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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 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 prone to develop serious infections 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 beta-amyloid protein formation interfere with neuron to neuron communication

10.2.2. Neurofibrillary tangles occur inside the neurons 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 start acting in a frenzied manner Beta -Amyloid Protein 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 beta-amyloid precursor protein presenilin protein lead ultimately to abnormal beta-amyloid protein build-ups 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 different from those responsible for Early-Onset Alzheimer's Apolipoprotein E gene located on chromosome 19 responsible for carrying fats into the bloodstream comes in various forms Apolopoprotein E-4 gene inherited by 30% of the population promotes excessive formation of bet-amyloid proteins 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 hippocampus amygdala diencephalon mammillary bodies thalamus 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 trigger a clumping of beta-amyloid protein similar to plaques found in brains of Alzheimer's patients

16.1.3. Lead many of today's elderly exposed to high levels in the 1960s/1970s regularly inhaling air pollution may be having negative effects on current cognitive functioning

16.2. Autoimmune theory

16.2.1. changes in aging brain cells may trigger autoimmune response mistaken attack by the immune system against itself

16.3. Viral theory

16.3.1. Alzheimer's Disease resembles other diseases Creutzfeldt-Jakob Disease neurocognitive disorder 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 accuracy rate of 71%

17.2.2. predict major neurocognitive impairment accuracy rate of 83%

18. Current Treatments

18.1. Drug therapy

18.1.1. affect neurotransmitters that play important roles in memory Acetylcholine 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 Meet regularly in classes perform simple calculations and read essays/novel out loud

18.2.2. based cognitive activities over 5 year period writing letters following the news reading books attending concerts/plays less likely to develop Alzheimer's Disease

18.2.3. focus on behaviors rather than cognitions physical exercise may reduce the risk of developing Alzheimer's seem to be more useful in preventing and managing Alzheimer's that are stressful for family/caregivers wandering at night loss of bladder control demands for attention inadequate personal care use of combination of several types to teach when to use reinforcement role-playing excercises modeling

18.3. Support for Caregivers

18.3.1. almost 90% of people with Alzheimer's are cared for by relatives usually adult children/spouses many experience anger/depression their own physical/mental health decline 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 regular time out education about the disease psychotherapy caregiver support groups

18.4. Sociocultural Approaches

18.4.1. daycare facilities for patients provide treatment programs activities for outpatients during the day return to families and homes at night

18.4.2. assisted living facilities live in apartments designed to meet special needs of the residents receive needed supervision take part in stimulating activities

18.4.3. wearing of practical devices for those that like to wander shoes that contain a GPS tracker 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