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Alzheimerā€™s Disease
Mr. Iswar Hazarika M. Pharm, (PhD)
Assistant Professor
College of Pharmaceutical science,
DSU
To start with..
ā€¢ Forgot your name!!
ā€¢ Got lost in your neighbourhood!
ā€¢ Putting the ice tray in the oven instead of the
freezer.
Dementia is loss of memory
Retrograde amnesia (RA) is a loss of
memory-access to events that occurred, or
information that was learned, before an
injury or the onset of a disease.
Movie: Notebook
Movie: Rise of the planet of the apes
Alzheimerā€™s Disease
Alzheimerā€™s is a progressive
neurodegenerative disorder that gradually
destroys a personā€™s memory, ability to learn,
reasoning, making judgments,
communicate and carry out daily activities.
Alzheimerā€™s Disease
ā€¢ First described by German psychiatrist
-Alois Alzheimer (1906)
ā€¢Generally diagnosed in people over 65
years of age
-Early-onset (before 65); only 5-10% of patients
-Several genetic causes
ā€¢ 1 in 6 women over 55; 1 in 10 men over 55
Whatā€™s Normal Whatā€™s Not
Forgetting your ATM
number or where you
parked.
Forgetting what an ATM
card is or what kind of car
you own.
Forgetting what you were
about to say
Forgetting how to do an
everyday task, like writing
a check.
Forgetting which day of
the week you had a dental
appointment
Getting lost in your own
neighborhood.
Misplacing of losing your
keys or phone
Putting the ice tray in the
oven instead of the freezer
Forgetting the name of the
person who sits in front of
you in class
Forgetting who your family
members are
Symptoms
Basic anatomy of Brain
Etiology and Pathogenesis
Etiology & Pathogenesis
Several competing hypotheses:
1. Cholinergic hypothesis
2. Amyloid hypothesis
3. Tau hypothesis
4. Genetic cause
5. Recent development
1. Cholinergic hypothesis
-ā†“ acetylcholine in Cortex and
Hippocampus
ā†“
- ā†“perception, memory, judgment
2. Amyloid hypothesis
Abnormal breakdown of Amyloid precursor protein (APP)
ā†“
buildup of amyloid beta deposits
ā†“
Damaged amyloid proteins build to toxic levels
ā†“
call damage and death
3. Tau hypothesis
-Caused by tau protein
abnormalities
ā†“
-Formation of
neurofibrillary tangles
tangle
plaques
4. Genetic Cause
mutations in one of three genes encoding:
-Amyloid precursor protein (APP)
-Presenilins 1
-Presenilins 2
5. Disturbance of
Glymphatic system
ā†“Sleep
ā†“
ā†“ drainage
ā†“
Waste removal from brain
ā†“
Accumulation of Amyloid
plaque and Tangles
ā†“
Alzheimer
Recent development
http://www.alz.org/brain/14.asp
http://www.ahaf.org/alzheimers/about/understanding/brain-with-alzheimers.html
Cleared by glymphatics
Risk Factors
ā€¢ Obesity
ā€¢ Sleep apnea
ā€¢ Heavy alcohol use
ā€¢ High blood pressure
ā€¢ Head trauma
ā€¢ High cholesterol
ā€¢ Diabetes
ā€¢ Depression
ā€¢ Lower rates in highly educated
ā€“ Beneficial consequences of learning and
memory
Diagnosis of AD
ļ‚ž patient history:
ļ‚ž collateral history from relatives,
ļ‚ž clinical observations, based on the presence/absence of
certain neuropsychological features
ļ‚ž Medical imaging:
ļ‚ž computed tomography (CT) or
ļ‚ž magnetic resonance imaging (MRI), and with
ļ‚ž single photon emission computer tomography (SPECT) or
ļ‚ž positron emission tomography (PET)
ļ‚ž Confirmatory diagnosis: can be examined histologically
post mortem
.
PET scan of the brain of a person with AD showing a loss
of function in the temporal lobe.
Any questions?
Thank you!!

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Alzheimer's disease

  • 1. Alzheimerā€™s Disease Mr. Iswar Hazarika M. Pharm, (PhD) Assistant Professor College of Pharmaceutical science, DSU
  • 2. To start with.. ā€¢ Forgot your name!! ā€¢ Got lost in your neighbourhood! ā€¢ Putting the ice tray in the oven instead of the freezer.
  • 3.
  • 4. Dementia is loss of memory Retrograde amnesia (RA) is a loss of memory-access to events that occurred, or information that was learned, before an injury or the onset of a disease.
  • 6. Movie: Rise of the planet of the apes
  • 7. Alzheimerā€™s Disease Alzheimerā€™s is a progressive neurodegenerative disorder that gradually destroys a personā€™s memory, ability to learn, reasoning, making judgments, communicate and carry out daily activities.
  • 8. Alzheimerā€™s Disease ā€¢ First described by German psychiatrist -Alois Alzheimer (1906) ā€¢Generally diagnosed in people over 65 years of age -Early-onset (before 65); only 5-10% of patients -Several genetic causes ā€¢ 1 in 6 women over 55; 1 in 10 men over 55
  • 9.
  • 10. Whatā€™s Normal Whatā€™s Not Forgetting your ATM number or where you parked. Forgetting what an ATM card is or what kind of car you own. Forgetting what you were about to say Forgetting how to do an everyday task, like writing a check. Forgetting which day of the week you had a dental appointment Getting lost in your own neighborhood. Misplacing of losing your keys or phone Putting the ice tray in the oven instead of the freezer Forgetting the name of the person who sits in front of you in class Forgetting who your family members are
  • 12.
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  • 18. Etiology & Pathogenesis Several competing hypotheses: 1. Cholinergic hypothesis 2. Amyloid hypothesis 3. Tau hypothesis 4. Genetic cause 5. Recent development
  • 19. 1. Cholinergic hypothesis -ā†“ acetylcholine in Cortex and Hippocampus ā†“ - ā†“perception, memory, judgment
  • 20. 2. Amyloid hypothesis Abnormal breakdown of Amyloid precursor protein (APP) ā†“ buildup of amyloid beta deposits ā†“ Damaged amyloid proteins build to toxic levels ā†“ call damage and death
  • 21. 3. Tau hypothesis -Caused by tau protein abnormalities ā†“ -Formation of neurofibrillary tangles
  • 23. 4. Genetic Cause mutations in one of three genes encoding: -Amyloid precursor protein (APP) -Presenilins 1 -Presenilins 2
  • 24. 5. Disturbance of Glymphatic system ā†“Sleep ā†“ ā†“ drainage ā†“ Waste removal from brain ā†“ Accumulation of Amyloid plaque and Tangles ā†“ Alzheimer Recent development
  • 28. Risk Factors ā€¢ Obesity ā€¢ Sleep apnea ā€¢ Heavy alcohol use ā€¢ High blood pressure ā€¢ Head trauma ā€¢ High cholesterol ā€¢ Diabetes ā€¢ Depression ā€¢ Lower rates in highly educated ā€“ Beneficial consequences of learning and memory
  • 29. Diagnosis of AD ļ‚ž patient history: ļ‚ž collateral history from relatives, ļ‚ž clinical observations, based on the presence/absence of certain neuropsychological features ļ‚ž Medical imaging: ļ‚ž computed tomography (CT) or ļ‚ž magnetic resonance imaging (MRI), and with ļ‚ž single photon emission computer tomography (SPECT) or ļ‚ž positron emission tomography (PET) ļ‚ž Confirmatory diagnosis: can be examined histologically post mortem
  • 30. . PET scan of the brain of a person with AD showing a loss of function in the temporal lobe.
  • 31.

Editor's Notes

  1. Alzheimerā€™s Disease: is the most common form of dementia in which structural and chemical brain deterioration is associated with gradual loss of many aspects of thoughts and behaviors.
  2. Alzheimerā€™s Disease: is the most common form of dementia in which structural and chemical brain deterioration is associated with gradual loss of many aspects of thoughts and behaviors.
  3. Alzheimerā€™s Disease: is the most common form of dementia in which structural and chemical brain deterioration is associated with gradual loss of many aspects of thoughts and behaviors.
  4. These images represent a cross-section of the brain as seen from the front. The cross-section on the left represents a normal brain and the one on the right represents a brain with Alzheimer's disease.In Alzheimer's disease, there is an overall shrinkage of brain tissue. The grooves or furrows in the brain, called sulci (plural of sulcus), are noticeably widened and there is shrinkage of the gyri (plural of gyrus), the well-developed folds of the brain's outer layer. In addition, the ventricles, or chambers within the brain that contain cerebrospinal fluid, are noticeably enlarged. In the early stages of Alzheimer's disease, short-term memory begins to fade (see box labeled ā€˜memory') when the cells in the hippocampus, which is part of the limbic system, degenerate. The ability to perform routine tasks also declines. As Alzheimer's disease spreads through the cerebral cortex (the outer layer of the brain), judgment declines, emotional outbursts may occur and language is impaired. As the disease progresses, more nerve cells die, leading to changes in behavior, such as wandering and agitation. In the final stages of the disease, people may lose the ability to recognize faces and communicate; they normally cannot control bodily functions and require constant care. On average, the disease lasts for 8 to 10 years, but individuals with Alzheimerā€™s can live for up to 20 years.