Alzheimer's
Definition
Investigations
Treatment
Symptoms
Pathophysiology
Risk factors
Defective clearance of beta-amyloid plaques by macrophages relates to altered macrophage gene expression
Neuronal loss is selective- confined to hippocampus, amygdala, subcortical nuclei, temporal neocortex
Accumulation leads to progressive neuronal damage, Neurofibrillary tangles, increased amyloid plaques and ACh loss
Accumulation of beta-amyloid peptide (Amyloid precursor protein degradation product)
It is a progressive disease that destroys memory and other important mental functions
95% of AD show evidence of vascular dementia
Memory loss ( speech and writing)
Losing muscle control
Depression and loneliness
Down syndrome
Decreased physical and cognitive activity
Hallucinations- only late disease
Loss of visuo-spatial skill
Mood changes (depression)
1st degree relative with Alzheimer
Smoking
Vascular risk factors like hypertension anddiabetes
Supportive treatment
Acetylcholinesterase inhibitor like donepezil
Anti-glutamates like memantine
Medication delays progression and is not a cure
Prevention by exercises, healthy diet, no smoking and low alcohol intake
Test episodic memory e.g last weekend activities
Amyloid imaging and glucose metabolism via PET scan
Thorough history taking from patient and family
6CIT test for cognitive function e.g counting forward and backwards
MRL to exclude other causes
NEUROLOGICAL DISORDERES