Alzheimers

what is alzheimers disease?

- a type of dementia (accounts for majority of dementia cases)

what is dementia?

- loss of cognitive functioning (thinking, remembering, reasoning) that interferes with a persons daily life and activities

is there a cure for alzheimers?

- no

- progressive loss of neurons

T/F: dementia is an umbrella term for a group of brain diseases that impact memory, judgement, and personality?

true

what causes alzheimers disease?

- amyloid plaques and beta tangles

what are symptoms of alzheimers disease?

- impairments in:

> memory

> language

> visuospatial skills

what is vascular dementia?

- disease of injury to the blood vessels leading to the brain

what are symptoms of vascular dementia?

- impaired motor skills and judgement

what causes frontotemporal dementia?

- deterioration of frontal and temporal lobes of the brain

what are symptoms of frontotemporal dementia?

- personality changes

- difficulty with language

what causes lewy body dementia?

- lewy body protein deposits on nerve cells

what are symptoms of lewy body dementia?

- hallucinations

- disordered sleep

- impaired thinking and motor skills

what are 5 other conditions that dementia can be associated with?

- parkinsons

- huntingtons

- HIV

- crutzfield jakob disease

- korsakoff disease

T/F: there are early changes in the hippocampus with alzheimers?

- true (the memory changes)

_____ stops clearing debris with alzheimers?

microglia

what are vascular issues of alzheimers?

- amyloid causes atrophy of the smooth muscles of the arteries

> causes leaky vessels that increase cell death in the brain

what is the purpose of Tau?

- part of microtubules that help to stabilize neuron transport system

- released to create tangles

is there a known cause to alzheimers?

no

what are some hypotheses for alzheimers cause?

- low levels of neurotransmitters

- high levels of Al within the brain

- genetic

- autoimmune / viral

does incidence of alzhimers increase with age?

yes

who is alzheimers most common in - males or females?

females

can alzheimers disease be truly diagnosed?

- can't truly be diagnosed until post-mortem during biopsy of brain to look for tangles and amyloid plaque

how might alzheimers disease be diagnosed (unofficially)? (6)

- neurologic exam --> at least 2 deficits in cognition, memory, and related cognitive functioning (without any other disease/reason)

- cognitive testing

- input from family

- spinal tap to measure levels of proteins

- brain imaging

- genetic testing

what brain imaging can be done to diagnose alzheimers?

- PET scan = shows pattern of brain metabolism or the presence of amyloid plaques and tau tangles

- MRI/CT = brain's structure and rule out other issues like stroke

when might genetic testing be useful for diagnosing alzheimers?

- to look for early-onset cases

T/F: bio-markers can be used to unofficially diagnose alzheimers, but the true diagnoses cannot be made until after death?

true

what is the prognosis for alzheimers disease?

- 4-6th leading cause of death

what is the leading cause of death with alzheimers disease?

- infection or dehydration

what is cachexia?

- weakness/wasting due to chronic illness

what is sundowning?

- increased confusion that people with alzheimers/dementia experience from dusk through night

what are some strategies that might help with sundowning?

- maintain consistent routine

- increase light exposure in the morning

- minimize noise and visitation in the evening

- encourage physical activity

- avoid daytime naps

- limit caffeine and alcohol

what is neuropsychological testing?

- helps to diagnose alzheimers during early and mid stages of cognitive decline

- focuses on feelings, emotions, and psychiatric disorders

- assesses cognition through thinking and problem solving

what are some team members that you may seen with the alzheimers interdisciplinary team? (4)

- geriatricians

- geriatric psychiatrists

- neurologists

- neuropsychologist

what are some drugs that can be used for alzheimers?

- Ab protein antibody

- cholinesterase inhibitors

what are PT considerations for alzheimers disease?

- maximizing patient function

- educating patient family

- modifying layout of house to make things easier to find

- continue to encourage participation

can PT alter or cease progression of alzheimers disease?

- no

attentional abilities assessment (4)

- sustained concentration = able to stay on task

- focused/selective = resisting distraction

- alternating = flexible

- divided = simultaneously processing multiple stims/tasks

what is immediate memory recall?

retention of info for a few seconds

what is short term memory?

- retention for minutes, hours, days

- often refers to information learned AFTER a lesion

what is working memory?

- capacity to hold and manipulate information "on-line" in our minds

what is long term memory?

- retention of information for months, years

- often refers to PRIOR to a lesion

what is volition?

- determine what one needs and wants to do

- includes reasoning, judgement

- problem solving

> do they recognize the problem? do they analyze all the factors?

what outcome measures can be used for dementia patients?

- MoCA

- mini mental state exam

what are treatment considerations for dementia patients?

- attention deficits

> provide speed/time limits for tasks

> may need to initially limit distractions / alter environment

- memory strategies

what is the goal of memory treatment?

- effectively encode and reinforce info so it is more easily retrieved