Alzheimer's disease

Ayunan, Maomina S.
2 BSN – 2k
Pharmacology (Bio.223)
Group 5
MWF / 7:40 – 8:40 am / D405
Date: November 26, 2008

Teacher: Dr. Elvira donado

 Content:
oWhat is Alzheimer’s disease?
oWhat causes Alzheimer's disease?
oWhat are the Symptoms of Alzheimer’s disease?
oHow is Alzheimer’s diseas diagnosed?
oHow is it treated?
oVideo of a Patient with Alzheimer’s disease.
 What is
Alzheimer's
disease?
What causes
Alzheimer's
disease?
 Definition:
 
Alzheimer’s disease or Alzheimer's-type dementia is a
progressive degeneration of brain tissue that primarily
strikes people over age 65. It is the most common
cause of dementia in this age group and is marked by a
devastating mental decline. Intellectual functions such
as memory, comprehension and speech deteriorate.
 
Alzheimer's disease damages the brain. It causes a
steady loss of memory and how well you can speak,
think, and carry on daily activities.
Alzheimer’s disease happens because of changes in the
brain. These include lower levels of chemical messengers (
neurotransmitters) that help brain cells work properly.
What causes these changes is not clear.
 
The risk of getting Alzheimer’s disease increases as you
get older. But this does not mean that everyone will get it.
By age 85, about 35 out of 100 of people have some form
of dementia1. That means 65 out 100 don't have it.
Dementia is rare before age 60.
 
Having a relative with Alzheimer’s raises your risk of
getting it, but most people with Alzheimer's disease do
not have a family history of it.
 
Although many people develop Alzheimer's disease as t
hey grow older, the disease is not a natural result of aging.
It is an abnormal condition whose causes continue to be
investigated.
Researchers are not yet sure why or how these
processes occur, but some of the most promising
recent research points to a normally occurring
blood protein called ApoE (for apolipoprotein E),
which is required for the transport of fatty
substances in the body.

As with all proteins, the form of ApoE that each

person has in their body is genetically determined,
and several different types have been identified --
some of them apparently associated with a higher
risk of Alzheimer's. It may be that certain forms of
ApoE lead to the nerve damage.
 
Another possibility is that the protein, perhaps
working in combination with other substances, is
involved in the formation of the plaques. Whether
or not ApoE partly causes Alzheimer's disease,
genes almost certainly play a role in the disease and
a person with a parent who had Alzheimer's disease
is at higher risk.
Other causes have been proposed. One theory
suggests that ingesting tiny particles of aluminum
-- from cookware, for example -- may lead to
Alzheimer's. Another proposes a link between
plaque formation and free radicals -- unstable,
free-ranging molecules that can produce
destructive chemical reactions.
Both theories are controversial and unproven. Indeed,
many researchers now consider the link between
Alzheimer's and aluminum extremely questionable.
 
Another controversy centers on zinc. But the
connection between zinc and Alzheimer's remains
unclear. It is thought that at low levels zinc may be
protective but at higher doses it may be harmful. For
one thing, scientists remain unsure whether plaques
cause Alzheimer's or are themselves a result of the
disease. If the latter, zinc's ability to form plaques
might be unrelated to what causes Alzheimer's
disease in the first place.
There is some evidence that people with
high blood pressure and high cholesterol have an
increased chance of developing Alzheimer's. In a
minority of cases, trauma may be a contributing
factor. The more severe the head injury, the greater
the risk of Alzheimer's dementia later in life.

While many of these theories are still being

studied, it is clear that the biggest risk factors
associated with developing Alzheimer's disease are
increasing age and family history.
What are the
symptoms?
For most people, the first symptom of Alzheimer's disease is
memory loss. Often the person who has a memory problem does
not notice it, but family and friends do. But the person with the
disease may also know that something is wrong.

As the disease gets worse, the person may:

Have trouble making decisions.

Be confused about what time and day it is.
Get lost in places he or she knows well.
Have trouble learning and remembering new information.
Have trouble finding the right words to say what he or she wants to
say.
Have more trouble doing daily tasks like cooking a meal or paying
bills.
The symptoms of Alzheimer’s get worse slowly over time. A person
who gets these symptoms over a few hours or days or
 whose symptoms suddenly get worse needs to see a doctor right
away, because there may be another problem.

As people with Alzheimer’s get worse, they may get restless and
wander, especially in late afternoon and at night. This is called
sundowning. Over time, they may also start to act very different.
They may withdraw from family and friends. They may see or
hear things that are not really there. They may falsely believe
that others are lying, cheating, using them, or trying to harm
them. They may strike out at others.

Later, they may not be able to take care of themselves. They may
not know their loved ones when they see them. They may forget
how to eat, dress, bathe, use the toilet, or get up from a bed or a
chair and walk.
 
  
How is Alzheimer's
disease diagnosed?
To check for the disease, your doctor will ask about
your past health and do a physical exam. He or she
may ask you to do some simple things that test your
memory and other mental skills. Your doctor may
also check how well you can do daily tasks.

The exam usually includes blood tests to look for

another cause of your problems. You may have tests
to look at a picture of your brain, such as CT and
MRI scans. By themselves, these tests can't show for
sure whether you have Alzheimer’s. But they may
find small changes in the brain related to the
disease.
 How is it treated?
Drug Treatment

Supplements
There is no cure for Alzheimer's disease,
but there are medicines that may slow it
down for a while and make it easier to live
with. Drugs that may be prescribed include:
Medicines to help with memory and
thinking problems, such as donepezil
(Aricept).
Medicines to help with help with moderate
to severe confusion and memory loss, such
as memantine (Namenda).
These medicines may not work for
everyone or have a big effect, but
most experts think they are worth a
try.
As the disease gets worse, the
person may get depressed or angry
and upset. The doctor may also
prescribe medicines to help with
these problems.
 DRUG TREATMENT:

Several drugs are available to try to

slow the progression of AD and
possibly improve the person's mental
capabilities. Memantine (Namenda) is
currently the only drug approved for
the treatment of moderate-to-severe
Alzheimer’s disease.
 DRUG TREATMENT:

Other medicines include donepezil (Aricept),

rivastigmine (Exelon), galantamine (Razadyne,
formerly called Reminyl), and tacrine (Cognex).
These drugs affect the level of a neurotransmitter
in the brain called acetylcholine. They may cause
nausea and vomiting. Tacrine also causes an
elevation in liver enzymes and must be taken four
times a day. It is now rarely used.
 DRUG TREATMENT:

Aricept is taken once a day and may

stabilize or even improve the person's
mental capabilities. It is generally well
tolerated. Exelon seems to work in a similar
way. It is taken twice a day.
Other medicines may be needed to control
aggressive, agitated, or dangerous behaviors.
These are usually given in very low doses
 SUPPLEMENTS

Folate (vitamin B9) is critical to the health of the

nervous system. Together with some other B vitamins,
folate is also responsible for clearing homocysteine (a
body chemical that contributes to chronic illnesses)
from the blood. High levels of homocysteine and low
levels of both folate and vitamin B12 have been found
in people with AD. Although the benefits of taking
these B vitamins for AD is not entirely clear, it may be
worth considering them, particularly if your
homocysteine levels are high.
 SUPPLEMENTS

Antioxidant supplements, like ginkgo

biloba and vitamin E, scavenge free
radicals. These products of metabolism
are highly reactive and can damage
cells throughout the body.
 A Video about
Alzheimer’s Disease
THE END