Alzheimer’s Disease HEAL 3600:003 Prevention and Control of Disease Fall, 2017 1 1 # 7 World # 6 U.S. 2 Alzheimer’s Disease Defined Characterized by beta-amyloid deposits and neurofibrillary tangles in the cerebral cortex and subcortical gray matter. Progressive form of pre-senile dementia Except it usually starts in the 40s or 50s Accounts for 60 - 80% dementias in the elderly. 3 3 Alzheimer’s Disease Neurocognitive disorder Causes progressive cognitive deterioration Most common cause of dementia Dementia is the loss of cognitive functioning Thinking, remembering, reasoning, and behavioral abilities to such an extent that it interferes with a person’s daily life and activities. 4 Dementia is chronic, global, usually irreversible deterioration of cognition 4 Etiology of Alzheimer’s Cause, Causation 5 Alzheimer’s Cause Most cases are sporadic with late onset (≥ 65 yr) and unclear etiology Risk of developing the disease is best predicted by age. 5 to 15% of cases are familial half of these cases have an early (presenile) onset (< 65 yr) and are typically related to specific genetic mutations. 6 Alzheimer’s Cause Early-onset Alzheimer’s disease Has a genetic component Late-onset Alzheimer's Arises from complex series of brain changes occurring over decades The causes probably include a combination of genetic, environmental, and lifestyle factors. The importance of these factors in increasing or decreasing the risk of developing Alzheimer’s differ from person to person. 7 Genetics At least 5 distinct genetic loci, located on chromosomes 1, 12, 14, 19, and 21, influence initiation and progression of Alzheimer disease. 8 Alzheimer’s Cause Early Onset Mid 30s to mid 60s 10% of all people with Alzheimer’s Some inherited changes in 1 of 3 genes Early-Onset familial Alzheimer’s disease (FAD) Most people with Down Syndrome develop Alzheimer’s Chromosome 21,- contains gene that generates harmful amyloid. Late Onset Mid 60s – symptoms apparent 90 – 95 % of all people with Alzheimer’s Complex series of brain changes that occur over decades Apolipoprotein E (APOE) gene is involved 9 Alzheimer’s Ongoing Research Relationship between cognitive decline and Vascular conditions Heart disease, Stroke, and High blood pressure Metabolic conditions Diabetes and obesity Ongoing research will help us understand whether and how reducing risk factors for these conditions may also reduce the risk of Alzheimer’s. 10 Pathogenesis Of Alzheimer’s Development of Alzheimer’. . . 11 12 Development of Alzheimer’s One great mystery of Alzheimer’s is why it largely strikes older adults Normal brain aging research is shedding light Scientists are learning how age-related changes in the brain may harm neurons and contribute to Alzheimer’s damage. Age-related changes Atrophy (shrinking) of certain parts of the brain Inflammation, production of unstable molecules called free radicals, Mitochondrial dys.