Alzheimer’s Disease (mini presentation)
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Transcript of Alzheimer’s Disease (mini presentation)
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ALZHEIMER’S DISEASEGregor Alfonsin C. Pondoyo
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What is it?
Alzheimer’s disease is a type of dementia that is progressive and is accompanied by “profound effects on memory, cognition, and ability for self-care” (Smeltzer et al, 2008).
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most common form of dementia among 65 years old and above
constitutes at least half of all dementias progressive decline in two or more areas
of cognition: memory and language calculation and visuospatial perception constructional praxis judgement, abstraction, or personality (Black
and Hawks, 2004)
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Epidemiology
in 1996 4 million people were diagnosed with the disease in the US (Tavee and Sweeney, 2010)
more women are affected than men in a ratio of 2:1
Age is a very important risk factor
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As of 2006, Alzheimer’s disease in the US is considered the 7th leading cause of death and the primary cause of it are intercurrent illnesses such as pneumonia for those who have suffered advanced Alzheimer’s disease hence immobility and difficulty swallowing (Anderson, 2010).
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In a worldwide prevalence, DOH estimated that 11 million people suffer and about 5% of people reaching 65 are affected while 15-25% of people reaching 85 are affected.
“Today more than 5.5 million Americans have Alzheimer’s...” (Barglow, 2010)
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Essential Anatomy and Physiology
Human nervous system major conductor of the body as it governs its
varied functions like exerting control over glands, organs and muscles
controls, the urination, defecation, sleeping and waking time, the osmotic concentration of the blood, the rate of breathing and heart beat, and even the blood pressure
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Important Higher Function of the Nervous System
processing of information that helps us to remember, think, and judge, making us humans highly superior from other species
I think; therefore I am
Rene Descartes
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Nervous system consists of two divisions
central nervous system or the CNS
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peripheral nervous system or the PNS
ZOOM
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Two Divisions of PNS
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To be specific, the nervous system has three major functions to wit: sensory, integrative,
and motor (Herlihy and Maebius, 2000)
The sensory nerves gather information from the environment (either internal or external) and carry them to the CNS.
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Integrative (processing of information like thinking)
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Motor
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There is conversion of the previously planned action into actual action and this function is the motor function.
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What makes up the Nervous System?
Neurons
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Neuroglia
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Neurotransmitters
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The Human Brain
Cerebrum
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Diencephalon
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Cerebellum
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Brain Stem
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Limbic system
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Hippocampus
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Etiology
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Important Predisposing Factors
Age the frequency of the disease increases to 20-
40% of the population over 85 years of age (Fauci et al, 2009)
Positive health history of Alzheimer’s disease in the family
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Genetic Links
Sporadic AD (most common)
genetic and environmental factors
Familial AD (FAD)
autosomal dominant form of disease which means that it needs 1 parent to let the gene be passed on to the next generation
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...”Diabetes Mellitus, high cholesterol, elevated homocysteine, low exercise are risk factors of AD” (Fauci et al., 2009).
(Morhan, 2008)
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It is important to remember that the precise cause of this condition however is
still not thoroughly known.
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Plaque Formation
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Pathogenesis
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Neurofibrillary tangles
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PET scan
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The Progression
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Alzheimer’s Disease Diagram
Oxidative Stress(Further) insulin resistance
Hyperlipidemia
Lipid Peroxidation
Hyperglycemia
Cardiovascular Diseases
Alpha and Gamma Secretase
APP will then be cut either by:
Predisposing FactorsAgeGenetic Factor (family history)Gender (women)DMDown syndromeSmall head size
Precipitating factorStroke (brain attack)Head InjuryProlonged loss of consciousness (as in drowning)Low exercise and cigarette smokingLower levels of educationHigh blood pressureHigh cholesterol levelsHigh homocysteine levels
Increased ROS (free radicals) and RNS
Damages proteins, lipids, DNA
VITAMIN E
Cellular starvation
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PET will show hypomebolism
Non-usage of neuron
Nerve Impulse Blocking
Atrophy
CELL DEATH
Acetylcholine not transported
Plaque build up (esp. In hippocampus and cerebral
cortex)
Depletion of intrinsic antioxidants
(Chronic) Inflammation
Amplification of oxidative stress
Generation of more free radicals
Disrupts microtubules
Nutrient transport system goes awry
Cleared in the brain
Continuous productionClings between nerve synapse
Not cleared in the brain
Clumping effect
Harmless P3 Protein fragment
42 Amino Acid
Beta and Gamma Secretase
40 Amino Acid Tau hyperphosphorylation
Tau protein pair up
Form helical shape
Clump together
Neurofibrillary tangles formed
Microscopy but only after death or AUTOPSY
CT scan and/ MRI will show reduction in size of brain, widened indentations, enlarged cerebral ventricles
Cholinesterase Inhibitors
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Motor neuron involvement
Paralysis
Susceptibility to other complications
Death
From mild forgetfulness to inability to generate short term memory to inability to perform ADL to loss of long term memory and the capability to do abstract thinking, reason, do arithmetical procedures, to inability to talk, move and recognize place, time, and person around.
Legend: Phenomenon
Manifestation
Management
Consecutively: Direction of Pathogenesis; Manifestation; Management; Direction of a Possible Phenomenon
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What's good for your heart is good for your head! Choosing to eat well and exercise can help reduce your risk for developing Alzheimer's (Alzheimer Society Columbia, 2010).
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Sources Alzheimer's Disease – Pathophysiology (2010). Medicine Encyclopedia. Retrieved on November 26, 2010 from
http://medicine.jrank.org/pages/80/Alzheimer-s-Disease-Pathophysiology.html Alzheimer’s Disease: Overview of Diagnostic Tests (2005). Cleaveland Clinic.org. Retrieved on December 4, 2010 from
http://www.cchs.net/health/health-info/docs/2300/2346.asp?index=9176 Alzheimer’s Disease (2006, December 17). Great Controversies in Neurobiology. Retrieved on December 3, 2010 from
https://wiki.brown.edu/confluence/display/BN0193S04/Project+Group+3 Alzheimer’s Disease (2006). Republic of the Philippines, Department of Health. Retrieved on November 20, 2010 from
http://www.doh.gov.ph/faq/show/489.html Alzheimer’s Disease (n.d.) Medicine. Web-books.com. Retrieved on December 8, 2010 from
http://www.web-books.com/eLibrary/Medicine/Neurological/Alzheimer.htm#Top Anderson, Heather S. (2010, July 22). Alzheimer’s Disease. Medscape. Retrieved on December 8, 2010 from
http://emedicine.medscape.com/article/1134817-overview APP (2010, November 7). Genetics Home Reference. Retrieved on December 5, 2010 from http://ghr.nlm.nih.gov/gene/APP Arrasate, Montserrat, Mitra, Siddhartha, Schweitzer, Erik S., Segal, Mark R., and Finkbeiner, Steven (2004, October 14). Inclusion body
formation reduces levels of mutant huntingtin and the risk of neuronal death. Nature Publishing Group. Retrieved on December 7, 2010 from https://wiki.brown.edu/confluence/download/attachments/11719/Nature-Huntingtin's.pdf?version=1&modificationDate=1165777192000
Askari, Famia (2009). Alzheimer’s: research on prevention, management and care. Retrieved on December 7, 2010 from http://www.medlink-uk.org/Site/documents/Alzheimers2010/AskariF.pdf
Barglow, Raymond (2010, February 25). Alzheimer’s Disease- How Long Before We Find a Cure? The Berkley Daily Planet. Retrieved on December 5, 2010 from http://www.berkeleydailyplanet.com/issue/2010-02-25/article/34707?headline=Alzheimer-s-Disease-How-Long-Before-We-Find-a-Cure-
Black, Joyce M. and Hawks, Jane H. (2004). Medical-Surgical Nursing: Clinical Management for Positive Outcomes volume 2. 7 th edition. Elsevier. Philippines. page 2162-2170
Brain Structures and Their Functions (2005, June 3). Serendip. Retrieved on November 12, 2010 from http://serendip.brynmawr.edu/bb/kinser/Structure1.html
Bruton, Linda J (2007, February 20). Alzheimer's Disease Diagnostic Tests and Tools. Retrieved on December 2, 2010 from http://ezinearticles.com/?Alzheimers-Disease-Diagnostic-Tests-and-Tools&id=454483
Caimi, G., Carollo, C., and Lo Presti, R. (2003). Oxidative Stress and Diabetes Mellitus. Retrieved on December 6, 2010 from http://www.medscape.com/viewarticle/463121_4
Castellani, Rudy J., Lee, Hyoung-gon, Perry, George, and Smith, Mark A. (2006). Antioxidant protection and neurodegenerative disease: The role of amyloid-f3 and tau. American Journal of Alzheimer's Disease and Other Dementias, Volume 21, Number 2, March/April 2006. Retrieved from https://wiki.brown.edu/confluence/download/attachments/11719/neuro.pdf?version=1&modificationDate=1162759321000
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Chronic Inflammation (n.d.). FlameEz.com. Retrieved on December 2, 2010 from http://www.flameez.com/inflammation Fauci, Anthony S., Braunwald, Eugene, Kasper, Dennis L., Hauser, Stephen L., Longo, Dan L., Jameson, J. Larry, and Loscalzo, Joseph (2009).
Harrison’s Manual of Medicine 17th Edition. New York: McGraw Hill Medical pages 2478, 2540, 2541 Hesselink, John R. (2008). THE TEMPORAL LOBE & LIMBIC SYSTEM. UCSD Neuroradiology. Retrieved on December 8, 2010 from
http://spinwarp.ucsd.edu/NeuroWeb/Text/br-800epi.htm Inflammation: Chronic (n.d.). Life Extension.org. Retrieved on December 1, 2010 from http://www.lef.org/protocols/prtcl-146.shtml Morhan, Simona D., Chong, Zhao-Zhong, and Maiese, Kenneth (2008). Oxidative Stress and Diabetes. Harlem Children Society. Retrieved on
December 8, 2010 from http://www.harlemchildrensociety.org/misc/StudentInfo/MorhanSimona/paper_morhan.pdf Nordqvist, Christian (2009, June 31). What is Alzheimer’s Disease? What Causes Alzheimer’s Disease? Medical News Today. Retrieved on
December 8, 2010 from http://www.medicalnewstoday.com/articles/159442.php Norman, William (2009, November 27). Neuron Glucose Metabolism & Alzheimer's Disease. Retrieved on November 29, 2010 from
http://www.ehow.com/about_5693153_neuron-glucose-metabolism-alzheimer_s-disease.html Nourish- Carbohydrates Fuel Your Brain (2004). The Franklin Institute Online. Retrieved on December 6, 2010 from
http://www.fi.edu/learn/brain/carbs.html Olson, Scott (2008, November 12). What Sugar Does to Your Brain. Retrieved on December 6, 2010 from http://olsonnd.com/what-sugar-does-
to-your-brain/ Oxidative Stress (2010). The Free Dictionary.Retrieved on December 3, 2010 from
http://medical-dictionary.thefreedictionary.com/oxidative+stress Prasad, Kedar N., Cole, William C., and Prasad, K. Che (2002). Risk Factors for Alzheimer’s Disease: Role of Multiple Antioxidants, Non-Steroidal
Anti-inflammatory and Cholinergic Agents Alone or in Combination in Prevention and Treatment. Journal of the American College of Nutrition, Vol. 21, No. 6, 506-522. Retrieved on December 5, 2010 from http://www.jacn.org/cgi/content/full/21/6/506
Rand, James B. (2007). Acetylcholine. WormBook.org. Retrieved on December 6, 2010 from http://www.wormbook.org/chapters/www_acetylcholine/acetylcholine.html
Rienstra, Douwe (November 2006). Medicine For People! Retrieved on December 4, 2010 from http://www.rienstraclinic.com/newsletter/2006/2006Nov.html
Saint Louis University (2009, July 9). Inflammation May Trigger Alzheimer's Disease. ScienceDaily. Retrieved December 9, 2010, from http://www.sciencedaily.com /releases/2009/07/090708181204.htm
Smeltzer, Suzanne C., Bare, Brenda G., Hinkle, Janice L., and Cheever, Kerry H. (2008). Textbook of Medical-Surgical Nursing volume 2. 11th Edition. Lippincott Williams and Wilkins. Philippines. Page 2320-2323
Spies, Petra E., Claassen, Jurgen, Slats, Diane, Rikkert, Marcel, Verbeek, Marcel, and Kessels, Roy (2009, May 10). Cerebrospinal Fluid Tau and Amyloid Beta Proteins Do Not Correlate With Cognitive Functioning in Cognitively Impaired Memory Clinic Patients. CNS Spectrums. Retrieved on December 6, 2010 from http://www.cnsspectrums.com/aspx/articledetail.aspx?articleid=2836
Tavee, Jinny and Sweeney, Patrick (2010, August 1). Alzheimer’s Disease. Retrieved on December 4, 2010 from http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/neurology/alzheimers-disease/
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Additional Reading Materials
Adams, Amy (2000, September 8). Genes Can Cause Alzheimer’s Disease. Genetic Health. Retrieved on December 8, 2010 from http://www.genetichealth.com/alz_genetics_of_alzheimers_disease.shtml
Aluminium and Alzheimer’s Disease (September 2008). Alheimer’s Society. Retrieved on December 8, 2010
from http://alzheimers.org.uk/site/scripts/documents_info.php?documentID=99 Alzheimer’s Disease (n.d.). DNA Learning Center Home. Retrieved on November 23, 2010 from
http://www.yourgenesyourhealth.org/alz/whatisit.htm Campbell, Denis (2009, August 4). Middle-aged smokers at higher risk of dementia. The Guardian. Retrieved on
December 7, 2010 from http://www.guardian.co.uk/lifeandstyle/2009/aug/04/middle-aged-smokers-risk-dementia
Champeau, Rachel (2006, May 22). UCLA Study Finds that Simple Lifestyle Changes May Improve Cognitive Function and Brain Efficiency. UCLA Newsroom. Retrieved on December 7, 2010 from http://www.newsroom.ucla.edu/portal/ucla/UCLA-Study-Finds-that-Simple-Lifestyle-7062.aspx?RelNum=7062
George, Kelly (2010, October 26). New study: Smoking can lead to Alzheimer’s and Dementia. Examiner.com Retrieved on December 8, 2010 from http://www.examiner.com/healthy-trends-in-atlanta/new-study-smoking-can-lead-to-alzheimer-s-and-dementia
Healthy Brain (2010). Alzheimer Society Columbia. Retrieved on December 8, 2010 from http://www.alzheimerbc.org/Alzheimer-s-Disease-and-Dementia/Brain-Fitness-Plan.aspx
Lowe, Derek (2010, March 16). Beta-Amyloid: An Antibiotic? In The Pipeline. Retrieved on December 7, 2010 from http://pipeline.corante.com/archives/2010/03/16/betaamyloid_an_antibiotic.php
Mayo Clinic Staff (2010, August 5). Alzheimer’s Disease, Alzheimer’s genes: Are you at risk? Mayo Foundation
for Medical Education and Research. Retrieved on December 7, 2010 from http://www.mayoclinic.com/health/alzheimers-genes/AZ00047
Sample, Ian (2009, September 6). Alzheimer’s research links three genes to disease. The Guardian. Retrieved on December 7, 2010 from http://www.guardian.co.uk/science/2009/sep/06/alzheimers-disease-genes-research