psychology: alzheimer’s disease & dementia. dementia is a loss of mental functions that is...

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).