ALZHEIMER'S DISEASE

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ALZHEIMER'S DISEASE by Mind Map: ALZHEIMER'S DISEASE

1. Most common type of Neurocognitive disorder

1.1. accounting for 2/3 of all cases

1.2. Around 5.4 million people in the United States

1.3. number expected to triple by 2050

1.4. currently responsible for almost 94,000 deaths each year in the United States

1.4.1. 40% higher than it was a decade ago

1.5. Is the sixth leading cause of death in the country

1.6. It is the third leading cause of death among the elderly

2. Who this affects

2.1. sometimes appears in middle age

2.2. vast majority occurs after age 65

2.2.1. 11% of people over 65 have this

2.3. prevalence increases in people in their late 70s

3. Cultures of those affected

3.1. African Americans

3.1.1. twice as likely to get this disease

3.2. Hispanic Americans

3.2.1. twice as likely to get this disease

3.3. Non-Hispanic White Americans

4. Gradually Progressive Disease

4.1. Memory impairment is the most prominent cognitive dysfunction

5. DSM-5 diagnosis

5.1. mild neurocognitive disorder

5.1.1. Alzheimer's Disease during the early and mild stages of the syndrome

5.2. major neurocognitive disorder

5.2.1. Alzheimer's Disease during the later, more severe stages

6. Naming of this disease

6.1. Alois Alzheimer

6.1.1. German physician who identified it

6.1.2. Identification happened in 1907

6.1.3. First became aware of the syndrome in 1901

6.1.3.1. Auguste D placed under his care

7. Life Expectancy of those affected

7.1. many survive for as many as 20 years

7.2. time between onset and death is typically 3-8 years

8. Symptoms in the early stages

8.1. mild memory problems

8.2. lapses of attention

8.3. difficulties in language and communication

8.4. difficulty with simple tasks

8.5. forget distant memories

8.6. noticeable changes in personality

8.7. 17% develop major depressive disorder

8.8. denial of having a problem

9. Symptoms in the middle and late stages

9.1. show less awareness of their limitations

9.2. may withdraw from others during the late stages

9.3. become more confused about things

9.3.1. Time

9.3.2. Place

9.4. Wander

9.5. Speak little

9.6. Show vewry poor judgment

9.7. Eventually become dependent on other people

9.8. May lose knowledge of past

9.8.1. fail to recognize close relatives

9.9. Become increasingly uncomfortable at night

9.10. take frequent naps during the day

9.11. during the late stage-require constant care

9.12. nonactive in the late stages

9.12.1. spend much of their time sitting of lying in bed

9.12.1.1. prone to develop serious infections

9.12.1.1.1. pnemonia

10. Diagnosis

10.1. In most cases can only be certain after death

10.2. Structural changes in the brain that contribute to death of the neurons

10.2.1. Excessive Senile plaques

10.2.1.1. beta-amyloid protein

10.2.1.1.1. formation

10.2.1.1.2. interfere with neuron to neuron communication

10.2.2. Neurofibrillary tangles

10.2.2.1. occur inside the neurons

10.2.2.2. block the transportation of certain molecules inside the neurons

11. Genetic causes of the disease (generic explination)

11.1. Proteins essential for proper functioning of organisms

11.1.1. two important proteins

11.1.1.1. start acting in a frenzied manner

11.1.1.1.1. Beta -Amyloid Protein

11.1.1.1.2. Tau Protein

12. Early-Onset Alzheimer's Disease

12.1. relatively rare form of the disease

12.2. occurs before age 65

12.2.1. in fewer than 1% of cases

12.3. typically runs in families

12.3.1. transmitted by mutations

12.3.2. transmitted by abnormalities

12.4. caused by

12.4.1. abnormalities in genes responsible for the production of two proteins

12.4.1.1. beta-amyloid precursor protein

12.4.1.2. presenilin protein

12.4.1.3. lead ultimately to abnormal beta-amyloid protein build-ups

12.4.1.3.1. plaque formations

13. Late-Onset Alzheimer's Disease

13.1. vast majority of the cases

13.2. develop after age 65

13.3. do not typically run in families

13.4. caused by combinations

13.4.1. genetic

13.4.1.1. different from those responsible for Early-Onset Alzheimer's

13.4.1.2. Apolipoprotein E gene

13.4.1.2.1. located on chromosome 19

13.4.1.2.2. responsible for carrying fats into the bloodstream

13.4.1.2.3. comes in various forms

13.4.1.3. Apolopoprotein E-4 gene

13.4.1.3.1. inherited by 30% of the population

13.4.1.3.2. promotes excessive formation of bet-amyloid proteins

13.4.1.3.3. not everyone with this form of the gene develops Alzheimer's disease

13.4.2. environmental

13.4.3. lifestyle factors

14. Brain Structures Related to Alzheimer's Disease

14.1. prefrontal cotex

14.1.1. important in short term memory

14.2. temporal lobes

14.2.1. made up of

14.2.1.1. hippocampus

14.2.1.2. amygdala

14.2.1.3. diencephalon

14.2.1.3.1. mammillary bodies

14.2.1.3.2. thalamus

14.2.1.3.3. hypothalamus

14.2.2. responsible transforming short-term memory into long-term memory

15. Biochemical changes in the brain that relate to Alzheimer's Disease

15.1. Brain chemicals responsible for production of memory linked proteins

15.1.1. acetylcholine

15.1.2. glutamate

15.1.3. RNA (ribonucleic acid)

15.2. If production interupted

15.2.1. prevention of proper proteins

15.2.2. formation of memories interupted

15.2.3. may contribute to symptoms of Alzheimer's Disease

16. Other Explanations of Alzheimer's Disease

16.1. certain substances in nature may contribute to the development of Alzheimer's

16.1.1. found in brains of Alzheimer's patients

16.1.2. High levels of zinc

16.1.2.1. trigger a clumping of beta-amyloid protein

16.1.2.1.1. similar to plaques found in brains of Alzheimer's patients

16.1.3. Lead

16.1.3.1. many of today's elderly exposed to high levels in the 1960s/1970s

16.1.3.1.1. regularly inhaling air pollution

16.1.3.1.2. may be having negative effects on current cognitive functioning

16.2. Autoimmune theory

16.2.1. changes in aging brain cells

16.2.1.1. may trigger autoimmune response

16.2.1.1.1. mistaken attack by the immune system against itself

16.3. Viral theory

16.3.1. Alzheimer's Disease resembles other diseases

16.3.1.1. Creutzfeldt-Jakob Disease

16.3.1.1.1. neurocognitive disorder

16.3.1.1.2. known to be caused by a slow acting virus

16.3.2. To date, no virus has been detected in the brains of Alzheimer's victims

17. Biomarkers

17.1. Characteristics that usually accompany Alzheimer's Disease that appear long before the onset of Alzheimer's

17.1.1. Biochemical

17.1.2. Molecular

17.1.3. Genetic

17.1.4. Structural

17.2. tests administered long before onset of symptoms

17.2.1. predict mild neurocognitive impairment

17.2.1.1. accuracy rate of 71%

17.2.2. predict major neurocognitive impairment

17.2.2.1. accuracy rate of 83%

18. Current Treatments

18.1. Drug therapy

18.1.1. affect neurotransmitters that play important roles in memory

18.1.1.1. Acetylcholine

18.1.1.2. Glutamate

18.1.2. Donepezil (Aricept)

18.1.3. Rivastigmine (Exelon)

18.1.4. Galantamine (Reminyl)

18.1.5. Memantine (Namendal)

18.1.6. improves short term memory and reasoning ability for some patients

18.1.7. improves language and their ability to cope under pressure

18.1.8. benefits are limited

18.1.9. side effects can be problematic

18.1.10. Approved by the FDA

18.1.11. Prescribed AFTER person has developed Alzheimer's Disease

18.2. Cognitive-Behavioral Interventions

18.2.1. Japan

18.2.1.1. Meet regularly in classes

18.2.1.1.1. perform simple calculations and read essays/novel out loud

18.2.2. based cognitive activities

18.2.2.1. over 5 year period

18.2.2.1.1. writing letters

18.2.2.1.2. following the news

18.2.2.1.3. reading books

18.2.2.1.4. attending concerts/plays

18.2.2.2. less likely to develop Alzheimer's Disease

18.2.3. focus on behaviors rather than cognitions

18.2.3.1. physical exercise

18.2.3.1.1. may reduce the risk of developing Alzheimer's

18.2.3.1.2. seem to be more useful in preventing and managing Alzheimer's

18.2.3.2. that are stressful for family/caregivers

18.2.3.2.1. wandering at night

18.2.3.2.2. loss of bladder control

18.2.3.2.3. demands for attention

18.2.3.2.4. inadequate personal care

18.2.3.3. use of combination of several types to teach when to use reinforcement

18.2.3.3.1. role-playing

18.2.3.3.2. excercises

18.2.3.3.3. modeling

18.3. Support for Caregivers

18.3.1. almost 90% of people with Alzheimer's are cared for by relatives

18.3.1.1. usually adult children/spouses

18.3.1.1.1. many experience anger/depression

18.3.1.1.2. their own physical/mental health decline

18.3.1.2. some have to take care of parents and teenage children

18.3.2. clinicians now recognize that it is important to focus on the emotional needs of the caregivers in order to help Alzheimer patient

18.3.2.1. regular time out

18.3.2.2. education about the disease

18.3.2.3. psychotherapy

18.3.2.4. caregiver support groups

18.4. Sociocultural Approaches

18.4.1. daycare facilities for patients

18.4.1.1. provide treatment programs

18.4.1.2. activities for outpatients during the day

18.4.1.2.1. return to families and homes at night

18.4.2. assisted living facilities

18.4.2.1. live in apartments

18.4.2.1.1. designed to meet special needs of the residents

18.4.2.2. receive needed supervision

18.4.2.3. take part in stimulating activities

18.4.3. wearing of practical devices for those that like to wander

18.4.3.1. shoes that contain a GPS tracker

18.4.3.2. tracking beacons worn on wrists

18.5. Taking Vitamin E either alone or with combination of Drug Therapy

18.5.1. Thought to help slow down cognitive difficulties

18.5.2. Modestly supported by various studies