Unit 2C: Alzheimer's Disease

Front 1

A syndrome characterized by dysfunction or loss of memory, orientation, attention, language, judgement, and reasoning
-personality and behavior changes result is alterations in the individ's ability to work, to fulfill social and family responsibilities, and to perform ADLs
-NOT a normal part of aging

Back 1

-Dementia

Front 2

Describe etiology and pathophysiology of dementia:

Back 2

-due to both treatable and nontreatable conditions
-two most common causes: neurodegenerative conditions (AD) and vascular disorders (CVA)
-family hx and age are important risk factors

Front 3

Describe s&s of dementia:

Back 3

-may be insidious and gradual or more abrupt
-neurologic degeneration is gradual and progressive where as vascular dementia is more abrupt

-s&s are classified as mild, moderate, and severe
-MILD: forgetfull, short-term memory impairment, difficulty recognizing what numbers mean, loss of interests, decreased judgement, geographic disorientation
-MODERATE: impaired ability to recognized friends and family, agitation, wandering, loss of remote memory, confusion, forgetful of simple tasks, apraxia, aphasia, insomnia, hallucinations, behavior problems
-SEVERE: little memory, unable to produce new memory, cannot understand words, difficulty eating/swallowing, unable to perform ADLs, immobility, incontinent

-initially symptoms are seen as cognitive impairments

Front 4

A state of cognitive functioning that is below defined norms, yet does not meet the criteria for dementia

1.) memory complaint, preferably confirmed by another person
2.) measurable memory impairment as detected with standard assessment tests
3.) normal overall thinking and cognitive function
4.) ability to perform ADLs

-causes may include stress, anxiety, depression, or physical illness

Back 4

-Mild Cognitive Impairment (MCI)

Front 5

A chronic, progressive, degenerative disease of the brain
-most common form of dementia

Back 5

-Alzheimer's Disease (AD)

Front 6

When AD develops in someone less than <60 years, it is referred to as:

Back 6

-early-onset AD

Front 7

Describe etiology and pathophysiology of AD:

Back 7

-Cause is unknown
-Characteristic findings include:
1. amyloid plaques
2. neurofibrillary tangles
3. loss of connections between cells and cell death

-plaques first develop in areas used for memory and cognitive functioning (hippocampus)

Front 8

Describe s& s for a patient with AD:

Back 8

-inital sign is subtle deterioration of memory that progresses to more profound memory loss that interferes with the pt's ability to function
-recent events and new info cannot be recalled
-personal hygiene deteriorates, as does the ability to concentrate and maintain attention
-act altered or impulsive
-agitation
-delusions, illusions, hallucinations
-dysphasia: difficulty comprehending language and oral communication
-apraxia: inability to manipulate objects or perform purposefulacts
-visual agnosia: inability to recognize objects by sight
-dysgraphia: difficulty communicating via writing

Front 9

Describe drug therapy for a patient with AD:

Back 9

-Cholinesterase Inhibitors: mild to moderate treatment; responsible for the breakdown of acetycholine in the synaptic cleft (Aricept)

-Antipsychotics
-Antidepressants
-Antiseizure

-gingko biloba
-NSAIDs may have a protective effect

Front 10

A state of temporary but acute mental confusion, is a common, life-threatening, and possibly preventable syndrome in older adults
-cholinergic deficiency, excess release of dopamine and both increased and decreased serotonergic activity may contribute to delirium
-chronic stress may be a cause
-clinically, delirium is rarely caused by a single factor

Back 10

-delirium

Front 11

What is a key distinction between delirium ad dementia?

Back 11

The person who exhibits sudden cognitive impairment, disorientation, or clouded sensorium is more likely to have delirium rather than dementia