dementia alzheimer (own) ppt
TRANSCRIPT
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Alzheimer Disease the most
common of Dementia
Kartika
030.08.134
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Introduction
Dementia describes progressive decline of cognitive function,
usually affecting the cortex as a whole, though sometimes
patchily.
Memory is especially affected, intellect gradually fails. There is
loss of emotional control, deterioration of social behavior and
loss of motivation.
There are many causes of this syndrome. Dementia is a
substantial cause of morbidity in any ageing population, with
profound social and economic effects.
Dementia affects some 10% of any population over 65, and
20% over 80. The commonest causes are Alzheimers
disease.(1)
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What is Dementia?
Dementia isn't a specific disease. Instead,
dementia describes a group of symptoms
affecting intellectual and social abilities
severely enough to interfere with daily
functioning.
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Etiology
Many cause of dementia, such us:
degenerative disease, vascular, metabolic,
vitamin deficiency, toxic, endocrine, infection,
trauma. And many more
But the most common of dementia is
Alzheimer disease that include the generative
disease about 60%
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Symptoms
The symptoms of dementia is divide into ABC
A : activity of daily living
B : behaviour/ behaviour psychologicalsyndrome of dementia (BPSD)
C : cognition or cognitive defisicits
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B/ Behaviour Psychological syndrome
of dementia (BPSD)
Paranoid: the people have taken his/hermoney, house in not oness home
Hallucination:
Depression:
Anxiety:
Social dysinhibition:
Wandering
Agitation
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C/Cognitive deficits
Memory: shortterm and longterm
Orientation: time,person, place
Language : Aphasia, anomian thingking,calculation, learning capacity
Personality
Judgement : ability to perform tasks insequence
Reduce activity daily living
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Risk factor
Risk factors that can not be changed
Age. The risk of Alzheimer's disease, vascular dementia andseveral other dementias increases significantly with age.However, dementia isn't a normal part of aging.
Family history. People with a family history of dementia areat greater risk of developing it. However, many people witha family history never develop symptoms, and many peoplewithout a family history do.
Down syndrome. By the time they reach middle age, most
people with Down syndrome develop the plaques andtangles characteristic of Alzheimer's disease, according tostudies. Many, but not all, also develop dementia.(6)
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Can be change Alcohol use. Consuming large amounts of alcohol appears to increase the risk
of dementia.
Atherosclerosis. This buildup of fats and other substances in and on your artery
walls (plaques) is a significant risk factor for vascular dementia because it
interferes with blood flow to your brain.
Blood pressure. Blood pressure that's too high, and also possibly too low, can
put you at risk of developing Alzheimer's disease and vascular dementia.
Cholesterol. High levels of low-density lipoprotein (LDL) cholesterol, the
"bad" cholesterol, can significantly increase your risk of developing vascular
dementia.
Depression. Although not yet well understood, late-life depression, may be an
indication for the development of Alzheimer's-related dementia.
Diabetes. If you have type 2 diabetes, you're at increased risk of developingboth Alzheimer's disease and vascular dementia.
High estrogen levels. High levels of total estrogen in women have been
associated with greater risk of developing dementia. This can be determined
through a blood test.
Smoking. Smoking likely increases the risk of developing dementia because itputs you at a higher risk of atherosclerosis and other types of vascular disease.(6)
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DSM-IV criteria for the diagnosis of Dementia of the Alzheimer's Type(4)
A. The development of multiple cognitive deficits manifested by both:
1.Memory impairment (impaired ability to learn new information or torecall previously
learned information)
2.One or more of the following cognitive disturbances:
(a) aphasia (language disturbance)
(b) apraxia (impaired ability to carry out motor activities depite intactmotor function)
(c) agnosia (failure to recognize or identify objects despite intactsensory function)
(d) disturbance in executive functioning (i.e., planning, organizing,sequencing, abstracting)
B. The cognitive deficits in criteria A1 and A2 each cause significantimpairment in social or
occupational functioning and represent a significant decline from aprevious level of functioning.
C. The course is characterized by gradual onset and continuing
cognitive decline.
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D. The cognitive deficits in Criteria A1 and A2 are not due to any
of the following:
(1) other central nervous system conditions that causeprogressive deficits in memory and cognition (e.g.,
cerebrovascular disease, Parkinson's disease, Huntington's
disease, subdural hematoma, normal-pressure hydrocephalus,
brain tumor)
(2) systemic conditions that are known to cause dementia (e.g.,
hypothyroidism, vitamin B or folic acid deficiency, niacin
deficiency, hypocalcaemia, neurosyphilis, HIV infection)
(3) substance-induced conditions
E. The deficits do not occur exclusively during the course of a
delirium.
F. the disturbance is do not better accounted for by another axis
I disorder (e.g., major depressive disorder, schizophrenia) (2)(4)
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Test in Dementia
Blood test: full blood count, ESR, C-reactiveprotein, urea, electrolytes, blood glucose, liverbiochemistry, serum calcium, vitamin B12, folate,T3 T4, HIV serology.
Imaging : Chest X-rays, CT scan, MRI brain Other: genetic studies, EEG, CSF, brain biopsy.
Psychiatric evaluation/neuropsychiatri:
MMSE(mini mental states examination)CDT (clock drawing test)
IADL
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What is Alzheimer Disease?
Alzheimers disease is an irreversible,
progressive brain disease that slowly destroys
memory and thinking skills.
This is the commonest dementia, a
degenerative disease of the cortex, accounting
for over 65% of dementia in any age group.(3)
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Etiology
AD develops when genetic, lifestyle, and
environmental factors work together to cause
the disease process to start.
In recent years, scientists have discovered
genetic links to AD. They are also investigating
other factors that may play a role in causing AD
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Genetic
The two main types of AD are early-onset and late-onset:
Early-onset AD is rare, usually affecting people aged 30to 60 and usually running in families. Researchers haveidentified mutations in three genes that cause early-onset AD.
Late-onset AD is more common. It usually affectspeople over age 65.
Researchers have identified a gene that produces aprotein called apolipoprotein E (ApoE). Scientistsbelieve this protein is involved in the formation of beta-amyloid plaques.
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To understand Alzheimers disease, its
important to know about the brain
Cerebellum in charge of balance and coordination
Brain Stem connects the spinal cord with the brain
relays and receives messages to and from muscles, skin, and
other organs
controls automatic functions such as heart rate, blood
pressure, and breathing.
Hippocampus: where short-term memories are converted to
long-term memories
Thalamus: receives sensory and limbic information and sends tocerebral cortex
Hypothalamus: monitors certain activities and controls bodys internalclock
Limbic system: controls emotions and instinctive behavior (includes
the hippocampus and parts of the cortex)
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Neuropathology
Amyloid plaque : which are dense deposits of
protein and cellular material that accumulate
outside and around nerve cells
Neurofibrillary tangles : which are twisted
fibers that build up inside the nerve cell
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Beta-amyloid PlaquesAmyloid precursor protein (APP) is theprecursor to amyloid plaque.
1. APP sticks through the neuronmembrane.
2. Enzymes cut the APP into fragmentsof protein, including beta-amyloid.
3. Beta-amyloid fragments cometogether in clumps to form plaques.
1.
2.
3.
AD and the Brain
In AD, many of these clumps form,
disrupting the work of neurons. This
affects the hippocampus and other areas
of the cerebral cortex.
Slide 17
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NeurofibrillaryTangles
Neurons have an internal support structure partly made up of
microtubules. A protein called tau helps stabilize microtubules. In AD,
tau changes, causing microtubules to collapse, and tau proteins clump
together to form neurofibrillary tangles.
AD and the Brain
Slide 18
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Amyloid accumulation and Neurofibrillary
tangles nerve cell death neurochemical
deficiency cognitive and behaviour changes
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Conclusion
Alzheimer's disease is the most common cause of dementiain people age 65 and older.
Symptoms usually appear after age 60, but early-onsetforms of the disease can occur, usually as the result of adefective gene.
Alzheimer's disease usually progresses slowly, over seven toten years, causing a gradual decline in cognitive abilities.
Caring for a person with Alzheimers disease can have highphysical, emotional, and financial costs.
The demands of day-to-day care, changing family roles, anddifficult decisions about placement in a care facility can behard to handle. (8)