Alzheimer's Disease Flashcards
What is Alzheimer’s Disease
Progressive neurodegenerative disorder results in:
- deterioration and irreversible damage to the cerebral cortex and subcortical areas
- Neurons that are normally involved with AcH transmission deteriorate within the cerebral cortex.
- Development of amyloid plaques and neurofibrillary tangles leading to further damage.
Etiology
Exact Etiology: Unknown
- Perhaps Genetic Inheritance
- Higher levels of aluminium in the brain
- Lower levels of Neurotransmitters; AcH
- Autoimmune Disease
- Amyloid
Incidence increases with age
Higher Risk in Women
Early Stage: Signs and Symptoms
Changes in higher cortical functions:
- Difficulties with new learning
- Subtle changes in memory and concentration.
Progression:
- Poor judgement
- Bradykinesia
- Rigidity
Middle Stage Symptoms
- Aphasia
- Apraxia
- Preservation
- Agitation
- Wandering
End-Stage Signs and Symptoms
End-Stage Disease: (vegetative symptoms)
- severe intellectual and physical destruction
- incontinence
- functional dependence
- inability to speak
Eventual: inability to to learn and loss of long term memory
What are patients with End -Stage Alzheimer’s disease at high risk of?
Infection and Pneumonia
Other complication (associated with vegetative state):
- Contractures
- Fracture
- Pulmonary Compromise
- Decubiti; Pressure Ulcers
Treatment Options
No curative treatment
- Medications for:
- Inhibiting acetylcholinesterase
- Alleviating Cognitive Symptoms
- Controlling Behavioral Changes
Meds: Cognex, Aricept, Exelon
Medications that may be appropriate?
Meds:
- Cognex; Tacrine
- Aricept; Donepezil
- Exelon; Rivastigmine
What is the Medication Cognex?
A prescription medicine used to treat the symptoms of mild to moderate dementia in patients with Alzheimer Disease
- Cognex® (tacrine hydrochloride) is a reversible cholinesterase inhibitor
- Off of the market now, withdrawn for causing liver failure
Who is more at risk of developing Alzheimer’s, Men or Women?
Women
What can physical therapy do or should focus on?
Maximizing patients remaining function and providing family and caregiver instruction
- Provide opportunities that would promote success
- Modifying patients living space
What Structures are mainly injured in this pathology?
- Neurons that are normally involved with Ach transmission deteriorate within the cerebral cortex.
What do amyloid plaques consist of?
- Fragmented Axons
- Altered Glial Cells
- Cellular Waste: that results in inflammatory response > causing further damage
What age does the prevalence increase significantly?
> 80 y/o
What laboratory findings or imaging studies would confirm the diagnosis?
Cannot be confirmed until post-mortem biopsy revealing neurofibrillary tangle and amyloid plaques
- MRI: may be useful in assessing any signs of atrophy
- Single Photon Emission Tomography (SPECT): determine brain activity associated with Alzheimer’s
Ruling out other pathology through urine and spinal fluid analysis
