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Psychology: Alzheimer’s disease &
dementia
Alzheimer’s disease & dementia
Dementia
is a loss of mental functions that is severe enough to interfere with a person’s daily functioning
the loss of mental functions: thinking memory reasoning
Change may also occur in: Personality Mood Behavior
Alzheimer’s disease continued…
Dementia is not a disease itself but rather a group
of symptoms that go along with several different diseases or conditions
is irreversible when caused by disease, or injury, but “might” be reversible when caused by: drugs, alcohol, hormone, vitamin
imbalances, or depression
Alzheimer’s disease continued…
Dementia Develops when the parts of the brain
that are involved with learning, memory, decision-making, and language are affected by various infections of diseases
(the decline of intellectual functioning is not as wide spread as most people believe and it is not a normal part of aging but is in fact caused by disease)
Alzheimer’s disease continued…
Dementia cont… old age dementia is not inevitable in most cases, declines in intellectual
functioning do not significantly impair people’s lives as they age
Most people retain the bulk of their mental abilities throughout their lives
Alzheimer’s disease continued…
Dementia cont… some people do develop dementia in
late adulthood The most common cause of dementia is
Alzheimer’s disease Alzheimer’s disease is a degenerative
brain disease and is NOT a normal part of aging
Alzheimer’s disease continued…
Other causes of dementia There can be many causes of dementia
other than Alzheimer’s disease Example: vascular dementia- is caused
by blood-flow-related problems There are at least 51 different causes of
dementia
Alzheimer’s disease continued…
Other causes of dementia continued… Alzheimer’s, Parkinson’s and Huntington’s are
degenerative neurological diseases in which neurons in the brain are being attacked by the disease
Huntington’s is caused by a single abnormal gene It is a genetically inherited disease Middle-aged people can have Huntington’s and
Parkinson’s Alzheimer’s is found among the elderly In all of these diseases, the brain is slowly
disintegrating
Alzheimer’s disease continued…
What is a stroke? Example: multiple-infarct dementia is
also caused by blood-flow-related problems
multiple-infarct dementia is caused by multiple strokes in the brain
A stroke is a serious medical condition that occurs if the brain does not receive an adequate supply of blood
Alzheimer’s disease continued…
What is a stroke? CONT… the constant circulation of blood through
the brain provides it with oxygen and nutrients
Permanent damage can occur if the brain lacks enough oxygen for 3 to 10 minutes
Strokes can be caused by blood clots, cerebral hemorrhages (bleeding in the brain), and other causes.
Strokes can cause dementia
Alzheimer’s disease continued…
Stroke symptoms dizziness tingling sensations in the skin (fingers,
toes, arms, legs) weakness or exhaustion slurred speech visual problems in one eye
Alzheimer’s disease continued…
This is a brain image from a 45 year-old woman who noticed the sudden onset of right body weakness and trouble speaking.
Stroke occurred on left side of the brain which caused right body weakness.
The Broca’s area was affected by the stroke since she was having trouble speaking.
Alzheimer’s disease continued…
This is a brain image from a fatal stroke
This patient died.
Alzheimer’s disease continued…
Other causes of dementia continued… chronic drug use prolonged Depression fluid accumulation in the brain due to:
brain development problems brain infections brain injury brain tumors
The discovery of Alzheimer’s disease Dr. Alois Alzheimer (German
neurologist) Findings:
conducted a postmortem examination of the brain of a 56 year old woman who died after years of progressive mental deterioration and dementia
the examination disclosed that cells in her cerebral cortex were bunched up like a rope tied in knots
cellular debris (waste) had collected around the affected nerves
The discovery of Alzheimer’s disease continued…. Dr. Alois Alzheimer findings
continued… these destroyed areas of the brain
came to be known plaques and tangles
Tangles are twisted fibers within neurons Plaques are deposits of proteins and
parts of dead cells found between neurons
Alzheimer’s disease
Alzheimer’s disease causes 50 to 70 percent of all
dementia Approximately 5.2 million Americans
have Alzheimer’s disease dementia has become even more
common among the elderly in recent years
Alzheimer’s disease
Alzheimer’s disease Medical authorities estimate that by
the year 2050 that 14 million Americans will be affected by Alzheimer’s disease
It is not clear if the “apparent” increased frequency of dementia reflects a greater awareness of the symptoms OR…
if people are living longer and thereby more likely to develop dementia in their older age
Alzheimer’s disease
Cognitive abilities as we age, all of us will experience
changes in our cognitive abilities our fluid intelligence begins to decline
Adult Cognitive Development
Fluid Intelligence ones ability to reason speedily and
abstractly tends to decrease during late
adulthood
Adult Cognitive Development
Fluid Intelligence declines older people typically require more
time to solve problems they have greater difficulty with tasks
that involve pattern recognition such as piecing together jigsaw puzzles
older people have more difficulty remembering new information such as people’s names
Adult Cognitive Development
Crystallized Intelligence one’s accumulated knowledge and
verbal skills tends to increase with age for instance, one’s vocabulary grows
over the years as well as general knowledge and information
Adult Cognitive Development
Crystallized Intelligence cont… one’s accumulated knowledge and
verbal skills tends to increase with age for instance, one’s vocabulary grows
over the years as well as general knowledge and information
Recognizing the symptoms of Alzheimer’s disease
People with mild Alzheimer’s disease may: have difficulty learning &
remembering new information have difficulty managing their
finances, planning meals, or taking medication on schedule
show symptoms of depression (sadness, decreased interest in usual activities, loss of energy)
Recognizing the symptoms of Alzheimer’s disease
People with moderate Alzheimer’s disease may: forget old facts, such as past careers
or the names of friends seem agitated, restless, or anxious Lack concern for their appearance,
hygiene, or sleep
Recognizing the symptoms of Alzheimer’s disease
People with severe Alzheimer’s disease may: refuse to eat fail to recognize family or other
familiar faces have difficulty with essential
activities of daily living, including toileting & walking
Alzheimer’s: neurotransmitters
Alzheimer’s disease: Brain structures affected
Hippocampus brain structure located in the limbic system
responsible for new learning and memories damage to the hippocampus results in an
inability to form new memories cholinergic neurons are being destroyed by
the Alzheimer’s disease these neurons produce acetylcholine which
is a neurotransmitter involved in new learning and memories
Alzheimer’s disease: Brain structures affected
Hippocampus continued… the hippocampus of Alzheimer’s
patients has been found to be smaller than in normal people
even a healthy person experiences a reduction in the size of their hippocampus as they age
Alzheimer’s disease: Brain structures affected
Hippocampus continued… older healthy people, who did not have
Alzheimer’s disease, experienced a decrease in volume of their hippocampus by about 4% over a two year period
during that same two year period, Alzheimer’s patients had a decrease in volume of their hippocampus by 10%
a smaller than average hippocampus in the elderly predicts the onset of the disease
Alzheimer’s disease: Brain structures affected
Cerebral cortex outer layer of the brain; the body’s
ultimate control and information center
Alzheimer’s disease: Brain structures affected Cerebral cortex
interference with the cerebral cortex causes: emotional outbursts disorientation aimless wandering becoming lost decline in judgment, reasoning, &
decision-making ability to recognize faces is lost
Alzheimer’s disease: Brain structures affected
Cerebral cortex Alzheimer’s interferes with everyday
tasks performed in this area of the brain such as: balancing your checkbook making a telephone call
Alzheimer’s disease: Brain structures affected
Ventricles the chambers within the brain that
contain cerebrospinal fluid
Sulcus the grooves, or furrows, of the brain
Alzheimer’s disease & the brain there is an overall shrinkage of brain tissue in the Alzheimer’s brain
normal brain Alzheimer’s brain
Alzheimer’s disease & the ventricles the ventricles, or chambers, within the brain that contain cerebrospinal fluid are noticeably enlarged
normal brain Alzheimer’s brain
Alzheimer’s disease & the sulcus the grooves, or furrows, of the brain called the sulcus are noticeably widened and there is shrinkage of the brain tissue
normal brain Alzheimer’s brain
Alzheimer’s SPECT scan
http://www.amenclinics.com/the-science/spect-gallery/item/dementia-versus-pseudodementia?category_id=129
Alzheimer’s SPECT scan
Alzheimer’s SPECT scan
Alzheimer’s SPECT scan
Alzheimer’s disease: medications Aricept Tacrine Exelon Reminyl Namenda
Alzheimer’s disease: medications Aricept (acetylcholinesterase inhibitor)
a drug that can provide some relief from the symptoms of early Alzheimer’s disease
temporarily improves brain function in some Alzheimer’s sufferers
does not halt the progression of the underlying neural destruction
works by increasing the neurotransmitter acetylcholine which is used in learning and forming new memories
Alzheimer’s disease: medications
Namenda a drug that can provide some relief from
the symptoms of early Alzheimer’s disease
Slows the progression of symptoms does not halt the progression of the
underlying neural destruction works by increasing the neurotransmitter
glutamate which is also involved in memory
Alzheimer’s disease: Brain Reorganization
Synaptic Plasticity The brain has a remarkable property called
synaptic plasticity Synaptic plasticity is the ability to
strengthen neural connections at synapses as well as to establish new synapses
However, the brain’s plasticity is severely limited when it comes to repairing damage
Most brain damage leaves the victim permanently disabled in some way
Alzheimer’s disease: replacing brain tissue
Replacing brain tissue One approach to helping people recover from brain
damage is to replace lost brain tissue with tissue from another brain
Scientists have transplanted, or grafted, tissue from a still-developing fetal brain into the brain of an adult animal of the same species
If the receiving animal does not reject the tissue, the transplanted brain tissue sends axons out into the brain and makes some functional connections
Alzheimer’s disease: replacing brain tissue
Replacing brain tissue continued… This treatment has reversed some animals
learning difficulties, movement disorders, and other results of brain damage
The technique has also been used to treat a small number of people with Parkinson’s disease- a disorder characterized by tremors, rigidity of the arms and legs, difficulty in initiating movement, and poor balance
Alzheimer’s disease: replacing brain tissue
Replacing brain tissue continued… The brain tissue transplant procedure is
promising, but because its use with humans would require tissue from aborted fetuses, it has generated considerable controversy
Alzheimer’s disease: nerve growth
factor
Nerve growth factor Another treatment uses “engineered” cells
from rats to produce nerve growth factor- a substance that helps stimulate and guide the growth of newly sprouted axons in the central nervous system
When the “engineered cells” were implanted into the brains of rats with brain damage or disease, the cells secreted nerve growth factor
Alzheimer’s disease: nerve growth
factor
Nerve growth factor continued… Based on these animal studies, nerve
growth factor- has been infused directly into the brain of a person with Alzheimer’s disease
The results were encouraging, and trials with other patients are in progress
Alzheimer’s disease: stem cells
Stem cells scientists have been studying the
formation of new neurons in the brain
Alzheimer’s disease: stem cells
stem cells the source of these new neurons has been
recently been identified as “stem cells” which reside in the lining of the ventricles of the brain
The discovery of these stem cells, which have the ability to develop into many types of cells, including neurons, creates the exciting possibility that degenerative disorders such as Alzheimer’s disease may eventually be cured by actually replacing dying neurons with new neurons
Alzheimer’s disease: other possible preventative measures
blueberries (antioxidants may be linked to improved memory)
aspirin/ibuprofen (my decrease the rate of cognitive decline)
vitamin E
vitamin B12
estrogen replacement in women
testosterone replacement in men
Long-Term care :
Provision of a safe environment, control of aggressive or agitated behavior, and the ability to meet physiologic needs may require monitoring and assistance in the home or in an institutionalized setting.
This may include in-home care, boarding homes, adult day care, or convalescent homes.
Long-Term Treatment:
Family counseling may help in coping with the changes required for home care.
Visiting nurses or aides, volunteer services, homemakers, adult protective services, and other community resources may be helpful in caring for the person with Alzheimer’s disease (AD).