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Neurodegenerative Disorders Explained
- 2. • DEMENTIA • ALZHIMERS DISEASE • PARKINSONS DISEASE • AMYOTROPHIC LATERAL SCLEROSIS
- 3. NEURODEGENERATIVE DISORDERS • Neurodegenerative disease is an umbrella term for a range of conditions which primarily affect the neurons in the human brain • Neurons are the building blocks of the nervous system • Which includes the brain and spinal cord • Neurons normally don’t reproduce or replace themselves • So when they become damaged or die they cannot be replaced by the body • Examples of neurodegenerative diseases include Parkinson’s, Alzheimer’s, etc….
- 6. Cont…… • Neurodegenerative diseases are incurable and debilitating conditions that result in progressive degeneration or death of nerve cells • This causes problems with movement (called ataxias), or mental functioning (called dementias)
- 7. DEMENTIA • Dementia, also known as senility • Broad category of brain diseases that cause a long term and often gradual decrease in the ability to think and remember • Great enough to affect a person's daily functioning • Other common symptoms include emotional problems, problems with language, and a decrease in motivation • A person's consciousness is usually not affected • A dementia diagnosis requires a change from a person's usual mental functioning and a greater decline than one would expect due to aging • The most common type of dementia is Alzheimer's diseases
- 9. Alzheimer's disease • Alzheimer’s disease is the most common form of dementia • It is a neurological brain disorder named after a German physician, Alois Alzheimer • Who first described it in 1906. Alois Alzheimer
- 10. Cont…. •What is Alzheimer’s Disease • Alzheimer’s disease is an irreversible, progressive brain disease that slowly destroys memory and thinking skills • Abnormal changes in the brain worsen over time • Memory loss is one of the earliest symptoms, along with a gradual decline of other intellectual and thinking abilities, called cognitive functions, and changes in personality or behavior
- 11. Cont.. • Alzheimer's advances in stages, progressing from mild forgetfulness and cognitive impairment to widespread loss of mental abilities • The time course of the disease varies by individual, ranging from five to 20 years
- 12. Who Is Affected by Alzheimer’s Disease? • 35 million people worldwide have Alzheimer’s • Alzheimer's is the fifth leading cause of death in people 65 and older • Approximately 496,000 people will develop Alzheimer’s in 2015
- 13. The main symptoms of Alzheimer's Memory loss and confusion are the main symptoms Cognitive: mental decline • Difficulty thinking and understanding • Confusion in the evening hours • Delusion, disorientation, forgetfulness, making things up • Mental confusion, difficulty concentrating • Inability to create new memories • Inability to do simple maths • Inability to recognise common things
- 14. Cont….. • Behavioural: aggression • Agitation • Difficulty with self care • Irritability • Meaningless repetition of own words • Personality changes, lack of restraint • Wandering and getting lost • Mood: anger, • apathy, loneliness • mood swings
- 15. Cont… • Mood: anger • Apathy • General discontent • Psychological: depression, hallucination, or paranoia • Whole body: loss of appetite or restlessness • Also common: behavioral symptoms, inability to combine muscle movements, or jumbled speech
- 16. • In advanced Alzheimer's, people become dependent on others for every aspect of their care
- 17. What Causes Alzheimer’s Disease? • Alzheimer's disease causes loss of brain cells in areas of the brain • Some of the deterioration may be related to a loss of chemical messengers in the brain, called neurotransmitters • That allow nerve cells in the brain to communicate properly • People with Alzheimer's disease have two things in the brain that are not normal: amyloid plaques and neurofibrillary tangles
- 18. Cont…. Amyloid plaques are clumps of a protein called beta amyloid This plaque builds up around the cells in the brain that communicate with each other Neurofibrillary tangles are made from a protein called tau Normally, the tau protein helps cells communicate in the brain In Alzheimer's disease, the tau protein twists and tangles The tangles clump together, and some nerve cells die, which makes communication in the brain much harder
- 21. Cont……….. • As brain cells die, it shrinks • The damage to the brain eventually causes problems with memory, intelligence, judgment, language, and behavior • Experts don't know if amyloid plaques and neurofibrillary tangles are side effects of Alzheimer's disease or part of the cause • These plaques and tangles are not found in people who do not have the disease
- 22. Cont…… • Scientists believe that there are several reasons also that lead to Alzheimer's disease : •Genetical and biological factors •Lifestyle factors (dietary habits, high blood pressure and high cholesterol ) •Stress
- 23. Where are people with Alzheimer’s Disease cared for? •Home •Assisted living facilities (those in the early stages) •Nursing homes (special care units)
- 24. Cont…… • Managing difficult behaviors •Stay calm and be understanding •Be patient and flexible. Don’t argue or try to convince •Acknowledge requests and respond to them •Try not to take behaviors personally • Remember: it’s the disease talking, not your loved one
- 25. Drugs for Alzheimer’s Diseases • Donepezil (Aricept) is the only Alzheimer's drug approved to treat all stages of the disease. ... • Galantamine (Razadyne) is approved to treat mild to moderate Alzheimer's. ... • Rivastigmine (Exelon) is approved for mild to moderate Alzheimer's disease
- 27. PARKINSONS DISEASE • Degenerative brain disorder affecting movement • Symptoms caused by the deficiency of a chemical in the brain called Dopamine • Not fatal but progressive and incurable and, with time, severely affects quality of life • Currently there is no one specific test to diagnose Parkinson’s Disease – diagnosis is a combination of symptoms exhibited and eliminating other possible causes
- 28. Cont………. • Named after James Parkinson • Who published 'An Essay on the Shaking Palsy' in 1817, which established Parkinson’s as a recognised medical condition • He studied at the London Hospital Medical College, qualifying as a surgeon in 1784 when he was 29
- 29. Who Is Affected by Parkinsons Disease •Approx. 80,000 people in India live with Parkinson’s Disease •It can last up to 50% of our life •It is the next most common brain disease after Alzheimer’s disease •There is no remission with Parkinson’s Disease •Even with medicines, symptoms vary in incidence, severity and timing from person to person, day to day, hour to hour – the disease is totally unpredictable
- 30. The main symptoms of Parkinsons Disease • Tremor: can occur at rest, in the hands, limbs, or can be postural • Muscular: difficulty standing, • Difficulty walking, difficulty with bodily movements, • Involuntary movements, muscle rigidity, • Problems with coordination, rhythmic muscle contractions, • Slow bodily movement,
- 31. Cont………. • Sleep: daytime sleepiness, early awakening, nightmares, or restless sleep • Whole body: dizziness, fatigue, poor balance, or restlessness • Cognitive: amnesia, confusion in the evening hours, dementia, or difficulty thinking and understanding • Speech: impaired voice, soft speech, or voice box spasms • Mood: anxiety or apathy
- 32. Cont………. • Nasal: distorted sense of smell or loss of smell • Urinary: dribbling of urine or leaking of urine • Facial: jaw stiffness or reduced facial expression • Also common: blank stare, constipation, depression, difficulty swallowing, drooling, falling, fear of falling, loss in contrast sensitivity, neck tightness, small handwriting, trembling, unintentional writhing, or weight loss
- 33. What Causes Parkinsons Disease? • Parkinson's disease is caused by the progressive impairment or deterioration of neurons (nerve cells) in an area of the brain known as the substantia nigra • When functioning normally, these neurons produce a vital brain chemical known as dopamine • Dopamine serves as a chemical messenger allowing communication between the substantia nigra and another area of the brain called the corpus striatum
- 34. Cont…. • This communication coordinates smooth and balanced muscle movement • A lack of dopamine results in abnormal nerve functioning, causing a loss in the ability to control body movements
- 36. Treatment of Parkinsons Disease • Surgical Stereotactic thalamotomy- temporary improvement of symptoms • Physiotherapy Reduces rigidity & corrects abnormal posture • Speech therapy Dysarthria/dysphonia • Neuropsychiatric For depression
- 37. Drugs for Parkinsons Disease • Carbidopa-levodopa. ... • Carbidopa-levodopa infusion. ... • Dopamine agonists. . • Catechol-O-methyltransferase (COMT) inhibitors. ... • Anticholinergics. ... • Amantadine
- 38. Amyotrophic Lateral Sclerosis (ALS)
- 39. Amyotrophic Lateral Sclerosis (ALS) • A progressive neurodegenerative disease “is a condition in which cells of the brain and spinal cord are lost.” • This affects mostly motor neurons • The cells that control needed voluntary muscle activity such as speaking, skeletal muscle movement, breathing, and swallowing
- 40. Cont……. • When the motor neurons eventually die, the ability of the brain to control muscle movement is lost • Causing paralysis of essential body systems • When muscles no longer receive the messages from the motor neurons that they require to function, the muscles begin to atrophy (become smaller)
- 41. Cont……. • Was discovered in 1850 by English scientist Augustus Waller who didn’t know he had discovered ALS but saw nerve fibers that had extreme atrophy • But 19 years later a French neurologist Jean-Martin Charcot took credit for it in publishing the disease in a scientific journal Augustus Waller
- 42. Signs and Symptoms • Early symptoms • Increasing muscle weakness “especially in the arms and legs” • Difficulty speaking • Trouble swallowing • Problems with breathing • Twitching • Cramping of muscles (mostly hands and feet)
- 43. Cont……. • Late Symptoms • Extreme muscle atrophy • Reflexes that are slow to non-existent • Excessive drooling • Increased spasticity (muscle rigidity) • Weight loss • Choking • Cardiac arrest due to respiratory arrest usually resulting in death
- 45. Possible causes of ALS • Oxidative stress • Oxidative stress is a phenomenon that occurs when there's an imbalance between the production of oxygen-containing molecules that carry an electrical charge • Which can be toxic, and a biological system's ability to readily detoxify them • Oxygen-containing, charged particles are common byproducts of cellular metabolism
- 46. Cont…….. • Mitochondrial dysfunction • The mitochondria are microscopic energy "factories" inside cells • They resemble miniature cells themselves and have their own DNA • Abnormalities of the mitochondria may be involved in ALS causation and/or progression. • Abnormalities of the immune system • There is evidence that the immune system, particularly immunologic cells in the nervous system known asmicroglia, can be both beneficial and harmful in ALS
- 47. Cont…….. • Microglia may be protective up to a certain point and then become damaging • Modifying the actions of the immune system is an active area of ALS research • Glutamate Toxicity • People who have ALS typically have higher than normal levels of glutamate • A chemical messenger in the brain, and spinal fluid • Too much glutamate is known to be toxic to some nerve cells
- 48. How to diagnose • x-rays • MRI • Blood and urine studies • Muscle and nerve biopsy • Electomyography (EMG) • Nerve conduction velocity (NCV) • Spinal tap • Even with all this technology ALS is extremely difficult to diagnose. This is because many diseases mimic signs of ALS
- 49. Treatment of ALS • Breathing care • Physical therapy • Occupational therapy • Nutritional support • Psychological and social support.
- 50. Drug for ALS • U.S. officials have approved only one drug that can help slow down ALS • It’s called riluzole (Rilutek) • It’s designed to reduce damage to your motor nerve cells by lowering the amount of a substance called glutamate
- 51. SENILE DEMENTIA
- 52. SENILE DEMENTIA • Senile dementia is a disease caused by degeneration of the brain cells • It is different from normal senility in the elderly • In that the patient's brain function will gradually deteriorate resulting in progressive loss of memory and mental abilities, and noticeable personality changes • Senile Dementia is otherwise call as Senility……
- 53. Cont…….. • Senility, which is now more commonly referred to as senile dementia • Characterized by a decrease in cognitive abilities • This may include the person’s ability to concentrate, to recall information, and to properly judge a situation • Senility is a deterioration of body and mind associated with advanced aging • Indications of old age vary in the time of their appearance.
- 54. Symptoms of Senile Dementia Senility symptoms are many of the physical changes associated with old age: • Stooped posture • Wrinkled skin • Decrease in muscle strength • Changes in the lens and muscles of the eye • Brittleness of bone and stiffness of the joints • Hardening of the arteries
- 55. There are also mental changes associated with senility: • Impaired judgment • Loss of memory • Sometimes childish behavior
- 56. Cont…….. Symptoms at the early stage include the following: • Forgetting recent events (distant memories also fade as the disease progresses) • Experiencing difficulty in reasoning, calculation, and accepting new things • Becoming confused over time, place and direction • Impaired judgment • Changes in personality • Becoming passive and losing initiative
- 57. Cont…….. Symptoms at the middle stage include the following: • Losing cognitive ability, such as the ability to learn, judge, and reason • Becoming emotionally unstable, and easily losing temper or becoming agitated • Needing help to simply live from day to day • Confusing night and day; disturbing others' normal sleeping time.
- 58. Cont…….. Symptoms at the later stage include the following: • Losing all cognitive ability • Becoming entirely incapable of self-care, including eating, bathing, and so on • Neglecting personal hygiene • Incontinence • Losing weight gradually • Walking unsteadily and becoming confined to bed.
- 59. Causes and Development of Senile Dementia • Senile Dementia is always caused by an underlying disease or condition • Brain tissue is damaged, and functioning is diminished • The most common cause of dementia is Alzheimer's disease Other causes include: • Vascular dementia • Huntington disease
- 60. Cont…….. Certain abnormalities of a person's metabolism or hormones may also be responsible for the development of dementia, including the following: • Hypothyroidism, which means the thyroid gland is underactive • Hyperthyroidism, which means the thyroid gland is overactive • High-dose steroid abuse • Deficiency, or low body levels, of vitamin B12 • Thiaminedeficiency • Deficiency of niacin, or vitamin B3 • Chronic exposure to metals, such as lead or mercury, and to dyes, such as aniline
- 61. Cont…….. • Atherosclerosis or hardening of the arteries • Multiple sclerosis, a disorder of the sheath that lines the brain and spinal cord • HIV, the immunodeficiency disorder that leads to AIDS • Parkinson's disease • Creutzfeldt-Jakob disease, a rapidly progressing degenerative disorder of the nervous system causing problems with walking, talking, and the senses
- 62. Treatment and Prevention • Senile dementia that is caused by depression, poor nutrition, thyroid dysfunction, drug poisoning, alcoholism, and so on, can often be corrected by treating the underlying problem • Alzheimer's disease and multi-infarct dementia are degenerative diseases, and up to now there is no effective treatment • It is best to recognize the symptoms early and be diagnosed and assessed by a doctor • There are currently some medications available to slow the progress of Alzheimer's disease
- 63. Cont…….. If we recognize the symptoms of senile dementia in a family member, • Consult your doctor to confirm the diagnosis • Join a family support group for senile dementia patients • This will help to ease the pressure of looking after the patient through sharing of experience • Take advantage of social services such as day care centers for the elderl.
- 64. Cont…….. • Make alterations in your home environment to prevent accidents • Establish a daily routine for the patient to reduce his or her feelings of confusion . • Have the patient wear a wrist bracelet labeled with his name and telephone number. Always have a recent photo of the patient at home so that it will help to find him if he or she gets lost.
- 65. T H A N K Y O U