Alzheimer's Disease CAT

Question 1

What is Alzheimer’s?

Answer 1

A progressive neurological disorder that results in deterioration and irreversible damage in the cerebral cortex and subcortical areas of the brain

Question 2

What structures are usually damaged with Alzheimer’s?

Answer 2

Neurons that are normally involved w/ ACh transmission deteriorate in the cerebral cortex

Question 3

Other contributing factors to Alzheimer’s

Answer 3

• Low levels of neurotransmitters
• Higher levels of aluminum
• Genetic inheritance
• Autoimmune disease
• Abnormal processing amyloid
• Virus

Question 4

What demographics are most susceptible to Alzheimer’s?

Answer 4

• Risk increases with age (80+)
• Females > males

Question 5

Clinical presentation for early alzheimer’s

Answer 5

• Subtle changes in memory, impaired concentration, difficulty w/ new learning
• Loss of orientation, word-finding difficulties, emotional lability, depression, poor judgment, impaired self-care

Question 6

Clinical presentation for mid-stage alzheimer’s

Answer 6

• Develop behavioral and motor problems
• Neurological symptoms (aphasia, apraxia, perseveration, agitation, wandering, and violent or socially unacceptable behavior)

Question 7

Clinical presentation for end-stage alzheimer’s

Answer 7

• Severe intellectual and physical destruction
• Vegetative symptoms (incontinence, functional dependence, inability to speak, seizures)

Question 8

Role of imaging in managing Alzheimer’s

Answer 8

• Diagnosis cannot be confirmed until postmortem biopsy to reveal changes to tissue
• MRI can be used to find abnormalities or signs of atrophy, OR rule out other conditions
• SPECT can be used to determine brain activity and predict potential for Alzheimer’s
• Lab values can be used to rule out other diseases

Question 9

Risk is elevated for what conditions with end-stage Alzheimers?

Answer 9

• Infection and pneumonia
• Complications from vegetative state (contractures, ulcers, fracture, and pulmonary compromise)

Question 10

How is Alzheimer’s managed pharmacologically?

Answer 10

• Goal is to inhibit AChesterase, alleviate cognitive symptoms, and control behavioral changes
• Usually short-term (6-9 months)
• Tacrine (cognex)
• Donepezil (aricept)
• Rivastigmine (exelon)

Question 11

Tacrine (cognex)

Answer 11

acetylcholinesterase inhibitor

Question 12

Donepezil (aricept)

Answer 12

• used to treat confusion related to Alzheimer’s disease.
• may improve memory, awareness, and the ability to function

Question 13

Rivastigmine (exelon)

Answer 13

• used to treat confusion related to Alzheimer’s disease and to Parkinson’s disease
• may improve memory, awareness, and the ability to perform daily functions

Question 14

What should the focus of physical therapy be with patients who have Alzheimers?

Answer 14

• Maximizing remaining function
• Provide family and caregiver education
• Modify living space to facilitate easily finding stuff

Question 15

Long-term effects of alzheimer’s

Answer 15

• 4th leading cause of death in US
• Typical course of disease 7-11 years
• Infection or dehydration is usually how they will pass