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Porter

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									Update on Alzheimer’s Disease
        (A.D. 2002)


         Neil C. Porter, M.D.
  Assistant Professor of Neurology
       University of Maryland
Learning Objectives
   To better understand how Alzheimer’s
    Disease is diagnosed and treated

   To learn to distinguish between a
    typical patient with Alzheimer’s Disease
    from other conditions that affect
    thinking
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.
What is Alzheimer’s Disease?
   (a.k.a. “old timers” disease)
   Alzheimer’s 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.
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
 one’s ability to think.
What are clues that a person has
Alzheimer’s 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 Alzheimer’s Disease
What are clues that a person doesn’t
have Alzheimer’s 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 Alzheimer’s Disease!
 What are clues that a person doesn’t
 have Alzheimer’s disease?



The sudden loss of anything is not a sign
          of Alzheimer’s disease
How can one be sure that a person
has Alzheimer’s disease?


   A definite diagnosis of Alzheimer’s
    Disease can only be made through
    looking at a person’s brain after death.
How common is Alzheimer’s
Disease?
   Some believe that the number of
    patients with Alzheimer’s Disease
    doubles every 5 years after the age of
    60.
       1% of 60 year-olds affected
       40% of 85 year-olds affected
What Costs are Associated
with Alzheimer’s Disease
   Total cost of caring for patients with
    Alzheimer’s Disease in 1991 was
    estimated at $76 Billion
   Cost of nursing home care is estimated
    at $47,000 per patient
What Causes Alzheimer’s
Disease?
What Causes Alzheimer’s
Disease?



    No one knows!
What Causes Alzheimer’s
Disease?
   A number of in-born and environmental
    factors appear to be important
       Age
       Education
       Certain genes
What Can Family and Friends
Expect?


  A steady, slow loss of faculties.

          No cure exists.
Can Alzheimer’s Disease be
Prevented?
   No medications are available to prevent
    Alzheimer’s disease
   Living “right” may help
       Stay active mentally and physically
       Monitor and control high blood pressure
       Avoid excessive alcohol use
What Treatments Exist for
Alzheimer’s Disease
   The only FDA approved medications for
    Alzheimer’s Disease are ones that
    increase a certain chemical in the brain
    (acetylcholine)
       Aricept
       Cognex
       Exelon
       Reminyl
Additional Treatments for
Alzheimer’s 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
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
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 )

								
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