Alzheimers disease & Parkinsons disease

Lecture Outline
Aging & the brain Alzheimers disease Parkinsons disease

The Aging Brain

Maximum weight 20 years of age
Slowly loses weight (10% over a lifetime)

Aging Neurons
Rate of change may be slowed by lifestyle factors
Weight Education Exercise Rest Hypertension Stress Head trauma

Cause of Aging Brain: A Mystery

Genetic? Aging genes are turned on? Hormonal influences? Immune systems awry? Accumulation of damage caused by cell byproducts that destroy fats and proteins vital to normal cell function? Majority are forgetful in old age
Especially forming memories of recent events -- Not a disease.

~ 1/3 population -- do well even in old age

Cognitive Decline Associated with Aging

Park et al. Psychology & Aging, 2002

Dementia
Deterioration of mental functioning Common forms
Alzheimers disease Multi-infarct dementia

Incidence

Alzheimers Disease

Alzheimers Disease
Progressive and fatal brain disease Affects > 5 million Americans Destroys brain cells 7th-leading cause of death in the United States No cure. Treatments for symptoms.

www.alz.org

Alzheimer's and the brain

Brains change as we age: slowed thinking and occasional problems remembering certain things Serious memory loss, confusion are not a normal part of aging
May be a sign that brain cells are failing

The brain has 100 billion nerve cells.

Nerve cell networks have special jobs In Alzheimers disease, parts of the cells factory stop running well

Signal Coding
Reading words Hearing words

Thinking about words

Saying words

Alzheimers Changes the Whole Brain

Hallmarks of Alzheimers Disease

Tangles & Plaques

Plaques: abnormal build-ups, in spaces between nerve cells Tangles: abnormal collections, inside neurons

Alzheimers Disease
A Progressive Disorder

Learning & memory Thinking & planning

Speaking Understanding speech

Sense of where your body is in relation to objects around you

10 Warning Signs of Alzheimer's

1. Memory loss.
Forgetting recently learned information What's normal? Forgetting names or appointments occasionally.

2. Difficulty performing familiar tasks.

Lose track of the steps involved in preparing a meal, placing a telephone call or playing a game. What's normal? Occasionally forgetting why you came into a room or what you planned to say.

3. Problems with language.

Often forget simple words or substitute unusual words What's normal? Sometimes having trouble finding the right word.

4. Disorientation to time and place.

Lost in their own neighborhood What's normal? Forgetting the day of the week or where you were going.

5. Poor or decreased judgment.

Dress inappropriately, give away large sums of money to telemarketers. What's normal? Making a questionable or debatable decision from time to time.

10 warning signs of Alzheimer's II

6. Problems with abstract thinking.
Performing complex mental tasks What's normal? Finding it challenging to balance a checkbook.

7. Misplacing things.
Put things in unusual places What's normal? Misplacing keys or a wallet temporarily.

8. Changes in mood or behavior.

Rapid mood swings from calm to tears to anger for no apparent reason. What's normal? Occasionally feeling sad or moody.

9. Changes in personality.
May become extremely confused, suspicious, fearful or dependent on a family member. What's normal? Peoples personalities do change somewhat with age.

10. Loss of initiative.

May become very passive, sitting in front of the TV for hours, sleeping more than usual or not wanting to do usual activities. What's normal? Sometimes feeling weary of work or social obligations.

The Difference Between Alzheimer's and Normal Age-Related Memory Changes

Alzheimer's disease symptoms
Forgets entire experiences
Rarely remembers later

Normal age-related memory changes

Forgets part of an experience
Often remembers later

Is gradually unable to follow written/spoken directions Is gradually unable to use notes as reminders Is gradually unable to care for self

Is usually able to follow written/spoken directions Is usually able to use notes as reminders Is usually able to care for self

Normal brain

Alzheimer's brain

Risk Factors
Age

Family History
Genetics Risk factors you may influence
Head injury
Heart-head connection
Monitor: high blood pressure, heart disease, stroke, diabetes, high cholesterol

Healthy aging
Maintain weight, avoid tobacco & excess alcohol, stay socially connected, exercise body & mind

Parkinsons Disease

Shaking Palsy

Epidemiology
Incidence
> 1 million people in US ~1% > 55 years

Onset
mean 62.4 years (35-85) rare before age 30; 4-10% cases before age 40

Course of disease
10-25 years

Male >= Female

www.wemove.org

Basal Ganglia

23

Parkinsons Disease
Pathology

Parkinsons Disease
Etiology
Environmental factors in susceptible individuals

Entirely genetic < 15%

Entirely toxic < 2%

Risk Factors
Definite risk factors
Old age MPTP

Possible risk factors

Herbicides, pesticides (mitochondrial toxins) Heavy metal exposure Wood preservatives Proximity to industry, rural residence, well water use Head trauma

Possible protective factors

Smoking (risk 60% less for current smokers; risk reduction even in monozygotic twins) Caffeine

PD Treatments
Drugs
Levodopa (L-dopa)

Dopamine neurons use l-dopa to synthesize dopamine

Dopamine Mimetics Enzyme Inhibitors

Increases dopamine availability

Transplantation Surgery

Transplantation:
A possible therapy for PD
Normal Parkinsons disease
Pre-transplant

Post-transplant

Alternative Treatments for PD

Surgical Procedures
Thalamotomy

Reduces tremors Improves tremors, rigidity, and bradykinesia Improves bradykinesia, rigidity, tremors

Pallidotomy

Deep Brain Stimulation

Diet
Vitamin E: no obvious benefits

Exercise
Improve body strength & mobility