Alzheimer's disease is a degenerative brain disorder

of unknown etiology which is the most common

form of dementia, that usually starts in late middle
age or in old age, results in progressive memory
loss, impaired thinking, disorientation, and changes
in personality and mood. There is degeneration of
brain neurons especially in the cerebral cortex and
presence of neurofibrillary tangles and plaques
containing beta-amyloid cells
 Alzheimer’s disease is a chronic, irreversible
disease that affects the cells of the brain and
causes impairment of intellectual functioning.

Alzheimer's disease is a brain disorder which

gradually destroys the ability to reason, remember,
imagine, and learn
First described by German psychiatrist
-Alois Alzheimer (1906)
Generally diagnosed in people over 65 years of age
-Early-onset (before 65); only 5-10% of patients
-Several genetic causes
4.5+ million Americans suffer from it
-5% of 65-74 years of age
-Nearly 50% of 85+
1 in 6 women over 55; 1 in 10 men over 55
 Unknown
 But advanced age
 Female
 Family history AD
 Head trauma with loss of consciousness
 Virus
 Environmental toxin
 Cerebrovascular disease
 DUE TO THE ETIOLOGICAL FACTORS

CHANGES OCCUR IN THE PROTIENS OF THE NERVE CELLSOF THE

CEREBRAL CORTEX

ACCUMULATION OF NEUROFIBRILLARY TANGLES AND PLAQUES

GRANULO VASCULAR DEGENERATION

LOSS OF CHOLINERGIC NERVE CELLS

LOSS OF MEMORY, FUNCTION AND COGNITION

  Mild Alzheimer’s Disease
 Memory loss for recent events
 hard time remembering newly learned information

 Difficulty with problem solving, complex tasks and sound

judgments
tasks such as planning a family event or balancing a checkbook
become overwhelming, often experience lapses in judgment
 Changes in personality
may become withdrawn, irritable, or angry when unexpected,
decreased attention span
 Difficulty organizing and expressing thoughts

 Getting lost or misplacing belongings

common to lose or misplace things, trouble finding way around
 Showing increasingly poor judgment and deepening
confusion
 lose track of where they are, confuse friends and family
members, and often wander
 Experience even greater memory loss
 may be unable to recall addresses, phone numbers, stories
 Need help with some daily activities

 Undergo significant changes in personality and behavior

 not uncommon to develop unfounded suspicions, hear or
see things, grow restless and agitated, may bite, kick,
scream, etc.
• Lose the ability to communicate coherently
• Require daily assistance with personal care
total assistance with dressing, eating, etc.
• Experience a decline in physical abilities
unable to walk, get up, or hold up one’s head
 Impairment of the ability to remember
information acquired in the past
 Gradual impairment of memory
 Short-long term memory
 Apraxia
 Aphasia
 Depression
 Inability to perform skilled motor activity
(dressing, walking)
 Psychiatric assessments.
 Mental status examination and neuro
psychological assessment.
 Laboratory tests
 Brain imaging.
• CT scan
• MRI
• PET
• SPECT
 CSF Examination
 Electro-encephalogram (EEG)
 Electromyogram
 Pharmacological intervention
 Acetylcholinesterase inhibitors -prevent the
breakdown of acetylcholine, a chemical
messenger important for learning and memory
 eg. Donepezil (Aricept)
 Rivastigmine (Exelon)
 Galantamine (Razadyne
 N-Methyl d-aspartate Receptor Antagonist
(NMDA)
Eg:Memantine – blocks the NMDA
receptor and inhibit their overstimulation
by glutamate (neurotransmitter)
 Antidepressents.
 Anxiolytics.
 Antipsychotics.
 Anticonvulsants
 Psychosocial intervention
 Behavioral approach
 Emotion oriented approach
 Reminiscence therapy
 Validation therapy
 supportive psychotherapy
 sensory integration
 stimulated presence therapy
 Cognition oriented approach
 Stimulation oriented approach
 Care giving
 Since Alzheimer's has no cure and it
 gradually renders people incapable of
 tending for their own needs, caregiving
 essentially is the treatment and must be
 carefully managed over the course of the
 disease
 Disturbed thought processes related to
physiologic disease process
 Risk for injury due to loss of cognitive
abilities
 Insomnia secondary to disease process
 Caregiver role stain related to physical
needs and behavioral manifestations of the
disease process
 Improving cognitive response
 Reduce noise and social interaction to a level tolerable for
the patient
 Provide physical activity
 Preventing injury
 Avoid restraints but maintain observation
 Provide adequate lighting to avoid misinterpretation of
the environment
 Remove unneeded furniture and euipment from the room
 Ensuring adequate rest
 Supporting care
 Encourage caregiver to discuss feeling
 Assess caregivers stress and refer for counseling
 Stress the need for relaxation time or respite care