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ALZHEIMERS DISEASE download - Coggle Diagram
ALZHEIMERS DISEASE 
Pathophysiology
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Memory loss
After the age of 65, the percentage of those affected with AD doubles with every decade of life, with the highest prevalence occurring in those 85 and older.
There is still no cure for AD, but efforts aimed at preventing and controlling the effects of Alzheimer’s exist.
Devastating condition that destroys brain cells, causing problems with memory, thinking and behaviour that leads to disability and decreased quality of life among older adults.
Chronic progressive and eventually fatal brain disorder. Most common cause of dementia.
The beta-amyloid deposition and neurofibrillary tangles lead to loss of synapses and neurons, which results in gross atrophy of the affected areas of the brain, typically starting at the mesial temporal lobe
Steps
- Then proceeds to the hippocampus (NB in memory formation)
- As hippocampus degenerate, memory begins to falter.
- Pathophysiology begins in entorhinal cortex (Medial Temporal Lobe)
- Disease spread to other regions of brain such as cerebral cortex, functions such as language and reason are affected.
Neurons start to degenerate, losing their connections or synapses with other neurons, leading to eventual death of some neurons
Atrophy of the cerebral cortex results in intellectual impairment, which progresses from increasing loss of memory to total disability.
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One can compare Alzheimer’s to heart disease, where reducing cholesterol levels aids in prevention and treatment.
As in heart disease, the cholesterol equivalent present in AD is beta-amyloid, which must be lowered to reduce the progression of neurofibrillary tangles that exacerbate the disease over time.
Life expectancy
Early mortality is common: Average length: 4-8 years
• However, persons can live for several years with AD, dying eventually from pneumonia or other diseases.
Treatment
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Exercise Testing
The effect of AD on mental capacity, tests involving treadmills and bike ergometers, may be difficult or impossible to obtain or may be unreliable, especially during the mid to late
stages of the disease.
AD patients have a high level of agitation or impaired cognition and therefore do not tolerate lengthy testing
Patient should be screened for Coronary Artery Disease and Hypertension
Exercise testing may be best suited for those with early-stage Alzheimer ’s
Several practice sessions should be conducted prior to the actual test.
If client becomes agitated or confused, the test should be stopped and scheduled for another day, or another test modality should be selected.
Conduct all testing in the morning as AD patient's function better during the early hours of the day.
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Exercise Prescription
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During early stages of AD, most clients should be able to participate in some form of PA.
A low-intensity program at the client’s usual level of ADL is recommended.
For this level of involvement, exercise testing is unnecessary
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Biokineticist must provide verbal
encouragement and support to maintain the client’s interest in the program.
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During the early stages of exercise training, simple repetitive exercises like walking, riding a stationary bike, or lifting a certain amount of weights on various exercise machines will be easier than more complex routines.
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The Caregiver
• If agitation is high, it may however be necessary to have the caregiver present
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• For some caregivers, the brief period away from their loved one is much desired.