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What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
What is Alzheimer's Disease? Alzheimer's disease is a ...
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What is Alzheimer's Disease? Alzheimer's disease is a ...

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  • 1.  
  • 2. What is Alzheimer’s Disease? <ul><li>Alzheimer’s disease is a progressive brain disorder that gradually destroys a person’s memory and ability to learn, reason, make judgments, communicate and carry out daily activities. </li></ul>
  • 3. Statistics on Alzheimer’s Disease <ul><li>More than 5 million people in the United States are affected with the disease. </li></ul><ul><li>Worldwide it is estimated that 22 million people suffer from the disease. </li></ul><ul><li>The prevalence of the disease doubles every five years beyond the age of 65. </li></ul><ul><li>By the year 2040, 14 million people in the Unites States are expected to have Alzheimer’s Disease. </li></ul><ul><li>Research suggests that the risk may be higher in African Americans and Hispanic Americans than for Caucasians. </li></ul><ul><li>Incidence of the disease is higher in women than men </li></ul><ul><li>People with AD live an average of 8 to 10 years after the diagnosis. </li></ul>
  • 4. <ul><li>The disease can last up to 20 years. </li></ul><ul><li>AD is the fourth leading cause of death in the United States killing more than 100,000 people annually. </li></ul><ul><li>Alzheimer’s care is estimated to cost the United States more than $100 billion a year </li></ul><ul><li>More than 7 out of 10 people with Alzheimer’s Disease live where almost 75 Percent of the care is done by family members </li></ul><ul><li>The average cost of a nursing home is $42,000 to $70,000 per year </li></ul><ul><li>The average lifetime cost of care for an individual with AD is $174,000. </li></ul>Statistics on Alzheimer’s Disease continued
  • 5. History of the disease <ul><li>First discovered in 1906 by a German Neurologist, Dr. Alois Alzheimer. </li></ul><ul><li>Subject was a 51 year old woman who exhibited problems with memory and disorientation. </li></ul><ul><li>The woman died at the age of 55 in a mental institution. An autopsy revealed that the brain had cortical atrophy and abnormalities in the cerebral cortex called NEUOFIBRILLARY TANGLES and NEURITIC PLAQUES . </li></ul>
  • 6.  
  • 7.  
  • 8. Causes of the disease <ul><li>Numerous theories have been developed about the underlying causes of AD such as environmental toxins, genetics, and viruses have all been suspected. </li></ul><ul><li>No single cause for Alzheimer’s Disease has been identified </li></ul>
  • 9. Definite risk factors for Alzheimer’s Disease. <ul><li>Advanced age </li></ul><ul><li>Family History of AD </li></ul><ul><li>Genetics </li></ul><ul><li>Down’s Syndrome </li></ul><ul><li>History of head trauma </li></ul><ul><li>Low educational and occupational status </li></ul>
  • 10. Possible risk factors for Alzheimer’s Disease <ul><li>Female gender </li></ul><ul><li>Small strokes of cerebral vascular disease </li></ul><ul><li>Parkinson’s Disease </li></ul><ul><li>Race and Ethnicity </li></ul><ul><li>Environmental Toxins </li></ul><ul><li>Diet </li></ul><ul><li>Lack of exercise </li></ul><ul><li>Stress </li></ul><ul><li>Depression before onset of AD </li></ul>
  • 11. Theories of Alzheimer’s Disease <ul><li>The Genetic Theory </li></ul><ul><li>Familial Alzheimer’s linked to Chromosome 21 </li></ul><ul><li>APP Gene </li></ul><ul><li>ApoE Genes </li></ul><ul><li>The Viral Theory </li></ul><ul><li>The Immune System Theory </li></ul><ul><li>The Aluminum Theory </li></ul>
  • 12.  
  • 13. The Need for an Accurate Diagnosis Components of diagnostic testing COMMONLY USED SOMETIMES USED History and Physical Psychological Tests Neurological Exam Spinal Tap Cognitive screening exam Brain scan Blood Tests PET SPECT Brain scan(CT MRI ) HIV blood test
  • 14. Reasons for obtaining a Diagnosis <ul><li>Rule out reversible forms of dementia </li></ul><ul><li>To provide a context and explanation for symptoms </li></ul><ul><li>To obtain appropriate medical treatment </li></ul><ul><li>To let you decide whether or not to enroll in research studies </li></ul><ul><li>To help family understand changing roles and responsibilities </li></ul><ul><li>To ease communication for all concerned </li></ul><ul><li>To plan for the future </li></ul>
  • 15. The Mini Mental Exam <ul><li>The most commonly used test for memory problems, not just a test for AD </li></ul><ul><li>Developed in l970 by Dr. Marshall Folstein </li></ul><ul><li>The test screens the presence of cognitive impairment over a number of areas </li></ul><ul><li>Cognition is defined as mental activity such as memory, thinking, attention, reasoning, decision making and dealing with concepts </li></ul><ul><li>Based on a series of questions and tests, points are achieved on MMSE when answered correctly. Maximum of 30. Scores 26 or less reported with people with AD </li></ul>
  • 16. Areas Tested by MMSE <ul><li>Orientation </li></ul><ul><li>Memory </li></ul><ul><li>Attention and Calculation </li></ul><ul><li>Language,Writing and Drawing </li></ul>
  • 17. Orientation <ul><li>What is the day of the week? </li></ul><ul><li>What year was last year? </li></ul><ul><li>What building are we in? </li></ul><ul><li>Ten points can be scored for answering questions about date and location </li></ul>
  • 18. Memory <ul><li>This tests recall. </li></ul><ul><li>Immediate memory scores 3 points. (One point for each of the three objects: pen, ball, ring.) </li></ul><ul><li>People are asked to remember each one and will be asked later in the test </li></ul>
  • 19. Attention and Calculation <ul><li>Tests the ability to concentrate. </li></ul><ul><li>One test, scoring a maximum of 5 points, requires the person to subtract 7 from 100 and continue. </li></ul><ul><li>The person may also be asked to spell a 5 letter word backwards. </li></ul><ul><li>The best of the two scores is included in the final score </li></ul>
  • 20. Language, Writing and Drawing <ul><li>The final 9 points of the MMSE test spoken and written language, the ability to write, copy, and remember named objects </li></ul><ul><li>This includes naming objects, e.g. a brush and a pen. One point for each correct answer </li></ul><ul><li>Carry out a three step process- 3 points </li></ul><ul><li>Repeat a sentence- 1 point </li></ul><ul><li>Copy a figure of shape- 1 point </li></ul><ul><li>Write a sentence on a piece of paper- I point </li></ul>
  • 21. Scoring the MMSE <ul><li>Score results of the MMSE are used in the diagnosis of AD </li></ul><ul><li>The scores indicate the areas of difficulty in a person presenting with cognitive problems such as memory, thinking, attention, reasoning, decision making and dealing with concepts </li></ul>
  • 22. Scores Indicating Dementia <ul><li>27 and above are considered normal </li></ul><ul><li>23 to 26 indicate a borderline condition </li></ul><ul><li>22 and below are abnormal </li></ul>
  • 23. Scoring and people with Alzheimer’s Disease <ul><li>20 to 26 Mild Alzheimer’s Disease </li></ul><ul><li>10 to 19 Moderate AD </li></ul><ul><li>Below 10 Severe AD </li></ul>
  • 24. Limitations of the MMSE <ul><li>Education levels </li></ul><ul><ul><li>The MMSE cannot take into account very well educated people who have mild dementia. They may score well within normal range because they find the questions easy. </li></ul></ul><ul><ul><li>Poorly educated people may score badly because they find the questions difficult. Their scoring may indicate dementia when none is present </li></ul></ul>
  • 25. Ten warning signs of Alzheimer’s Disease <ul><li>MEMORY LOSS </li></ul><ul><li>DIFFICULTY PERFORMING FAMILIAR TASKS </li></ul><ul><li>PROBLEMS WITH LANGUAGE </li></ul><ul><li>DISORIENTATION TO TIME AND PLACE </li></ul><ul><li>POOR OR DECREASED JUDGEMENT </li></ul><ul><li>PROBLEMS WITH ABSTRACT THINKING </li></ul><ul><li>MISPLACING THINGS </li></ul><ul><li>CHANGES IN MOOD OR BEHAVIOR </li></ul><ul><li>CHANGES IN PERSONALITY </li></ul><ul><li>LOSS OF INITIATIVE </li></ul>
  • 26. What’s the Difference? <ul><li>AD symptoms </li></ul><ul><li>Normal age related Memory changes </li></ul>Forgets entire experiences Forgets part of an experience Rarely remembers later Often remembers later Gradually unable to follow written/spoken directions Usually able to follow written/spoken directions Gradually unable to use notes as reminders Usually able to use notes as reminders Gradually unable to care for self Usually able to care for self
  • 27. STAGES OF ALZHEIMER’S DISEASE <ul><li>STAGE 1 No Impairment </li></ul><ul><li>STAGE 2 Very Mild Decline </li></ul><ul><li>STAGE 3 Mild Decline </li></ul><ul><li>STAGE 4 Moderate Decline = Early Stage AD </li></ul><ul><li>STAGE 5 Moderately Severe Decline = Mid Stage AD </li></ul><ul><li>STAGE 6 Severe Decline Moderate = Severe or Mid Stage AD </li></ul><ul><li>STAGE 7 Very Severe Decline = Late stage AD </li></ul>
  • 28. Treatment and Prevention of AD <ul><li>Cholinesterase inhibitors </li></ul><ul><li>Anti-inflammatory drugs </li></ul><ul><li>Estrogen Replacement Therapy </li></ul><ul><li>Antioxidants </li></ul><ul><li>Complementary and alternative medicine </li></ul><ul><li>The “ use it or lose it “ approach </li></ul><ul><li>A vaccine </li></ul>
  • 29. Medical legal considerations in a patient with AD <ul><li>Power of Attorney </li></ul><ul><li>Health Care Proxy </li></ul><ul><li>Guardianship </li></ul>
  • 30. Family dynamics in dealing with an AD patient <ul><li>Decision making </li></ul><ul><li>Safety </li></ul><ul><li>Maintaining good health </li></ul><ul><li>Medications </li></ul><ul><li>Nutrition </li></ul><ul><li>Financial well being </li></ul><ul><li>Alternative living situations </li></ul><ul><li>Choosing physicians and other professionals </li></ul><ul><li>Exploring community resources </li></ul>
  • 31.  

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