Alzheimer's disease causes neurodegeneration in the brain, especially in areas like the hippocampus and temporal lobe, leading to cognitive decline and impairment in functions like memory formation and verbal skills; it can be diagnosed through patient history, cognitive tests, and brain imaging showing changes like plaques and tangles; while there is no cure currently, treatments aim to improve symptoms and recent research explores approaches like antioxidants, music therapy, and behavioral enrichment.

1. Alzheimer’s Disease
Temporal Lobe

2. What do you think of when you
hear the word Alzheimer’s?
• What does the disease mean to you?
• What do you associate it with?
• Any personal experiences?

3. Video
What is Alzheimer's Disease?

4. Alois Alzheimer
(1864-1915)

5. “We must not be satisfied to
force it into the existing group of
well know disease patterns”

6. Research Tracks and
Understanding
1. Neurochemical
 Neurotransmitters
2. Pathognomic Lesions
 Neurotic Plaque
 Neurofibrillary Tangles
3. Molecular Genetic Approach
 Mendelian Cloning Strategies

7. Neurotransmitters
Possible selective neurotransmitter loss?

8. Plaques and Tangles

9. Temporal Lobe

11. Vital Structures
Hippocampus Amygdala

12. Temporal Lobe Functions
Visual and Auditory Input
Sensory Input
Memory Consolidation

13. Damage and Lesions in Temporal
Lobe
• Verbal impairment • Visual impairment
• Word recognition • Word formation
• Visual impairment • Musical memory
• Verbal memory
deficiencies

14. Process of Diagnosis
• Patient History
• Cognitive assessment tests
• Physical Examination
• Brain Imaging

15. Patient History
Look for 10 Signs of Early Detection:
1. Memory changes that disrupt daily life
2. Challenges in planning or solving problems
3. Difficulty completing familiar tasks
4. Confusion with time or place
5. Trouble Understanding visual images and
spatial relationships

16. Patient History
6. New problems with language
7. Misplace things
8. Decreased or poor judgment
9. Withdrawal from work or social activities
10. Changes in mood or Personality

17. Goal of Patient History
Rule out other possible causes
• Example 1: Vitamin B 12 deficient
• Example 2: Depression

18. Cognitive Assessment Tests
• Mini Mental Status Exam
• Blessed Dementia Scale
• Short Portable Mental Status Questionnaire

19. Mini Mental Status Exam
Asks patient questions about the present:
• What is the date?
• Where are we now?
-Mathematical Calculations
-Three Step Directions
-Read and follow a command
-Reproduce a figure by drawing

20. Mini Mental Status Exam
Score Evaluation:
• Each exercise has a value of 1,3 or 5 points
• Perfect score is 30
• Score under 20 points raises concern of dementia
• Similar questioning involved in Short Portable
Mental Status Questionnaire (SPMSQ)

21. Blessed-Dementia Scale
Look for changes in:
• Performance of every day activities
• Habits
• Personality
• Interests
• Drive

22. Short Portable Mental Status
Questionnaire
Ask patient simple questions about:
• What is the day of the week?
• What is the name of this place?
• What is your phone number?

23. Physical Examination
• Biomarkers
• Urinalysis
• CT Scan or MRI of brain

24. Biomarkers
Measure for variance from norm in:
• Electrolyte imbalance
• Vitamin deficiencies
• ApoE4 gene
• Tau protein
• Aß42

25. Urinalysis
• Physical color and appearance
• Microscopic appearance
• Chemical appearance

26. Brain Imaging
Looking for evidence of:
• Stroke
• Bleeding around the brain
• Brain tumor
• Normal pressure hydrocephalus
(excess of brain fluids)

27. Types of Brain Imaging
• Positron Emission Tomography (PET)
• CT Scan
• MRI

28. Positron Emission Tomography (PET)

29. CT Scan

30. CT Scan: Medial Temporal Lobe

31. Brain Imaging: MRI
(Magnetic Resonance Imaging)
Types of MRI used for AD:
• MRI
• Functional MRI

32. MRI
Normal Brain
AD Brain

33. Functional MRI
Functional MRI of AD versus Normal Control

34. Burton et al. (2008)
Can MRI distinguish AD from other forms of
dementia?

35. Burton et al. (2008)
Found distinguishing characteristics based on size:
•Lewy Bodies
•VCI

36. Confirm A Case: Autopsy
• 100% proven diagnostic of AD

38. Overview of Current Treatments
• Cholinergics
• Antioxidants
• Statins
• Anti-inflammatory drugs
• Memantine

39. Music Therapy
• Music as a Nursing Intervention for
Residents with Alzheimer’s Disease in
Long-Term Care (Sambandham & Schirm,
1995)
• Underwent music therapy sessions which
included music the patients preferred

40. Music Therapy
• Patients with the most severe impairments
displayed greater improvements in memory
and reminiscence abilities as compared to
patients with less severe impairment
• Can be used to minimize effects of AD until
more definitive treatments are discovered

41. Behavioral Enrichment/Antioxidant
Treatment
• Proteomic identification of brain proteins in
the canine model of human aging following a
long-term treatment with antioxidants and a
program of behavioral enrichment: Relevance
to Alzheimer’s disease (Opii et. Al 2006)
• Tested beagles for the effects of behavioral
enrichment and inclusion of antioxidants in
diet on Alzheimer’s Disease symptoms

42. Behavioral Enrichment/Antioxidant
Treatment
• Behavioral enrichment types
– Social Enrichment : Animals housed in pairs
– Environmental Enrichment : Toys provided
– Physical Enrichment : Providing outdoor walks
– Cognitive Enrichment : Continuous cognitive testing
• Diets were identical with the exception of antioxidants
and mitochondrial cofactor additions to enriched diet
• Groups were either both controlled, both enriched, or
one factor enriched and on controlled

43. Behavioral Enrichment/Antioxidant
Treatment
• Results of enrichment treatments
– Significantly less oxidation and increased
expression of important proteins which
correlated with improved cognitive function

44. New thoughts on the word
Alzheimer’s?
• What does the disease mean to you?
• What do you associate it with?
• Any personal experiences?