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Evaluation and management of oropharyngeal dysphagia in different types of dementia: A systematic review.

POWERPOINT PRESENTATION ON:
PATHOPHYSIOLOGY OF ALZHEIMER’S DISEASE

TANIA GONZALEZ DIAZ

WALDEN UNIVERSITY

NURS:6501C

AUGUST 03,2019

*

Alzheimer’s disease

Alzheimer disease (AD) is:

Chronic neurodegenerative disorder
The leading cause of dementia
According to Etindele Sosso, Nakamura & Nakamura (2017), as of 2015, 29.8 million people had AD.
Most prevalent among people whose ages are 65 years and above.
Alzheimer disease (AD) is a chronic neurodegenerative disorder that normally starts and gradually progresses with the brain cells dying off. Leading to memory loss.
The leading cause of dementia which affects an individual cognitive, social and behavioral skills that destroy the capability of a person to function properly.
According to Etindele Sosso, Nakamura & Nakamura (2017), as of 2015, there were 29.8 million people globally who had AD. I
t mostly starts in people whose ages are over 65 years.
*

Pathophysiology of Alzheimer’s Disease

Exact cause is unknown.
Early onset of Familial Alzheimer’s Disease is associated with 3 genes found in chromosome 21, namely;
Abnormal amyloid precursor protein 14 [APP14]
Abnormal presenilin 1 [PSEN1] and
Abnormal presenilin 2 [PSEN2])
Late onset of AD is related to changes in apolipoprotein E gene-allele 4 (APOE4) gene found in chromosome 19.
Source: (Huether, McCance, Brashers & Rote, 2016)
The exact cause of AD is still unknown till date.
Early onset of Familial Alzheimer’s Disease is associated with 3 genes found in chromosome 21, namely;
Abnormal amyloid precursor protein 14 [APP14]
Abnormal presenilin 1 [PSEN1] and
Abnormal presenilin 2 [PSEN2])
Late onset of AD is related to changes in apolipoprotein E gene-allele 4 (APOE4) gene found in chromosome 19.
*

Pathophysiology of Alzheimer’s Disease …contd

DNA methylation is one epigenetic markers for AD.
Pathological alterations in the brain causes the loss of memory.
These pathological alterations include;
Accumulation of extracellular neuritic plaques with core of amyloid Degeneration of basal forebrain ß-protein
Intraneuronal neurofibrillary tangles
cholinergic neurons with loss of acetylcholine
Source: (Huether, McCance, Brashers & Rote, 2016)
DNA methylation is one epigenetic markers for AD.
Pathological alterations in the brain causes the loss of memory.
These pathological alterations include;
Accumulation of extracellular neuritic plaques with core of amyloid ß-protein
Intraneuronal neurofibrillary tangles
Degeneration of basal forebrain cholinergic neurons
If the brain is unable to get rid of amyloid the precursor protein, toxic fragments of amyloid ß-protein accumulates and which trigger neuritic plaques to diffuse, the transmission of impulses by nerve cells to be disrupted and the nerve cells to die.
The tau protein in neiurons detaches forming an insoluble neurofibrillary tangles, which causes the neurons to die.
Neurofibrilary tangles and neuritic plaques which are more concentrated in the cerebral cortex are the one that contribute to memory loss, through the loss of neurons.
As shown in the figure attached in the slides above this causes the gri to shrink while the sulci widens.
*

Body Systems Affected by Alzheimer’s Disease

Almost body systems are affected by Alzheimer’s Disease.
Because with time and age are it affected other body functions.
Digestive system (Alagiakrishnan, Bhanji & Kurian, 2013)
Swallowing difficulties
People often eat while choking
Central Nervous system (Tina, n.d.)
AD is a CNS disease an d therefore affects both the brain and spinal cord
Amyloid plaque that is made up of fragments of dead brain cells and certain protein accumulates in the brain
Tau protein also accumulate at abnormal levels rendering the brain cells to die and to ultimately die
As AD continues, it often extends to other brain parts which control coordination, walking and swallowing.
Even though Alzheimer’s usually out as a problem that affect the thought and memory, it ultimately affects almost all the body functions.
Digestive system

Swallowing difficulties
People often eat while choking
Central Nervous system

AD is a CNS disease an d therefore affects both the brain and spinal cord
Amyloid plaque that is made up of fragments of dead brain cells and certain protein accumulates in the brain
Tau protein also accumulate at abnormal levels rendering the brain cells to die and to ultimately die
*

Diagnosis of Alzheimer’s Disease

Neurologist or geriatrician will first review clinical history of a client and their symptoms
The physician will then run tests:
Brain imaging
MRI,
CT scan
PET
Laboratory tests
Memory tests
Neuropsychological tests
Mental status testing
According to Mayo Clinic Staff (2019), the future diagnosis will apply tool that will involve the detection of tau proteins like PET
Neurologist or geriatrician will first review clinical history of a client and their symptoms
The physician will then run tests:
Brain imaging
MRI,
CT scan
Laboratory tests
Memory tests
Neuropsychological tests
Mental status testing
Future diagnosis will apply tool that will involve the detection of tau proteins like PET
*

Treatment of Alzheimer’s Disease

Cure for AD has not been established.
Are medicines that ease the symptoms in some people.
Some drugs curb the breakdown of acetylcholine which is crucial for learning and memory.
Are three drugs commonly used, these are;
Razadyne (galantamine)
Aricept (donepezil)
Exelon (rivastigmine)
Cure for AD has not been established.
Are medicines that ease the symptoms in some people.
Some drugs curb the breakdown of acetylcholine which is crucial for learning and memory.
Treatment options depend on factors such
Severity of the disease, clinical history, age, lifestyle, client’s or family’s or caregiver’ preferences
Are three drugs commonly used, these are;
Razadyne (galantamine)
Aricept (donepezil)
Exelon (rivastigmine)
*

A Mind Map of Alzheimer’s disease

Alzheimer’s disease

Clinical Manifestation

Behavioral changes
Mood changes
Treatment

Are three drugs commonly used, these are;
Razadyne (galantamine)
Aricept (donepezil)
Exelon (rivastigmine)
Support groups

Pathophysiology alterations

Plaque tangles and tau proteins leads to death of neuronal cell

Risk Factors

Hereditary
Abnormal amyloid precursor protein 14 [APP14]
Abnormal presenilin 1 [PSEN1] and
Abnormal presenilin 2 [PSEN2])
Cardiovascular disease
Diagnosis

Laboratory tests
Memory tests
Brain imaging
Epidemiology

Globally, about 29.8 million people have AD as of 2015
In a study conducted in the US people aged >70 years yielded a prevalence for AD of 9.7 %.
*

References

Alagiakrishnan, K., Bhanji, R., & Kurian, M. (2013). Evaluation and management of oropharyngeal dysphagia in different types of dementia: A systematic review. Archives Of Gerontology And Geriatrics, 56(1), 1-9. doi: 10.1016/j.archger.2012.04.011

Etindele Sosso, F., Nakamura, O., & Nakamura, M. (2017). Epidemiology of Alzheimer’s Disease: Comparison between Africa and South America. Journal Of Neurology And Neuroscience, 08(04). doi: 10.21767/2171-6625.1000204

Huether, S., McCance, K., Brashers, V., & Rote, N. (2016). Understanding pathophysiology (6th ed., pp. 1180-1200). Elsevier.

Mayo Clinic Staff. (2019). Learn how Alzheimer’s is diagnosed. Retrieved 30 July 2019, from https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers/art-20048075

Tina, M. What Body Systems Are Affected by Alzheimer Disease? | Livestrong.com. Retrieved 30 July 2019, from https://www.livestrong.com/article/177220-what-body-systems-are-affected-by-alzheimers-disease/

Thank you for listening.

You are a part of a global fight against Alzheimer’s disease

*

*

Alzheimer disease (AD) is a chronic neurodegenerative disorder that normally starts and gradually progresses with the brain cells dying off. Leading to memory loss.
The leading cause of dementia which affects an individual cognitive, social and behavioral skills that destroy the capability of a person to function properly.
According to Etindele Sosso, Nakamura & Nakamura (2017), as of 2015, there were 29.8 million people globally who had AD. I
t mostly starts in people whose ages are over 65 years.
*

The exact cause of AD is still unknown till date.
Early onset of Familial Alzheimer’s Disease is associated with 3 genes found in chromosome 21, namely;
Abnormal amyloid precursor protein 14 [APP14]
Abnormal presenilin 1 [PSEN1] and
Abnormal presenilin 2 [PSEN2])
Late onset of AD is related to changes in apolipoprotein E gene-allele 4 (APOE4) gene found in chromosome 19.
*

DNA methylation is one epigenetic markers for AD.
Pathological alterations in the brain causes the loss of memory.
These pathological alterations include;
Accumulation of extracellular neuritic plaques with core of amyloid ß-protein
Intraneuronal neurofibrillary tangles
Degeneration of basal forebrain cholinergic neurons
If the brain is unable to get rid of amyloid the precursor protein, toxic fragments of amyloid ß-protein accumulates and which trigger neuritic plaques to diffuse, the transmission of impulses by nerve cells to be disrupted and the nerve cells to die.
The tau protein in neiurons detaches forming an insoluble neurofibrillary tangles, which causes the neurons to die.
Neurofibrilary tangles and neuritic plaques which are more concentrated in the cerebral cortex are the one that contribute to memory loss, through the loss of neurons.
As shown in the figure attached in the slides above this causes the gri to shrink while the sulci widens.
*

As AD continues, it often extends to other brain parts which control coordination, walking and swallowing.
Even though Alzheimer’s usually out as a problem that affect the thought and memory, it ultimately affects almost all the body functions.
Digestive system

Swallowing difficulties
People often eat while choking
Central Nervous system

AD is a CNS disease an d therefore affects both the brain and spinal cord
Amyloid plaque that is made up of fragments of dead brain cells and certain protein accumulates in the brain
Tau protein also accumulate at abnormal levels rendering the brain cells to die and to ultimately die
*

Neurologist or geriatrician will first review clinical history of a client and their symptoms
The physician will then run tests:
Brain imaging
MRI,
CT scan
Laboratory tests
Memory tests
Neuropsychological tests
Mental status testing
Future diagnosis will apply tool that will involve the detection of tau proteins like PET
*

Cure for AD has not been established.
Are medicines that ease the symptoms in some people.
Some drugs curb the breakdown of acetylcholine which is crucial for learning and memory.
Treatment options depend on factors such
Severity of the disease, clinical history, age, lifestyle, client’s or family’s or caregiver’ preferences
Are three drugs commonly used, these are;
Razadyne (galantamine)
Aricept (donepezil)
Exelon (rivastigmine)
*

*

Thank you for listening.

You are a part of a global fight against Alzheimer’s disease

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