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Alzheimer Disease - Coggle Diagram
Alzheimer Disease
Pathophysiology
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Brain Vascular Disease
CV risk factors (HTN, HLD, diabetes)
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Other Mechanisms:
oxidative stress, mitochondrial dysfunction, loss of estrogen
Treatment
No treatment to prolong life, cure AD, or halt disease progression
Med Review (look for BZDs, anticholinergics, antipsychotics)
Pharm
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Memantine
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AEs: headache, constipation, confusion, dizziness
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Mild-to-Moderate Disease
Cholinesterase Inhibitor
Donepezil, Rivastigmine, Galanatamine
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Other
Manage BP, glucose, cholesterol, smoking, obesity
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NSAIDs, dietary supplements (Vitamin E/B)= insufficient evidence
Statins (only if need for another indication), rare AE with cognitive impairment
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Monitoring
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Cholinergic AEs --> urinary retention, GI, N/V
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Memantine - HA, confusion, dizziness, constipation
Diagnosis
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Mainly clinical dx today
If suspected then order, CT or MRI, serologic eval of blood cell counts, serum electrolytes, LFTs, thyroid fxn, and b12 to rule out other causes
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S/Sx:
Cognitive: memory loss, aphasia, agnosia, disorientation, impaired executive function
Neuropsychiatric: depression, psychotic Sx ( hallucination and delusion) ; behavioral disturbances
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Epi: AD is the most common cause of dementia, accounting for 60% to 80% of cases; 5.7M AD patients in the U.S.