enhancing abilities?

Answer 19

rivastigmine (Exelon)