Background Info on AD Flashcards
For every 5-year age
group beyond 65, the
percentage of people with
AD ……?
doubles
AD is Mostly found in people of what ages?
65+
What are the 10 Warning signs of AD?
- Recent memory loss affecting job
- Difficulty performing familiar tasks
- Problems with language
- Disorientation to time or place
- Poor or decreased judgment
- Problems with abstract thinking
- Misplacing things
- Changes in mood or behavior
- Changes in personality
- Loss of initiative
What are the Signs/Symptoms of Preclinical AD and MCI?
• Memory loss is the first sign.
- Signs of AD are first noticed in the entorhinal cortex, then it proceeds to the hippocampus.
• Wide variety of symptoms – hard to diagnose with certainty
• brain regions begin to shrink
• Changes can begin 10-20 years before symptoms appear.
• subtle behavioral and memory changes
What are the Signs/Symptoms of Mild to Moderate AD?
• The cerebral cortex begins to shrink
• MILD: memory loss, confusion, trouble handling money, poor judgment, mood changes, and increased anxiety.
• MODERATE: increased memory loss and confusion,
problems recognizing people, difficulty with language and thoughts, restlessness, agitation, wandering, and repetitive statements.
What are the Signs/Symptoms of Severe AD?
• Extreme brain shrinkage occurs. Brain retracts
from cranial vault – brain ventricles expand. Patients are completely dependent on others for care.
• Weight loss, seizures, skin infections, groaning, moaning, or grunting, increased sleeping, loss of bladder and bowel control.
• Death usually occurs from aspiration pneumonia or other infections.
What are the Risk Factors of AD?
- Age
- Gender – female has more risk
- Low education and low IQ (e.g., the Nun Study as an example)
- Low income
- family history of AD or dementia – also can inherit bad blood vessels
- Apolipoprotein alleles (esp. Apo E4 genotype – ApoE4 has been shown to be a carrier of the amyloid peptide across the blood-brain barrier)
- Systolic arterial hypertension – may relate to blood brain barrier leak
- Mutations in Amyloid Precursor Protein (APP) – generate more amyloid
- Mutations in genes processing APP (presenilin 1 & 2) – generate more amyloid, especially the bad version called Abeta42
- Down’s syndrome (chr. 21) – contains APP gene - 100% incidence of Alzheimer’s disease – generate more amyloid and bad blood vessels
- Head injury (Note: Recent studies of sports-related head injuries)
- Bad autoantibody profiles – with high titer of neuron-binding antibodies
What regions of the Brain are damaged by AD?
A. Cerebral Cortex
B. Basal forebrain
C. Hippocampus
The Cerebral Cortex controls what?
Involved in conscious thought and language.
The Basal Forebrain controls what?
Has large numbers of neurons containing acetylcholine, a chemical important in memory and learning.
The Hippocampus controls what?
Essential to memory storage. The earliest signs of Alzheimer’s are found in the nearby entorhinal cortex.
How do PET scans work on patients w/ AD?
PET scans show much reduced glucose utilization in the AD brain compared to controls
What is the Pathophysiology of AD?
- Deposition of insoluble *Amyloid Peptide both in and around neurons, which involves pyramidal neurons
- Formation of *Amyloid (neuritic) Plaques (dead neurons)
- Formation of *Neurofibrillary Tangles containing primarily the hyperphosphorylated tau protein
- Inflammatory Response
- Cholinergic deficit
What is the inflammatory response associated w/ AD?
Astrocytosis and Microgliosis
Astrocytosis -
activation of astrocytes – an early event involved
in clearing of synaptic debris
