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    Alzheimers

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    Alzheimer's disease is a progressive brain disorder that destroys memory and thinking skills. It is the most common cause of dementia. There are two main types - sporadic Alzheimer's which has no clear cause and affects those over 65, and familial Alzheimer's which is rare and runs in families. The disease is characterized by neuronal loss, amyloid plaques and neurofibrillary tangles in the brain which disrupt communication between neurons and eventually lead to brain cell death. Symptoms start with mild memory loss but progress to include problems with language, behavior, and loss of motor skills. Diagnosis is made through exclusion of other causes and tests like MRI, CT, lumbar puncture and neuropsychological exams. Current treatments focus on managing

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    Alzheimers

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    ENREFZ
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    Alzheimer's disease is a progressive brain disorder that destroys memory and thinking skills. It is the most common cause of dementia. There are two main types - sporadic Alzheimer's which has no clear cause and affects those over 65, and familial Alzheimer's which is rare and runs in families. The disease is characterized by neuronal loss, amyloid plaques and neurofibrillary tangles in the brain which disrupt communication between neurons and eventually lead to brain cell death. Symptoms start with mild memory loss but progress to include problems with language, behavior, and loss of motor skills. Diagnosis is made through exclusion of other causes and tests like MRI, CT, lumbar puncture and neuropsychological exams. Current treatments focus on managing

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    Alzheimer's disease is a progressive brain disorder that destroys memory and thinking skills. It is the most common cause of dementia. There are two main types - sporadic Alzheimer's which has no clear cause and affects those over 65, and familial Alzheimer's which is rare and runs in families. The disease is characterized by neuronal loss, amyloid plaques and neurofibrillary tangles in the brain which disrupt communication between neurons and eventually lead to brain cell death. Symptoms start with mild memory loss but progress to include problems with language, behavior, and loss of motor skills. Diagnosis is made through exclusion of other causes and tests like MRI, CT, lumbar puncture and neuropsychological exams. Current treatments focus on managing

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    402 views5 pages

    Alzheimers

    Uploaded by

    ENREFZ
    Alzheimer's disease is a progressive brain disorder that destroys memory and thinking skills. It is the most common cause of dementia. There are two main types - sporadic Alzheimer's which has no clear cause and affects those over 65, and familial Alzheimer's which is rare and runs in families. The disease is characterized by neuronal loss, amyloid plaques and neurofibrillary tangles in the brain which disrupt communication between neurons and eventually lead to brain cell death. Symptoms start with mild memory loss but progress to include problems with language, behavior, and loss of motor skills. Diagnosis is made through exclusion of other causes and tests like MRI, CT, lumbar puncture and neuropsychological exams. Current treatments focus on managing

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    ALZHEIMER S DISEASE PATHOPHYSIOLOGY Predisposing Factors Age Genetic Factor (family history) Gender (women) DM Down syndrome Small

    head size Precipitating factor Stroke (brain attack) Head Injury Prolonged loss of consciousness (as in drowning) Low exercise and cigarette smoking Lower levels of education High blood

    abnormalities in cholinergic neurotransmitters

    Decrease in acetylcholine synthesis

    Cellular degeneration & cellular atrophy

    Abnormal material builds up as neurofibrillary tangles in the center of the brain cells and amyloidal plaques deposits outside the brain cells

    Damaging connections between brain cells

    Disrupting messages within the brain

    Leads to the eventual death of the brain cells and prevents the recall of information

    Alzheimer s disease

    Definition Alzheimer's disease is a physical disease which attacks the brain resulting in impaired memory, thinking and behaviour. The disease is named for the German physician, Alois Alzheimer who, in 1907, first described it. Two different types:

    1. Sporadic Alzheimer's disease The disease can affect adults at any age, but usually occurs after age 65 Sporadic Alzheimer's disease is by far the most common form of Alzheimer's disease It affects people who may or may not have a family history of the disease

    2. Familial Alzheimer's disease The disease runs in a few families and is very rare If a parent has a mutated gene, each child has a 50% chance of inheriting it The presence of the gene means that the person will eventually develop Alzheimer's disease, usually in their 40's or 50's Familial Alzheimer's disease affects a very small number of people Clinical manifestations Stage 1. Mild (Early confusion) Early cognitive decline in one or more areas Memory loss Decrease ability to function in work Name finding deficit Decrease in social functioning Recall difficulties and anxiety

    Stage 2. Moderate Unable to perform complex tasks (e.g. managing personal finances, planning a dinner party, unable to concentrate, no knowledge of current events).

    Stage 3. Moderately severe ( Early Dementia) Usually needs assistance for survival Needs reminders to bath, selecting clothes and other daily functions. Maybe disoriented to time or recent events although this can fluctuate. May become tearful.

    Stage 4. Severe (Dementia) Needs assistance with dressing, bathing and toilet functions. May forget spouse, and other family members names. Generally unaware of his surroundings Increase in CNS disturbances (e.g. agitation, delusions, paranoia, obsessive anxiety, increase potential for violent behaviour and tendency to wonder.

    Stage 5. Very severe ( late dementia) Unable to speak May scream or make other sounds Unable to ambulate, sit up, smile or feed self. Unable to hold head erect. Will ultimately sleep into stupor or coma. Nursing Diagnosis Problem: Inability to dress/groom self Nursing diagnosis: Self-care deficit: Dressing/grooming related to psychologic impairment secondary to depression Problem: Suppressed feelings Nursing Diagnosis: In effected coping related to situational crisis. Problem: Immobility

    Nursing Diagnosis: Impaired physical mobility related to generalized weakness and fatigue. Problem: Disturbed Thought Process Nursing Diagnosis: Disturbed thought process related to Psychological changes: Neurochemical (deficiencies of neurotransmitters acetylcholine, somatostatin, substance P, and norepinephrine). Diagnostic test findings Dianosis is made by exclusion; tests are performed to rule out other diseases Positive diagnosis is made on autopsy Positron emission tomography shows metabolic activity of the cerebral cortex Computed Tomography Scan reveals excessive and progressive brain atrophy MRI rules out intracranial lesions. Cerebral blood flow studies show abnormalities in blood flow to the brain. CSF analysis uncovers chronic neurologic infection. EEG detects slowing of the brain waves in late stages of the disease. Neuropsychologic tests reveal impaired cognitve ability and reasoning. Treatment Cognitive Symptoms Cholinesterase inhibitors: donepezil (Aricept), rivastigmine ( Exelon), galantamine (Reminyl), tacrine (Cognex) Glutamate regulator: memantine (Namenda) Experimental agents to slow progression: CX516 (Ampalex), atorvastatin (Lipitor), dimethylaminoethanol (Deanol), nefiracetam (Translon)

    Behavioral Symptoms Antianxiety drugs Antidepressants Antipsychotics

    Nursing Considerations Provide the patient with the safe environment; this may involve admission to a facility outside of the home. Assist the patient with exercise, as ordered, to help maintain mobility. Maintain and established daily routine to decreased confusion and disorientation. Ensure adequate nutrition by basing food choices on the patients current abilities, including the ability to chew and swallow or use utensils. Intervene with an agitated or fearful patient by helping him focus on another activity. Refer the patient and his family to appropriate community resources and support services. Establish an effective communication system with the patient and his family to help them adjust to the patients altered abilities. Offer emotional support to the patient and his family.

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