The Alzheimers Disease

By:

-Desti Omega R -Devi Noviana -Lona Maharani O -Melanita Hardiyati -Resti M

Our Topic

Case

Pathophysiology Clinical Manifestation Risk Factors

Keywords

Case Explaination

Definitions

Test and Diagnosis

Etiology

Treatment

Outlook (Prognosis)

The Alzheimers Disease

Case 32

An 83 years-old women is brought to the clinic by her husband who was concerned with his wifes memory problems. He noticed some memory decline a few years ago, but the onset was subtle and did not interfere with her day-to-day activities. Mainly she has some difficulty remembering details repeating things, and is being forgetful. The patient family noticed her gradually increasing memory problems, particulary over the past year. She is unable to remember her appointment and relies heavily on writen notes and appointment books. Resently she got lost while driving and was found by her family 10 hours later. She was unable to use her cell phone and was unsure about her home address and phone number. She has also become more reclusive. She does not enjoy her church activities anymore and prefers to stay at home most of the time. She does not want to cook and she is less attentive to her housework. The patient says that she has always been forgetful. Her medical history is significant for well-controlled hypertention and a history of mastectomy secondary to breast cancer diagnosed 20 years ago. She has no significant story of tobacco or alcohol use. She is independent with all activities of daily living, but needs assistance with medication adminitration, banking, and transportation. She is up to date with her health maintenance and immunization. Her vital signs and general physical examination are normal.

 An 83 years-old women Memory problem decline a few years ago Difficult remembering details repeating things and being forgetful Unable to remember her appointment She does not enjoy her church activities Her medical history is significant for well-controlled hypertention History of mastectomy secondary to breast cancer No significant tobacco and alcohol use She is up to date about her health maintenance and immunization Her vital sign and physical examination are normal

Case Explaination

Component/ System
Name Age Sex Occuopation Marital status Present complaint Onset ENT

Complaint/Data
83 years-old Female Marriage Memory problem A few years ago -

Language Focus
Whats your name? How old are you? Are you male or female? Whats your job? Are you already have a family? Whats bought you along today? How long have you had them? Do you have any problem with your ear, nose, or throat?

RS

Do you have any problem with your respiration? Like cough or breathless?
Do you have any problem with your heart? Like chest pain? Do you have stomach pain after eating something? Any problem with your waterwork? Do you feel discomfort when look at the light?

CRV GIS GUS

CNS

Case Explaination

Immediate past history

Well-controlled hypertention Mastectomy secondary to breast

Do you have another sickness in the past? Do you have another sickness for now? Does something you want to tell again? Do you ever go somewhere and get lost? Can you use your cell phone?

Another data Difficult remembering details, repeating things and being forgetful. Recently she got lost while driving. Unable to use her cell phone

Unsure about home Can you tell me where is your address and phone number home is? Not enjoy her chruch Are you enjoy your activities on activities and prefers to stay chruch? at home. Are you a tobacco or alcohol No significant history of use? tobacco or alcohol use

Definition of Alzheimers

Alzheimer's disease is a progressive, degenerative disorder that attacks the brain's nerve cells, or neurons, resulting in loss of memory, thinking and language skills, and behavioral changes. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: ButterworthHeinemann Elsevier; 2008 A degenerative brain disease of unknown cause that is the most common form of dementia, that usually starts in late middle age or in old age, that results in progressive memory loss, impaired thinking, disorientation, and changes in personality and mood, that leads in advanced cases to a profound decline in cognitive and physical functioning, and that is marked histologically by the degeneration of brain neurons especially in the cerebral cortex and by the presence of neurofibrillary tangles and plaques containing beta-amyloidabbreviation AD; called also Alzheimer's Alois (18641915), German neurologist

Etiology of Alzheimers

The causes of Alzheimer's are not yet fully understood

Older

Genetic (APOE epsilon4 allele) Close blood

Pathophysiology

Genetic

Virus attact

Immunology

Abnormality neurotransmitten

Decreasing metabolism and blood flow in cortex parietale

Tangled neurofibril

loss of cholinergic fibers in the cerebellum

Abnormality of neurotransmitten

Atropy brain cells

Decrease in acetylcholine

memory loss, intellectual impairment, behavioral, cognitive

Alzheimers Disease

Clinical Manifestations

Repeat statement

Disorientation and misinterpreting spatial relationships

What day is it? Seasons?

Memory

Speaking and writing

Have trouble to identificate object

Clinical Manifestation Alzheimers

Difficult concentrating and thinking

Depression, social withdrawl aggresive

Thinking and reasoning

Changes in personality and behavior

Risk Factors

Age

Genetic

Lifestyle

Risk Factors

Test and diagnosis

Physical and neurological exam

Lab tests

Test and Diagnosis

Mental status testing

MRI dan CT-Scann

Treatment

Drug Cholinesterase inhibitors. These drugs work by boosting levels of a cell-to-cell communication chemical depleted in the brain by Alzheimer's disease. Most people can expect To keep their current symptoms at bay for a time. Less than half of those taking these drugs can expect to have any improvement. Commonly prescribed cholinesterase inhibitors include donepezil (Aricept), galantamine (Razadyne) and rivastigmine (Exelon). The main side effects of these drugs include diarrhea, nausea and sleep disturbances. Memantine (Namenda). This drug works in another brain cell communication network and slows the progression of symptoms with moderate to severe Alzheimer's disease. It's sometimes used in combination with a cholinesterase inhibitor. Exercise Nutritions

How quickly AD gets worse is different for each person. If AD develops quickly, it is more likely to worsen quickly. Patients with AD often die earlier than normal, although a patient may live anywhere from 3 - 20 years after diagnosis. The final phase of the disease may last from a few months to several years. During that time, the patient becomes totally disabled. Death usually occurs from an infection or organ failure.

Conclusion

Alzheimer's disease is a progressive, degenerative disorder that attacks the brain's nerve cells, or neurons, resulting in loss of memory, thinking and language skills, and behavioral changes. In Alzheimer's disease, the connections between brain cells and the brain cells themselves degenerate and die, causing a steady decline in memory and mental function. Current Alzheimer's disease medications and management strategies may temporarily improve symptoms. This can sometimes help people with Alzheimer's disease maximize function and maintain independence. But because there's no cure for Alzheimer's disease, it's important to seek supportive services and tap into your support network as early as possible.

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