Epidemiology of Alzeimers. Consists of information regarding its global and national burden , its agent ,host and environment ,causes, risk factors and preventive measures to control it.

1. Alzheimer's Disease
Presentation by:- Neeru Magar,SHAS ,Ist sem
POKHARA UNIVERSITY

2. Emerging NCDs Re-emerging NCDs
Emerging diseases are diseases that have recently
appeared in a population or have increased in
incidence or severity.
Re-emerging diseases are diseases that
had been previously controlled but have
become a problem again.
Cardiovascular diseases (CVDs):
• Coronary heart disease
• Stroke
• Heart failure
• Peripheral artery disease
Cancer:
• Breast cancer
• Lung cancer
• Prostate cancer
• Colorectal cancer
• Pancreatic cancer
• Leukemia
• Lymphoma

3. Chronic respiratory diseases:
• COPD
• Asthma
• Interstitial lung diseases
Diabetes:
• Type 1 diabetes
• Type 2 diabetes
• Gestational diabetes
Obesity
Chronic kidney disease:

4. Neurological disorders:
• Alzheimer's disease and other dementias
• Parkinson's disease
• Epilepsy
Mental health disorders:
• Depression
• Anxiety disorders
• Bipolar disorder
• Schizophrenia
Musculoskeletal disorders:
Eye diseases:
• Age-related macular degeneration (AMD)
• Glaucoma
Dental diseases:
• Tooth decay
• Periodontal disease

5. Contents
• Global and national scenario
• Introduction
• History
• Stages of Alzheimer's
• Causative Agents
• Signs and symptoms
• Risk factors
• Diagnosis
• Prevention and cure

6. Global Scenario
• Someone in the world develops dementia every 3 seconds.
• There are over 55 million people worldwide living with dementia in
2020.
• This number will almost double every 20 years, reaching 78 million
in 2030 and 139 million in 2050.
• Much of the increase will be in developing countries.
• Already 60% of people with dementia live in low and middle income
countries, but by 2050 this will rise to 71%.
• The fastest growth in the elderly population is taking place in China,
India, and their south Asian and western Pacific neighbors.
Alzheimer's Disease International

7. National Scenario
• The estimated number of people with dementia in Nepal
was 78,000 in 2015, and this number is expected to reach
134,000 by 2030 and 285,000 by 2050.
Alzheimer’s Disease International
• But, only around 300 cases were reported in the annual
report of the Ministry of Health, meaning many patients are
undiagnosed.
• Some estimates put that number even higher—one estimate,
calculated using the 5% prevalence rate, says at least
135,000 Nepalis suffer from the disease. And the number is
expected to double every 20 years.
The Kathmandu Post

8. Introduction
• Alzheimer’s is a progressive brain disorder that gradually
destroys a person’s memory, ability to learn, reasoning, making
judgments, communicate and carry out daily activities.
• As Alzheimer’s progresses, individuals may also experience
changes in personality & behavior, such as anxiety,
suspiciousness, agitation, delusions or hallucinations
• The exact cause of Alzheimer's disease is not yet fully
understood, although a number of things are thought to
increase the risk of developing the condition.

11. History
• The history of Alzheimer's disease is a long and complex one.
The disease has been known for centuries, but it was not until
the early 20th century that the first scientific studies of the
disease were conducted.
• In 1906, German psychiatrist Alois Alzheimer first described the
characteristic features of Alzheimer's disease in a patient named
Auguste Deter. Deter was a 51-year-old woman who had been
experiencing progressive memory loss and cognitive decline.
• Upon her death, Alzheimer found that her brain contained two
abnormal structures: amyloid plaques and neurofibrillary
tangles.

13. Stages of Alzheimer's
• Early-stage Alzheimer's (mild)
• Middle-stage Alzheimer's (moderate)
• Late-stage Alzheimer's (severe)

14. Early-stage Alzheimer's (mild)
• In the early stage of Alzheimer's, a person may function
independently.
• He or she may still drive, work and be part of social activities.
Despite this, the person may feel as if he or she is having
memory lapses, such as forgetting familiar words or the location
of everyday objects.
Middle-stage Alzheimer's (moderate)
• Middle-stage Alzheimer's is typically the longest stage and can
last for many years. During the middle stage of Alzheimer’s, the
dementia symptoms are more pronounced.

15. Symptoms varying from person to
person, may include:
• Being forgetful of events or personal history.
• Feeling moody or solitary, especially in socially or mentally
challenging situations.
• Being unable to recall information about themselves like their
address or telephone number, and the high school or college they
attended.
• Experiencing confusion about where they are or what day it is.

16. • Having trouble controlling their bladder and bowels.
• Experiencing changes in sleep patterns, such as sleeping during
the day and becoming restless at night.
• Showing an increased tendency to wander and become lost.
• Demonstrating personality and behavioral changes, including
suspiciousness and delusions or compulsive, repetitive behavior
like hand-wringing or tissue shredding.

17. Late-stage Alzheimer's (severe)
• Dementia symptoms are severe.
• Individuals lose the ability to respond to their environment,
to carry on a conversation and, eventually, to control movement.
• They may still say words or phrases, but communicating pain
becomes difficult.
• As memory and cognitive skills continue to worsen, significant
personality changes may take place and individuals need
extensive care.

18. Causative Agents
Exact cause of Alzheimer’s disease is not known. However, several
factors are thought to be implicated in this disease.
Neurochemical
Factors
Environmental/behavio
ral Factors
Genetic factors
• Amyloid plaques
• Tau tangles
• Decreased levels of
acetylcholine
• Inflammation
• Oxidative stress
• Neurodegeneration
• Cigarette smoking.
• Environmental pollution
• Certain Infections.
• Heavy metal exposure
• Use of cholesterol lowering
drugs (statin).
• High cholesterol, blood
pressure, obesity, stress, lack
of physical exercise
• Genes inherited
from biological
parents, can affect
how likely they are
to develop
Alzheimer’s disease.

19. RISK FACTORS
a) Old age
b) Down's syndrome.
c) Family History.
d) Chronic high BP.
e) Head injuries.
f) Gender.
g) Smoking and Drinking

20. PATHOPHYSIOLOGY
• AD attacks nerves and brain cells as well as neurotransmitters.
The destruction of these parts causes clumps of protein to form
around the brain's cells. These clumps are known as 'plaques'
and 'bundles'. The presence of the 'plaques' and 'bundles' start
to destroy more connections between the brain cells, which
makes the condition worse.
• Due to the Etiological factor changes occur in the proteins of the
nerve cells of the Cerebral cortex accumulation of
Neurofilrillary Tangles and plaques Granulo Vascular,
degeration loss of Cholinergic nerve cells causes loss of
memory , function and cognition.

21. Clinical Features
• Loss of short-term memory and ability to create memories
• Concentration on past
• Loss of time
• Communication diminishes
• Personality changes
• Delusions
• Become immobilized and expressionless
• Death due to respiratory failure
• 65 and up disease lasts 8-20 years
• 65 and down disease lasts 5-10 years disease more rapid

23. Signs and symptoms of AD
In general, the symptoms of AD involve a gradual decline in some,
most or all of the following:
• Memory.
• Reasoning and handling of complex tasks.
• Language.
• Understanding visual form and space relationship.
• Behavior and personality.

24. • People with memory loss or other signs of Alzheimer’s may have
difficulty recognizing their mental decline Symptoms of the mild
stage of Alzheimer’s dementia
• Symptoms become noticeable in the mild stage.
• The most common early symptom is forgetting newly learned
information, especially recent events, places and names.

25. Diagnosis
• There is no single test that can determine if a person is living
with Alzheimer’s or another dementia.
• Physicians use diagnostic tools combined with medical history
and other information, including neurological exams, cognitive
and functional assessments, brain imaging (MRI, CT, PET) and
cerebrospinal fluid or blood tests to make an accurate diagnosis.

26. How to Reduce Risk of
Alzheimer’s
• Prevent and manage high blood pressure.
• Manage blood sugar.
• Maintain a healthy weight.
• Be physically active.
• Quit smoking.
• Avoid excessive drinking.
• Prevent and correct hearing loss.
• Get enough sleep.
CDC

27. Treatment
• There's no cure for Alzheimer’s.
• But there are treatments that may change disease progression,
and drug and non-drug options that may help treat symptoms.
• Understanding available options can help individuals living
with the disease and their caregivers to cope with symptoms and
improve quality of life.

28. • https://kathmandupost.com/health/2019/08/02/dementia-is-
a-growing-health-epidemic-but-no-one-is-paying-attention
• https://www.alzint.org/about/dementia-facts-figures/dementia-
statistics/#:~:text=There%20are%20over%2010%20million,new%20ca
se%20every%203.2%20seconds.
• https://www.alz.org/alzheimers-
dementia/treatments#:~:text=There's%20no%20cure%20for%20Alzh
eimer's,and%20improve%20quality%20of%20life.

30. •Thankyou everyone !!!!!
•Have a great evening.