We forgot our team name…We forgot our team name…(A.K.A. Team 1)(A.K.A. Team 1)

Treatments for Alzheimer’s Treatments for Alzheimer’s Parkinson’s, Huntington’s Parkinson’s, Huntington’s

and Vascular types of and Vascular types of dementiadementia

By: Andrew, Anne, Connie and Diana

Alzheimer’s DiseaseAlzheimer’s Disease A type of dementia characterized by A type of dementia characterized by

progressive neurological progressive neurological degeneration and deterioration of degeneration and deterioration of mental functioning.mental functioning.

This disease results in impairment of :This disease results in impairment of : LanguageLanguage MemoryMemory Visual-Spatial OrientationVisual-Spatial Orientation

THERE IS NO CURETHERE IS NO CURE

TreatmentsTreatmentsDrugsDrugs

Cholinesterase InhibitorsCholinesterase Inhibitors (mild to (mild to moderate)moderate) Increase CNS acetylcholine (Ach) by inhibiting Increase CNS acetylcholine (Ach) by inhibiting

cholinesterase activity in the synapse.cholinesterase activity in the synapse. Tacrine Tacrine (Cognex)(Cognex)

Donepezil Donepezil (Aricept)(Aricept)]]Galantamine (Galantamine (Razadyn (name changed from Reminyl June 2005)Razadyn (name changed from Reminyl June 2005)))Rivastigmine (Rivastigmine (ExelonExelon))

Side EffectsSide Effects Nausea/VomitingNausea/Vomiting Loss of appetiteLoss of appetite Increased frequency of bowel movementsIncreased frequency of bowel movements Possible liver damage (Tacrine)Possible liver damage (Tacrine)

TreatmentsTreatmentsDrugsDrugs

MemantineMemantine (moderate to severe) (moderate to severe) Works by regulating glutamate which plays Works by regulating glutamate which plays

a key role in processing, storage and a key role in processing, storage and retrieval of information.retrieval of information. NamendaNamenda

Side EffectsSide Effects Headache Headache ConstipationConstipation ConfusionConfusion DizzinessDizziness

DrugsDrugs

Enbrel?Enbrel? Used for rheumatoid arthritis, Used for rheumatoid arthritis,

ankylosing spondylitis, and psoriatic ankylosing spondylitis, and psoriatic arthritis arthritis

Has not been approved for Alzheimer’sHas not been approved for Alzheimer’s Therefore insurance does not pay.Therefore insurance does not pay.

Alzheimer's Treatment Alzheimer's Treatment Before and After Enbrel Before and After Enbrel

Enbrel for Alzheimer's Enbrel for Alzheimer's Explanation Explanation

Gene Therapy Combined with Gene Therapy Combined with Nerve Growth Factor (NGF)Nerve Growth Factor (NGF)

Put extra copies of the gene in the brain of Put extra copies of the gene in the brain of people with Alzheimer’s for cellular growth people with Alzheimer’s for cellular growth factor and it slows the degenerative condition.factor and it slows the degenerative condition.

A study in 1996 involving monkeys (Tuszynski & A study in 1996 involving monkeys (Tuszynski & Blesch) who received grafts that produced NCF Blesch) who received grafts that produced NCF retained twice as many cholinergic neurons than retained twice as many cholinergic neurons than those receiving control grafts.those receiving control grafts.

A clinical trial on eight patients with mild AD A clinical trial on eight patients with mild AD (Tuszynski and others, 2005) showed no adverse (Tuszynski and others, 2005) showed no adverse effects after 22 months and showed increased effects after 22 months and showed increased metabolic activity and an autopsy performed on metabolic activity and an autopsy performed on another patient showed robust neuronal growth.another patient showed robust neuronal growth.

Stem CellsStem Cells

The use of embryonic stem cells have been The use of embryonic stem cells have been touted as possibilities in treating a variety of touted as possibilities in treating a variety of neurological diseasesneurological diseases

Researchers have injected human neuronal Researchers have injected human neuronal stem cells into the lateral ventricles of 2-stem cells into the lateral ventricles of 2-month and 24 month old rats, in the older month and 24 month old rats, in the older rats it showed dramatic cognitive rats it showed dramatic cognitive improvement (Qu & others, 2001; Sugaya, improvement (Qu & others, 2001; Sugaya, 2005).2005).

The use of stem cells, raises ethical The use of stem cells, raises ethical concerns. concerns.

Interventions and Reality Interventions and Reality Orientation ProgramsOrientation Programs

The use of mnemonic techniquesThe use of mnemonic techniques Memory aids that help improve Memory aids that help improve

retrieval and storage information.retrieval and storage information. Rely on associative processes to link events.Rely on associative processes to link events.

Reality orientation programsReality orientation programs Allows AD patients to maintain Allows AD patients to maintain

awareness of who they are.awareness of who they are. Support groups for families and Support groups for families and

caregivers.caregivers.

Parkinson’s DiseaseParkinson’s Disease

According to the University of Maryland According to the University of Maryland Medicine (UMM) Parkinson’s disease (PD) Medicine (UMM) Parkinson’s disease (PD) belongs to a group of conditions called motor belongs to a group of conditions called motor system disorders which are the result of the system disorders which are the result of the loss of dopamine producing brain cells.loss of dopamine producing brain cells.

It is a slowly progressing degenerative It is a slowly progressing degenerative disease that is usually associated with the disease that is usually associated with the following symptoms: tremor or trembling of following symptoms: tremor or trembling of the arms, jaw, legs and face, stiffness or the arms, jaw, legs and face, stiffness or rigidity of limbs and trunk, brady-kinesia rigidity of limbs and trunk, brady-kinesia (slowness of movement), postural instability, (slowness of movement), postural instability, impaired balance and coordination.impaired balance and coordination.

SymptomsSymptoms

As the symptoms become more As the symptoms become more pronounced, patients may have difficulty pronounced, patients may have difficulty walking and talking, sleeping, chewing, walking and talking, sleeping, chewing, swallowing, completing daily tasks. swallowing, completing daily tasks.

About 50,000 Americans are diagnosed About 50,000 Americans are diagnosed with Parkinson’s each year. It is believed with Parkinson’s each year. It is believed that more people suffer from Parkinson’s that more people suffer from Parkinson’s than multiple sclerosis, muscular than multiple sclerosis, muscular dystrophy and, amyotrophic lateral dystrophy and, amyotrophic lateral sclerosis combined. sclerosis combined.

Prevalence and TreatmentsPrevalence and Treatments

The prevalence of Parkinson's increases with age - The prevalence of Parkinson's increases with age - appearing in 1% of people over 60 and 4-5% of appearing in 1% of people over 60 and 4-5% of those over 85 but, the average onset is usually in those over 85 but, the average onset is usually in the late fifties.the late fifties.

Young onset PD refers to symptoms that begin as Young onset PD refers to symptoms that begin as early as in the twenties and thirties. early as in the twenties and thirties.

There is no cure for Parkinson’s but, treatment is There is no cure for Parkinson’s but, treatment is given based on the severity of symptoms. The given based on the severity of symptoms. The University of Maryland Medicine says that anti-University of Maryland Medicine says that anti-parkinsonian medication can be prescribed parkinsonian medication can be prescribed depending on the degrees of functional depending on the degrees of functional impairment, cognitive impairment, ability to impairment, cognitive impairment, ability to tolerate the medications as well as advice from tolerate the medications as well as advice from physicians. physicians.

DrugsDrugs

According to the National Institute of According to the National Institute of Neurological Disorders and Stroke, Levadopa Neurological Disorders and Stroke, Levadopa (L-Dopa), a natural chemical found in plants (L-Dopa), a natural chemical found in plants and animals, has been used for over thirty and animals, has been used for over thirty years to treat Parkinson’s Disease. Nerve cells years to treat Parkinson’s Disease. Nerve cells use the levadopa to make dopamine and use the levadopa to make dopamine and replenish the brain’s dwindling supply. This replenish the brain’s dwindling supply. This medication helps about ¾ of patients. L-Dopa medication helps about ¾ of patients. L-Dopa is used to help reduce brady-kinesia, rigidity is used to help reduce brady-kinesia, rigidity and tremors.and tremors.

Other medications include Bromocriptine, Other medications include Bromocriptine, Pramipexole, Ropinirole which all mimic Pramipexole, Ropinirole which all mimic dopamine in the brain.dopamine in the brain.

Treatment OptionsTreatment Options

Surgery becomes an option when the disease Surgery becomes an option when the disease does not respond to drugs any longer or at all. does not respond to drugs any longer or at all.

In a therapy called Deep Brain Stimulation In a therapy called Deep Brain Stimulation (DBS) electrodes are implanted into the brain (DBS) electrodes are implanted into the brain and connected to a device called a and connected to a device called a neurostimulator which can be externally neurostimulator which can be externally programmed. This neurostimulator is used to programmed. This neurostimulator is used to deliver electrical stimulation to areas in the deliver electrical stimulation to areas in the brain that control movement. This blocks the brain that control movement. This blocks the abnormal nerve signals that cause the tremors abnormal nerve signals that cause the tremors and other symptomsand other symptoms of of Parkinson’s DiseaseParkinson’s Disease..

What Is Huntington’s What Is Huntington’s DiseaseDisease

A genetic disease that causes A genetic disease that causes degeneration of brain cellsdegeneration of brain cells

This degeneration causes:This degeneration causes: Uncontrolled movementsUncontrolled movements Loss of intellectual facultiesLoss of intellectual faculties Emotional disturbancesEmotional disturbances

Huntington’s DiseaseHuntington’s Disease

No CureNo Cure MedicationsMedications

Tranquilizers like KlonopinTranquilizers like Klonopin Antipsychotics like Haldol or ClozarilAntipsychotics like Haldol or Clozaril Antidepressants like ZoloftAntidepressants like Zoloft Lithium drugs like LithobidLithium drugs like Lithobid

Huntington’s Disease Huntington’s Disease

Physical Therapy/ Occupational Physical Therapy/ Occupational TherapyTherapy

Speech TherapySpeech Therapy Picture boardsPicture boards

Experimental TreatmentsExperimental Treatments Cancer Drugs and AIDS drugsCancer Drugs and AIDS drugs Coenzyme Q10Coenzyme Q10

Self - Care for Self - Care for Huntington’sHuntington’s

Proper HydrationProper Hydration Exercise RegularlyExercise Regularly Continue proper nutritionContinue proper nutrition

5,000 calories per day5,000 calories per day Vitamins and supplementsVitamins and supplements

What is Vascular What is Vascular Dementia?Dementia?

Second most common form of dementia in the Second most common form of dementia in the U.S. (helpguide.org).U.S. (helpguide.org).

Caused by blockages in the brain’s blood supply Caused by blockages in the brain’s blood supply (helpguide.org).(helpguide.org).

Vascular dementia is a degenerative Vascular dementia is a degenerative cerebrovascular disease (helpguide.org).cerebrovascular disease (helpguide.org).

Leads to a progressive decline in (helpguide.org):Leads to a progressive decline in (helpguide.org): MemoryMemory Cognitive functioningCognitive functioning

Usually occurs between the ages of 60 and 70 Usually occurs between the ages of 60 and 70 (helpguide.org).(helpguide.org).

Affects more men than women (helpguide.org).Affects more men than women (helpguide.org).

Most Common Vascular Most Common Vascular DementiaDementia

Multi-infarct dementia (helpguide.org).Multi-infarct dementia (helpguide.org). Series of small strokes – sometimes called transient Series of small strokes – sometimes called transient

ischemic attacks (TIAs)ischemic attacks (TIAs) Often unnoticedOften unnoticed Damages the cortex of the brainDamages the cortex of the brain TemporaryTemporary

Partial blockages of blood supplyPartial blockages of blood supply Brief impairments in consciousness or sightBrief impairments in consciousness or sight

Over time – the damage caused to brain tissue Over time – the damage caused to brain tissue interferes with basic cognitive functions and disrupts interferes with basic cognitive functions and disrupts day to day functioningday to day functioning

When vascular dementia occurs with other types When vascular dementia occurs with other types of dementia (e.g., Alzheimer's) it is referred to as of dementia (e.g., Alzheimer's) it is referred to as “mixed dementia” (helpguide.org).“mixed dementia” (helpguide.org).

Treatment/Prevention of Treatment/Prevention of Vascular DementiaVascular Dementia

No treatment can reverse damage caused by No treatment can reverse damage caused by strokes (psychnet-uk.com, 2008)strokes (psychnet-uk.com, 2008)

Lower your risk for a stroke (helpguide.org).Lower your risk for a stroke (helpguide.org). Risk for vascular dementia is nine times higher Risk for vascular dementia is nine times higher

following a strokefollowing a stroke Risk factors of vascular dementia are the Risk factors of vascular dementia are the

same as for (psychnet-uk.com, 2008).same as for (psychnet-uk.com, 2008). StrokeStroke High blood pressureHigh blood pressure DiabetesDiabetes High cholesterol and heart disease (psychnet-High cholesterol and heart disease (psychnet-

uk.com, 2008)uk.com, 2008)

Prevention of Vascular Prevention of Vascular DementiaDementia

Things you can do (helpguide.org):Things you can do (helpguide.org): Don’t smokeDon’t smoke Exercise regularlyExercise regularly Eat healthy (limit alcohol, salt and saturated fat)Eat healthy (limit alcohol, salt and saturated fat) Try to reduce stress (relaxation techniques)Try to reduce stress (relaxation techniques) Routine blood pressure checksRoutine blood pressure checks Medications for blood pressure and blood thinners Medications for blood pressure and blood thinners

(e.g., Aspirin).(e.g., Aspirin). Even surgery may be necessary to restore blood Even surgery may be necessary to restore blood

flow to the brain.flow to the brain. Carotid endarterectomy – removes blockage in the carotid Carotid endarterectomy – removes blockage in the carotid

artery (the main blood vessel to the brain) (psychnet-artery (the main blood vessel to the brain) (psychnet-uk.com).uk.com).

Treatment of symptomsTreatment of symptoms Controlling symptoms of dementia (psychnet-Controlling symptoms of dementia (psychnet-

uk.com, 2008).uk.com, 2008). Treatment varies with the specific disorderTreatment varies with the specific disorder

Medications may be need to help with aggressive or Medications may be need to help with aggressive or agitated behaviors (including behaviors dangerous agitated behaviors (including behaviors dangerous to themselves or others) (psychnet-uk.com, 2008).to themselves or others) (psychnet-uk.com, 2008).

Possible medications used (psychnet-uk.com, 2008):Possible medications used (psychnet-uk.com, 2008): Anti-PsychoticsAnti-Psychotics Beta Blockers (if related to central nervous system lesions).Beta Blockers (if related to central nervous system lesions). Serotonin-Affecting Drugs (e.g., lithium, trazodone, Serotonin-Affecting Drugs (e.g., lithium, trazodone,

buspirone, clonazepam).buspirone, clonazepam). Dopamine BlockersDopamine Blockers CarbamazepineCarbamazepine Fuoxetine, ImipramineFuoxetine, Imipramine Stimulant drugs for mood (e.g., methylphenidate)Stimulant drugs for mood (e.g., methylphenidate)

ReferencesReferences Hill, C. Treatment of alzheimers. Retrieved April 18, 2008 from Hill, C. Treatment of alzheimers. Retrieved April 18, 2008 from

http://alzheimers.about.com/od/treatmentofalzheimers/a/treatments.htmhttp://alzheimers.about.com/od/treatmentofalzheimers/a/treatments.htm Klein, S. B. & Thorne, B. M. (2006). Klein, S. B. & Thorne, B. M. (2006). Biological psychology. Biological psychology. Worth: Washington D.C.Worth: Washington D.C. Seppa, N. (2005). Neuron savers: Gene therapy slows alzheimer’s disease. Retreived Seppa, N. (2005). Neuron savers: Gene therapy slows alzheimer’s disease. Retreived

April 18, from http://www.sciencenews.org/articles/20050430/fob1.aspApril 18, from http://www.sciencenews.org/articles/20050430/fob1.asp Helpguide.org (2007). Vascular dementia. Retrieved April 16, 2008 from Helpguide.org (2007). Vascular dementia. Retrieved April 16, 2008 from

http://www.helpguide.org/elder/vascular_dementia.htmhttp://www.helpguide.org/elder/vascular_dementia.htm Huntington’s Disease Society of America. (2008). Talking technology. Retrieved Huntington’s Disease Society of America. (2008). Talking technology. Retrieved

April 18, 2008, from April 18, 2008, from http://http://www.hdsa.orgwww.hdsa.org.. Mayo Clinic. (2008). Huntington’s disease. Retrieved April 18, 2008, from Mayo Clinic. (2008). Huntington’s disease. Retrieved April 18, 2008, from

http://www.mayoclinic.com.http://www.mayoclinic.com. Mental health and psychology directory. (2008). Disorder information sheet. Mental health and psychology directory. (2008). Disorder information sheet.

Retrieved April 16, 2008 from http://www.psychnet-uk.com/dsm_iv/dementia.htmRetrieved April 16, 2008 from http://www.psychnet-uk.com/dsm_iv/dementia.htm National Institute of Neurological Disorders and Stroke. (2008). NINDS huntington’s National Institute of Neurological Disorders and Stroke. (2008). NINDS huntington’s

disease information page. Retrieved April 18, 2008, from disease information page. Retrieved April 18, 2008, from http://www.ninds.nih.gov/disorders/huntington/huntington.htm.http://www.ninds.nih.gov/disorders/huntington/huntington.htm.

National Institute of Neurological Disorders and Stroke. 2008 National Institute of Neurological Disorders and Stroke. 2008 parkinson’s disease: parkinson’s disease: hope through research. hope through research. Retrieved April 19, 2008, from Retrieved April 19, 2008, from http://www.ninds.nih.gov/disorders/parkinsons_disease/parkinsons_disease.htmhttp://www.ninds.nih.gov/disorders/parkinsons_disease/parkinsons_disease.htm

University of Maryland Medicine. (2003, May). University of Maryland Medicine. (2003, May). Nervous system diseases: Nervous system diseases: Treatments for parkinson’s diseases. Treatments for parkinson’s diseases. Retrieved April 19, 2008 from the University Retrieved April 19, 2008 from the University of Maryland Medical System Web site: of Maryland Medical System Web site: http://www.umm.edu/nervous/parktrmt.htmhttp://www.umm.edu/nervous/parktrmt.htm

Wiki Page LinkWiki Page Link

http://wiki.ggc.usg.edu/mediawiki/http://wiki.ggc.usg.edu/mediawiki/index.php/PSYC3410:dementia/index.php/PSYC3410:dementia/Team1Team1