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Alzheimer's Disease, Citations - Coggle Diagram
Alzheimer's Disease
Risk factors
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Environmental Factors
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Diabetes mellitus
Hyperinsulinemia disrupts brain Amyloid Beta clearance by competing for the insulin-degrading enzyme
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Elevated blood pressure
Decreases vascular integrity of blood-brain barrier which results in protein extravasation into brain tissue causing cell damage, apoptosis, and increased risk in Amyloid Beta accumulation
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Clinical manifestations
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It is important not to get signs of early AD confused with typical-age related signs. For example, a person of older age may occasionally miss a monthly payment, occasionally forget what day it is (remembering later), and sometimes forget what word to use, but these are normal findings in elderly individuals as their brains slowly change and deteriorate.
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Treatments
Treatments for memory
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Memantine
Regulates the activity of glutamate, a chemical involved in information processing, storage and retrieval.
Can cause side effects, including headache, constipation, confusion and dizziness.
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Treatments for behavior
Antipsychotic medications (for hallucinations, delusions, aggression, agitation, hostility and uncooperativeness)
Olanzapine (Zyprexa)
Rebalances dopamine and serotonin to improve thinking, mood, and behavior.
Quetiapine (Seroquel)
Rebalances dopamine and serotonin to improve thinking, mood, and behavior.
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Clozapine (Clozaril)
Blocks dopamine type 4 receptors, serotonin type 2 receptors, norepinephrine receptors, acetylcholine receptors, and histamine receptors in the brain.
Risperidone (Risperdal)
Rebalances dopamine and serotonin to improve thinking, mood, and behavior.
Aripiprazole (Abilify)
Rebalances dopamine and serotonin to improve thinking, mood, and behavior.
Ziprasidone (Geodon)
Rebalances dopamine and serotonin to improve thinking, mood, and behavior.
Only used if...
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The person is experiencing inconsolable or persistent distress, a significant decline in function or substantial difficulty receiving needed care.
Anxiolytics (for anxiety, restlessness, verbally disruptive behavior and resistance)
Oxazepam (Serax)
Inhibits spinal polysynaptic afferent pathways together with inhibition of monosynaptic afferent pathways resulting in skeletal muscle relaxing.
Lorazepam (Ativan)
Increases the levels of gamma-amino-butyric-acid (GABA), in brain to help patient relax.
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Pathogenesis
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MAM (Mitochondria-associated ER membranes) are increased significantly in patients with altered findings noted above
Altered Calcium, elevated levels of cholesterol, and phospholipid metabolism
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Screening and diagnosis
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Cognitive Assessment
Identifying and classifying overall level of impairment (MCI, mild neurocognitive disorder, dementia, major neurocognitive disorder)
Citations
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Hersi, M., Irvine, B., Gupta, P., Gomes, J., Birkett, N., & Krewski, D. (2017). Risk factors associated with the onset and progression of Alzheimer's disease: A systematic review of the evidence. Neurotoxicology, 61, 143–187. https://doi-org.proxy.libraries.uc.edu/10.1016/j.neuro.2017.03.006.
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Vallerand, A. H., Sanoski, C. A., & Deglin, J. H. (2020). Omeprazole. In H. G. Mansell (Contributing Ed.), Davis’s Drug Guide (18th ed.). F.A. Davis Company.