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Alzheimer's Disease (Abnormal Psychology)

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Title: Alzheimer's Disease (Abnormal Psychology)


1
Alzheimers DiseaseAbnormal Psychology
2
Content
  • Introduction
  • 10 Signs and Symptoms
  • Causes
  • Treatment
  • References

(Trezvuy, 2020)
3
IntroductionAlzheimer's Awareness Ribbon is
PurpleWorld Alzheimer's Month is September
World Alzheimer's Day is 21 September
  • The campaign was launched in 2012, so the 9th
    World Alzheimer Month is in 2020
  • (World Alzheimers Month, 2020)

4
Alzheimers Disease (AD)
  • It is named with Dr. Alois Alzheimer, who first
    found on a post-mortem, and then termed the
    condition in 1906 (MacGrill, 2020)
  • It is the most common cause of dementia,
  • A general term for memory loss and cognitive
    abilities that restrict with independent function
    everyday (Alzheimer's Association, 2020a and
    Nall, 2017)
  • It is in the category of neurocognitive
    disorders, which lead to impaired mental function
    (Krause, 2018)
  • It is aging abnormally (World Health
    Organization, 2020)

5
Alzheimers Disease (AD)
  • It covers about 60 - 80 (Alzheimer's
    Association, 2020b)
  • The 6th leading cause of death in the US, and the
    5th among adults aged 65 years or older (Heron,
    2013)
  • Around 50 million people have dementia in the
    worldwide (World Health Organization, 2020)
  • The National Health and Morbidity Survey 2018 of
    Malaysia stated that those aged 60 years and
    above are 8.5 have dementia
  • It was significant in those living far from the
    city areas, females, those with poor education,
    and lower class society (Institute for Public
    Health, 2019)

6
10 Signs and Symptoms
  • (Centers for Disease Control And Prevention, 2019
  • and Alzheimer's Association, 2020c)

7
1 Memory Loss that Disrupts Daily Life
  • Problem
  • Thought
  • Normal
  • Forgetting events, repeating yourself or
    depending on more aids to help you not to forget
    (like sticky notes or reminders)
  • --- Have I taken medicine?
  • At times forgetting names or appointments, but
    recalling them later

8
2 Challenges in Planning or Solving Problems
  • Problem
  • Thought
  • Normal
  • Struggling to pay bills or cook recipes you have
    used for many years
  • --- How should I solve this problem?
  • Seldom make mistakes when managing finances or
    household bills

9
3 Difficulty Completing Familiar Tasks
  • Problem
  • Thought
  • Normal
  • Struggling to drive places, use a cell phone, or
    do shopping
  • --- How to use this mobile phone?
  • Seldom need help to use microwave settings or to
    record a TV show

10
4 Confusion with Time or Place
  • Problem
  • Thought
  • Normal
  • Losing track of dates, or cannot remember where
    they are or how they reached there
  • --- What is this place?
  • Forget the day of the week but remembering it
    later

11
5 Trouble Understanding Visual Images and Spatial
Relationships
  • Problem
  • Thought
  • Normal
  • Struggling to balance or judge distance, or
    easily dropping things quite often
  • --- Is this place far or near to me?
  • Vision changes due to cataracts

12
6 New Problems with Words in Speaking or Writing
  • Problem
  • Thought
  • Normal
  • Struggling to follow or join a conversation, or
    having trouble with vocabulary
  • --- How to write the word again?
  • Sometimes having trouble finding the right word

13
7 Misplacing Things and Losing the Ability to
Retrace Steps
  • Problem
  • Thought
  • Normal
  • Placing car keys anywhere or struggling to search
    something
  • --- Where are the keys?
  • Misplacing things rarely and retracing steps to
    search them

14
8 Decreased or Poor Judgment
  • Problem
  • Thought
  • Normal
  • Struggling to pay attention to hygiene or poor
    money management
  • --- Ah, the car nearly hits me!
  • Seldom make a bad decision or mistake, like not
    changing the oil in the car

15
9 Withdrawal from Work or Social Activities
  • Problem
  • Thought
  • Normal
  • Struggling to follow a favorite team or activity
  • --- What are they chatting about?
  • From time to time feeling bored in family or
    social commitments

16
10 Changes in Mood and Personality
  • Problem
  • Thought
  • Normal
  • Becoming anxious, confused, depressed, fearful or
    suspicious
  • --- What is going on now?
  • Making very specific ways of doing things and
    getting angry easily when a routine is interrupted

17
Causes
  • Brain Tour Visual Guide
  • Brain Imaging Studies
  • Alzheimers Seven Stages

18
Causes
  • AD develops because of the death of brain cells
    in a neurodegenerative condition
  • The brain tissue has a loss of connection between
    the nerve cells, or neurons, causing information
    cannot pass easily around inside the brain
  • Abnormal increase levels of tiny deposits
    (plaques and tangles) develop on the nerve tissue
  • Plaques are made from a protein called
    beta-amyloid, grow between the dying brain cells
  • Tangles are made from another protein called tau,
    appear within the nerve cells
  • It is not clear why these changes occur
  • (MacGrill, 2020)

19
Brain Tour Visual Guide- To show what happens in
the process of developing AD
  • (Alzheimer's Association, 2020d)

Brain Imaging Studies - A brief idea of how
inside the AD's brain looks like
  • MRI Brain with T1 and VBM
  • PET Scans Amyloid PET, Tau PET, FDG-PET and
    PiB-PET

20
Normal vs Alzheimer's Brain
21
Healthy vs Alzheimer's Brain (Keep Memory Alive,
2020)
22
MRI Brain
  • Top row
  • Healthy brain
  • Bottom row
  • Advanced AD brain
  • Severe volume loss
  • Enlarged ventricles
  • Loss of volume in the gyri and hippocampus
  • (Koran, 2019)

Sagittal
Coronal
Axial
23
Under the Microscope
24
More About Plaques
25
More About Tangles
In healthy areas
In areas where tangles are forming
Tau collapses into twisted strands called tangles
Orderly, parallel strands for providing key
materials to the cells
The strands cannot stay straight and disintegrate
Tau helps to keep the strands straight
26
Amyloid PET - Plaques
PET Scans
  • To check the brain deposition for amyloid plaques
  • Amyloid PET
  • (Jack, 2017a)
  • To check the neurofibrillary tangles for
    pathologic tau
  • Tau PET
  • (Jack, 2017b)

Tau PET - Tangles
27
PET Scans for Tau and Amyloid(University of
California at Berkeley, 2016)
28
T1-Weighted MRI, FDG-PET and PiB-PET Images of
Four Representative Participants
  • Notes
  • (A) 64yo female AD pt with Aß deposition on
    PiB-PET and AD type of hypometabolism on
    FDG-PET
  • (B) 76yo female MCI subject with Aß deposition
    on PiB-PET and AD type of hypometabolism on
    FDG-PET
  • (C) 78yo female AD pt with -PiB and FTD type of
    hypometabolism
  • (D) 71yo male AD patient with -PiB and
    non-specific hypometabolism on FDG-PET.
  • FDG, F-18 fluorodeoxyglucose PiB, Pittsburgh
    compound B PET, positron emission tomography
    AD, Alzheimers disease MCI, mild cognitive
    impairment FTD, frontotemporal dementia Aß
    deposition, beta-amyloid deposition pt, patient.
  • (Zhang et al., 2017)

There is a difference when comparing
from Participant A with moderate AD to
Participant D with mild AD
29
Alzheimers Seven Stages
  • Stage 1 - (Normal) No symptoms, but there might
    be strong family history
  • Stage 2 - (Normal aged forgetfulness) The
    earliest symptoms appear
  • Stage 3 - (Mild cognitive impairment) Mild
    physical and mental impairments appear, like
    lowered memory and focus, are noticeable by their
    close ones
  • Stage 4 - (Mild AD) Memory loss and the inability
    to perform daily tasks
  • Stage 5 - (Moderate AD) Need help from loved ones
    or caregivers
  • Stage 6 - (Moderately severe AD) May need help
    with eating and putting on clothes
  • Stage 7 - (Severe AD) May be a loss of speech and
    facial expressions
  • Moving through these stages, they will need more
    support from a caregiver
  • (Herndon MFA, 2018 and Kaufman, 2020)

30
Progression Plaques and tangles (blue areas)
spread through the cortex
31
Voxel-based Morphometry (VBM) of MRI Brain (Gray
Matter)
  • VBM analysis showed obvious atrophy in medial
    temporal structures at the mild cognitive
    impairment (MCI) stage initially.
  • As AD develops from early stage to late stage,
    atrophy of medial temporal structures becomes
    more noticeable.
  • (Matsuda, 2013)

32
Treatment
  • Can live 4 - 8 years on average after diagnosis,
    but the longest is 20 years (Alzheimers
    Association, 2020e)
  • Currently, there is no known cure, because AD is
    an irreversible progressive disease, which means
    the symptoms will be worsen day by day (Herndon
    MFA, 2018, and Centers for Disease Control and
    Prevention, 2020)
  • The support is available to help the condition
    includes (Alzheimer's Society, 2020)
  • Drug treatments
  • In the mild (early) or moderate (middle) stages,
    a drug like donepezil (e.g., Aricept),
    rivastigmine (e.g., Exelon) and galantamine
    (e.g., Reminyl) will be prescribed to temporarily
    ease symptoms, or slow down their progression
  • Without drugs treatments
  • Keeping mentally, physically and socially active
    can have a very positive impact
  • In Malaysia, support can be received from
    Alzheimers Disease Foundation Malaysia (ADFM)
    and Caring With You (Homage, 2020)

33
References
  • Alzheimer's Association. (2020a). What is
    dementia? Retrieved from https//www.alz.org/alzhe
    imers-dementia/what-is-dementia
  • Alzheimer's Association. (2020b). What is
    Alzheimer's? Retrieved from https//www.alz.org/al
    zheimers-dementia/what-is-alzheimers
  • Alzheimer's Association. (2020c). 10 early signs
    and symptoms of Alzheimer's. Retrieved from
    https//www.alz.org/alzheimers-dementia/10_signs
  • Alzheimer's Association. (2020d). Brain tour Part
    2. Retrieved from https//www.alz.org/alzheimers-
    dementia/what-is-alzheimers/brain_tour_part_2
  • Alzheimers Association. (2020e). Stages of
    Alzheimers. Retrieved from https//www.alz.org/al
    zheimers-dementia/stagestextOn20average2C2
    0a20person20with,any20signs20of20the20diseas
    e.

34
References
  • Alzheimer's Society. (2020). Treatment and
    support of Alzheimer's disease. Retrieved from
    https//www.alzheimers.org.uk/about-dementia/types
    -dementia/treatment-support-alzheimers-disease
  • Centers for Disease Control and Prevention.
    (2019). 10 warning signs of Alzheimer's.
    Retrieved from https//www.cdc.gov/aging/healthybr
    ain/ten-warning-signs.html
  • Centers for Disease Control and Prevention.
    (2020). Alzheimer's disease. Retrieved from
    https//www.cdc.gov/aging/aginginfo/alzheimers.htm
    l
  • Herndon, J., MFA. (2018). Everything you need
    to know about Alzheimers disease. Retrieved from
    https//www.healthline.com/health/alzheimers-disea
    sestages
  • Heron M. (2013). Deaths leading causes for 2010.
    National Vital Statistics Reports. 62(6), 194.
    Retrieved from https//www.cdc.gov/nchs/data/nvsr/
    nvsr62/nvsr62_06.pdf
  • Homage. (2020). Dementia 101 All you need to
    know. Retrieved from https//www.homage.com.my/car
    e-connect/tips/dementia-101/

35
References
  • Institute for Public Health (IPH), National
    Institutes of Health, Ministry of Health
    Malaysia. (2019). National Health and Morbidity
    Survey (NHMS) 2018 Elderly Health. Vol. II
    Elderly Health Findings, 2018. Retrieved from
    http//iku.moh.gov.my/images/IKU/Document/REPORT/N
    HMS2018/NHMS2018ElderlyHealthVolume2.pdf
  • Jack, C. R. (2017a). Amyloid PET - Plaques
    Picture. Retrieved from https//aspe.hhs.gov/adv
    isory-council-july-2017-meeting-presentation-impli
    cations-biologically-based-definition
  • Jack, C. R. (2017b). Tau PET - Tangles Picture.
    Retrieved from https//aspe.hhs.gov/advisory-counc
    il-july-2017-meeting-presentation-implications-bio
    logically-based-definition
  • Kaufman, P. (2020). What is Alzheimer's?
    Symptoms, causes, diagnosis, treatment, and
    prevention. Retrieved from https//www.everydayhea
    lth.com/alzheimers-disease/guide/
  • Keep Memory Alive. (2020). Picture. Retrieved
    from https//www.keepmemoryalive.org/cc-nevada/alz
    heimers-brain

36
References
  • Koran, M. E. (2019). Picture. Retrieved from
    https//practicalneurology.com/articles/2019-nov-d
    ec/neuroimaging-and-alzheimers-disease
  • Krause, L. (2018). Neurocognitive disorders
    (Organic brain syndrome). Retrieved from
    https//www.healthline.com/health/organic-brain-sy
    ndrome
  • Matsuda, H. (2013). Picture. Retrieved from
    https//www.ncbi.nlm.nih.gov/pmc/articles/PMC35701
    39/
  • MacGill, M. (2020). Alzheimer's disease
    Symptoms, stages, causes, and treatments.
    Retrieved from https//www.medicalnewstoday.com/ar
    ticles/159442what-is-it
  • Nall, R. (2017). Dementia (neurocognitive
    disorders) Types and causes. Retrieved from
    https//www.medicalnewstoday.com/articles/314850

37
References
  • Trezvuy. (2020). Vector modern ALZHEIMERS DISEASE
    awareness circles desigen Vector. Retrieved
    from https//www.123rf.com/photo_57608871_stock-ve
    ctor-vector-modern-alzheimers-disease-awareness-ci
    rcles-desigen-purple-ribbon-isolated-on-white-back
    groun.html
  • University of California at Berkeley. (2016).
    Picture. Retrieved from https//www.psypost.org/
    2016/03/pet-scans-reveal-key-details-alzheimers-pr
    otein-growth-aging-brains-41393
  • World Alzheimers Month. (2020). 2020 Campaign
    Materials. Retrieved from https//www.worldalzmont
    h.org/
  • World Health Organization (2020). Dementia.
    Retrieved from https//www.who.int/news-room/fact-
    sheets/detail/dementiatextDementia20is20a2
    0syndrome20in,million20new20cases20every20yea
    r.
  • Zhang, N., Zhang, L., Li, Y., Gordon, M. L., Cai,
    L., Wang, Y., Xing, M. (2017). T1-weighted MRI,
    FDG-PET and PiB-PET images of four representative
    participants. Picture. Retrieved from
    https//content.iospress.com/articles/journal-of-a
    lzheimers-disease/jad170383

38
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