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Pathopysiology of Alzheimer's disease
- 1. PATHOPHYSIOLOGY ALZHEIMER’S DISEASE NEM KUMAR JAIN MS (PHARM.) PHARMACOLOGY & TOXICOLOGY ASSISTANT PROFESSOR, SCHOOL OF PHARMACY ITM UNIVERSITY GWALIOR
- 2. Alzheimer’s Disease (AD) It is a neurodegenerative disease (characterized by the progressive loss of neurons, typically group of neurons with interconnected functions) that occurs in the brain. AD is the most common cause of Dementia Dementia is the common term used to describe a set of symptoms that can include changes in Memory, perception, thinking, judgement, reasoning, language, attention and concentration. AD is progressive and Irreversible disorder that impair mental functioning AD is an progressive irreversible neurological disorder that slowly destroy memory and impairs other cognitive functions (ability to reason, remember, imagine and learn)
- 3. History Dr Alois Alzheimer, a German physician is credited with being first to describe AD. In 1906, He presented the pathological findings on a brain of 56 years old women Auguste Deter who died after a progressive dementia. Dr Emil Kraepelin in 1910 describe it to as Alzheimer’s Disease in his psychiatric book
- 4. Etiology and Risk Factors Cause: unlikely to be a single clear cause of AD Result of complex series of events that place in brain over a long period of time More likely the result of a combination of inter-related factors Genetics: Activation of genes: Apolipoprotein4 (APOE4 ), TREM2 etc Down syndrome Family history and Gene mutations Non-Genetic (environmental and lifestyle) Head injury/ trauma Toxins Smoking and drinking High cholesterol and chronic high Blood Pressure Viruses Ageing
- 5. Incidence The incidence is about 3% in individuals 65 to 74 years of age, 19% in those 75 to 84 years of age, and 47% in those older than 84 years of age. Most cases of AD are sporadic, but at least 5% to 10% are familial. Sporadic cases rarely present before 50 years of age, but early onset is seen with some heritable forms.
- 9. Morphology
- 10. Sign and Symptoms Memory loss: especially recently learned information Asking for same information over and over Relying on memory aids like reminders or family members for things they used to handle on their own Forgetting important dates or events Difficulty to perform familiar task Driving to a familiar place Managing a budget at work Remembering the rules of a favourite game Problem with language Trouble in joining or following in conversation Stopping in the middle of conversation and have no idea how to continue or they may repeat themselve Trouble with finding right word or call things by wrong name
- 11. Disorientation to time and place Lose track of time, date, season Forget where they are and how they got there Poor or decreased judgement Poor judgement When dealing money, they may overpay someone They may pay less attention to grooming or keeping themselves clean Judgment in what to wear, selecting hot jacket in summer Problem with abstract thinking: challenges in planning or solving problems Difficulty in concentrating and take much longer to do things than they did before To develop and follow a plan or work with numbers To keep track of monthly bill or following a favourite recipe
- 12. Trouble understanding visual images or spatial relationships Difficulty in reading, judging distance and determining colour or contrast While seeing in mirror they may think there is someone else in room, they may not realise they are in the mirror Misplacing things and losing the ability to retrace steps May put things in unusual places, lose things and unable to go back over their steps to find them again Occur more frequently, may accuse other of stealing Changes in mood or personality: moodswings Upset in area of out of their comfort zone Easily depressed, confused, suspicious, fearful or anxious Loss of initiative or withdrawal from work or social activities: from hobbies, get together, games etc
- 13. Diagnostic Tests Psychiatric assessment Mental status examination Laboratory tests: neurotransmitter level, Cerebro-spinal fluid examination Brain imaging: PET Scan MRI CT SCAN Electroencephalogram (EEG)