Update on Alzheimers Disease A'D' 2002

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Update on Alzheimers Disease(A.D. 2002)

• Neil C. Porter, M.D.
• Assistant Professor of Neurology
• University of Maryland

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Learning Objectives

• To better understand how Alzheimers Disease is
  diagnosed and treated
• To learn to distinguish between a typical patient
  with Alzheimers Disease from other conditions
  that affect thinking

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A Case

• A 65-year-old woman comes into the office
  complaining that her 70-year-old husband keeps
  getting lost while driving back from the
  supermarket. He has become noticeably more
  forgetful over the past six years. The wife is
  now concerned that he not safe to drive.

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What is Alzheimers Disease?

• (a.k.a. old timers disease)
• Alzheimers disease is the most common form of
  dementia that affects the elderly. It generally
  worsens slowly, and is marked by certain forms of
  brain degeneration.

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What it is dementia?

• Dementia can be medically defined as the global
  loss of cognitive function in clear
  consciousness.
• For our purposes, however, dementia can be
  thought of as the gradual loss of ones ability
  to think.

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What are clues that a person has Alzheimers
Disease?

• A person who slow losses (over years)
• The ability to handle money
• The ability to care for themselves
• The ability to perform previously learned tasks
• The ability to remember the names of people and
  objects
• probably has Alzheimers Disease

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What are clues that a person doesnt have
Alzheimers disease?

• A person who loses the ability to think over
  night
• A person who loses the ability to think over
  weeks
• A person who loses the ability to think over
  months
• does not have Alzheimers Disease!

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What are clues that a person doesnt have
Alzheimers disease?

• The sudden loss of anything is not a sign of
  Alzheimers disease

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How can one be sure that a person has Alzheimers
disease?

• A definite diagnosis of Alzheimers Disease can
  only be made through looking at a persons brain
  after death.

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How common is Alzheimers Disease?

• Some believe that the number of patients with
  Alzheimers Disease doubles every 5 years after
  the age of 60.
• 1 of 60 year-olds affected
• 40 of 85 year-olds affected

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What Costs are Associated with Alzheimers Disease

• Total cost of caring for patients with
  Alzheimers Disease in 1991 was estimated at 76
  Billion
• Cost of nursing home care is estimated at 47,000
  per patient

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What Causes Alzheimers Disease?
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What Causes Alzheimers Disease?

• No one knows!

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What Causes Alzheimers Disease?

• A number of in-born and environmental factors
  appear to be important
• Age
• Education
• Certain genes

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What Can Family and Friends Expect?

• A steady, slow loss of faculties.
• No cure exists.

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Can Alzheimers Disease be Prevented?

• No medications are available to prevent
  Alzheimers disease
• Living right may help
• Stay active mentally and physically
• Monitor and control high blood pressure
• Avoid excessive alcohol use

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What Treatments Exist for Alzheimers Disease

• The only FDA approved medications for Alzheimers
  Disease are ones that increase a certain chemical
  in the brain (acetylcholine)
• Aricept
• Cognex
• Exelon
• Reminyl

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Additional Treatments for Alzheimers Disease

• Vitamin E may slow the progression of the disease
• Non-steroidal anti-inflammatory agents may help
  prevent the disorder
• Mild sedatives (Haldol) are helpful in reducing
  agitation and behavior disturbances

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What Safety Precautions Need to be Taken?

• Constant supervision to prevent wandering
• Restricted access to dangerous objects such as
  matches, knives, and stoves
• Revocation of driving privileges later in the
  course

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What Research is on the Horizon?

• Scientists are currently studying the ability of
  a vaccine to prevent or reverse the damage done
  by the disorder ( in animals )