Alzheimer‘s disease
Menoufia faculty of medicine
Anatomy department
of 2nd year students(group 25)
Project Team
Supervisor
Prof. Dr. Hanaa Nooh
Dr. Sara Gamal
Dr. Hadeer Elnaggar
Designer
5/9/2017
Contents
 Anatomy of brain memory areas.
 Physiology of memory
 What is Alzheimer’s disease ?
 History.
 Epidemiology
 Causes
 pathogenesis
 Stages
 diagnosis
 Treatment.
 Complications
 Prognosis
2nd year students {group 25) Anatomy departement
5/9/2017
Anatomy of brain memory areas
4 regions in the cerebral cortex charring in memory process
1. “prefrontal cortex in the frontal lobe; involved in conscious thought &
higher mental function . has role in processing short term memories which
aren’t task-based .
2. The parietal lobe>>involved in integration sensory information &
manipulation of objects.
3. The occipital lobe>> involved with sense of vision.
.4. The temporal lobe>> involved in sense of smell and sound, processing of
semantics in both speech & vision & in the formation of long-term memory
through the limbic system
5/9/2017
2nd year students {group 25) Anatomy departement
limbic system
It lies in a deep region inside the medial temporal lobe
1-The hippocampus: transference from short to long-term memory &
control of spatial memory & behavior .
2-Dentate gyrus : dense dark layer of cells at the tip of the hippocampus.
3- The amygdala also performs a primary role in the processing & memory
of emotional reactions.
the basal ganglia” is essential for formation & retrieval of procedural
memory.
5/9/20172nd year students {group 25) Anatomy departement
Physiology of the memory
Memory: processes storing and retrieving information in the brain.
Retrieval of information . It is 4 types : (recollecting, recall, recognition, relearning )
Memory process
5/9/2017
2nd year students {group 25) Anatomy departement
Classification of memory:
Short term memory:
stores a limited amount of information
for about 30 sec. . Contain recently
processed sensory input or items
recently retrieved.
Immediate memory: lasting
less than 2 sec. . Act as buffers for
stimuli received through senses like
visual & auditory senses (if ignored -
>forgotten .if attention is paid ->passed
into STM).
Long term memory: lasting
for days, months, years. Can store very
large quantity of information like (facts,
events, attitudes, etc..)& maintain them
for long time.
5/9/2017
2nd year students {group 25) Anatomy departement
Alzheimer Disease
2nd year students (group 25) Anatomy department
 Alzheimer‘s disease is an incurable neurological disease in which
changes in the nerve cells of the brain result in the death of a large
number of cells.
 This destruction of brain cells Eventually leads to serious mental
deterioration, dementia and death.
 Alzheimer‘s cause neurons to die which leads to shrinking of the brain.
This leads to a loss of functioning capabilities in almost all parts of the
brain, not just the ones that affect the memory.
 The cortex shrivels up, damaging areas involved in thinking, planning &
remembering.
 Shrinkage is especially severe in the hippocampus , An area of the cortex
that plays a key role in information of new memories.
Introduction
5/9/20172nd year students {group 25) Anatomy departement
 Ancient Greek and Roman philosophers and
physicians associated old age with dementia.
 In 1901 that German psychiatrist Alois Alzheimer
identified the first case (Auguste D; 50 ys) of what
became known as Alzheimer's disease.
 During the next five years, eleven similar cases
were reported in the medical literature, some of
them already using the term Alzheimer's disease.
Historical
background
5/9/20172nd year students (group25) Anatomy department
 It’s an international disease spreads in the 7 world
major markets.
 US, Japan, Germany,France,Italy,Spain and UK.
 In Japan specially, women are more likely to have
Alzheimer‘s other than men.
 This may be the result of differential survival rates
between genders with increasing age.
 It’s about 24 million worldwide and predicted to
double every 20 years.
 95% of patients are aged > 65 so it’s called late
onset.
Epidemiology
5/9/2017
2nd year students (group 25) Anatomy department
• Amyloid plaques and
neurofibrillary tangles.
• atrophy of certain parts of the
brain,
• inflammation, production of
unstable molecules (free radicals)
• mitochondrial dysfunction.
Age related changes in
brain
• The (APOE) gene is
involved in late-onset
Alzheimer‘s, it has
several forms.
• Most cases are caused
by an inherited change
in one of three genes.
Genetics
For example, in the
relationship between
congnitive decline and
vascular conditions such as
heart disease, strock and
high blood pressure.
Health, life style and
environmental factors
Causes
Several mechanism
involved in AD
plaque formation
over production of TAU protein
lead to formation nerofibrally
tangles
Neuronal cell death
Neuron and synapse
loss
Altered amyloid
precursor protein(APP)
processing
Over production of βAP
Plaque formation
Neurodegeneration
and
Neuronal loss
Dementia
Pathogenesis
Stages
5/9/2017
 alzheimers-disease
Alzheimer‘s disease is
usually diagnosed based
on the person’s medical
history, history from
relatives and behavioral
observations.
The presence of
characteristic
neurological and
neuropsychological
features and the absence
of alternative conditions
is supportive ,.
History
5/9/2017
2nd year students (group 25) Anatomy department
Difficulty
performing
familiar tasks
depression,
withdrawal,
aggressiveness,
change in
sleeping habits
and delusion
Memory loss Misplacing
things:
Poor or
decreased
judgement and
decisions:
Changing in
personality and
behavior
Problems with
obstract
thinking
Disorientation to
time, place
Clinical picture
5/9/2017
2nd year students (group 25) Anatomy department
Examination
 Neuropsychological screening tests can help in the
diagnosis of AD. In the tests, people are instructed to copy
drawings similar to the one shown in the picture,
remember words, read and subtract serial numbers.
 Neuropsychological tests such as the mini-mental state
examination (MMSE) are widely used to evaluate the
cognitive impairments needed for diagnosis. More
comprehensive test arrays are necessary for high
reliability of results
5/9/2017
5/9/2017
2nd year students {group 25) Anatomy department
with computed
tomography (CT) or
magnetic resonance
imaging (MRI), and with
single photon emission
computed tomography
can be used to help
exclude other cerebral
pathology or subtypes of
dementia .It may predict
conversion from prodromal
stages ( mild cognitive
impairment) to Alzheimer‘s
disease.
 Axial, T2-weighted magnetic resonance
imaging (MRI) scan of the brain reveals
atrophic changes in the temporal lobes.
 Coronal,T1-weighted magnetic
resonance imaging (MRI)scan in a
patient with moderate Alzheimer‘s
disease. Brain image reveals
hippocampal atrophy, especially on the
right side.
Investigations
5/9/2017
2nd year students (group 25) Anatomy department
5/9/2017
2nd year students (group 25) Anatomy department
There’s no specific treatment for
Alzheimer‘s disease completely
with the prescribed medecine,as
it‘s one of the most complicated
diseases ever found in history.
There are some prescribted
medecines ,food and drugs to
treat Alzheimer‘s disease, but they
only stabilize the memory and brain
function For limited period of time.
5/9/2017
2nd year students (group 25) Anatomy department
 There are some drugs that Treat problems with
mood, depression and irriability. These include:
Citalopram, Fluoxetine & Sertraline.
 For patients who have anxiety or restlessness ,
medecines that can help include: Alprazolam ,
Buspirone & Oxazepam.
 Doctors also may prescribe some medications to
ease confusion or hallucinations, these include:
Halopericol & Arepeprazole.
medical
5/9/2017
2nd year students (group 25) Anatomy department
As we a complete lifestyle
change; to slow the
disease down and try to
handle its symptoms.
fun activities solving a
puzzle keep your mind
sharp and active
Regular
Exercis
e
healthy
diet
staying out of
stress
supportive
educated
about the
disease.
Stimulate
your brain.
at least 8
hours
sleep
Stress also
puts stress
on the brain
Manage
stress
reduces the
risk by 50 %
Physical
Exercise
Genger, green
tea and fatty
fish are some
kind of food
that feed glial
cells that
remove toxins
Healthy
Diet
Prevention
5/9/2017
2nd year students (group 25) Anatomy department
Memorizing food
5/9/2017
2nd year students {group 25) Anatomy department
Restlessness
and agitation
Bladder and
bowl problems
Depression
complications
5/9/2017
2nd year students {group 25) Anatomy department
(cont.)
Malnutrition
and
dehydration;
They refuse to eat or drink
with difficult swallowing.
Infections
forgetting how to care with
your food and drinks)
Falls
due to balance and
coordination
Wandering
for their names, addresses,
phone numbers and some
information due to their
distribution in their normal
sleep patterns.
Cont.
5/9/2017
2nd year students {group 25) Anatomy department
Prognosis: NO CURE !!
5/9/2017
2nd year students {group 25) Anatomy department
Home Massage
 Alzheimer‘s disease is a neurological disease in which there is a progressive cell death,
That leads eventually to serious mental deterioration, dementia and death.
 There’s no specific treatment for Alzheimer‘s disease completely with the prescribed
medicine, as it‘s one of the most complicated diseases ever found in history.
There are some prescribed medicines ,food and drugs to treat Alzheimer‘s disease, but
they only stabilize the memory and brain function For limited period of time.
5/9/20172nd year students {group 25) Anatomy department
5/9/2017
2nd year students Anatomy department
2nd year students {group 25)
Anatomy departement

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alzheimers-disease

  • 1. Alzheimer‘s disease Menoufia faculty of medicine Anatomy department of 2nd year students(group 25)
  • 2. Project Team Supervisor Prof. Dr. Hanaa Nooh Dr. Sara Gamal Dr. Hadeer Elnaggar Designer 5/9/2017
  • 3. Contents  Anatomy of brain memory areas.  Physiology of memory  What is Alzheimer’s disease ?  History.  Epidemiology  Causes  pathogenesis  Stages  diagnosis  Treatment.  Complications  Prognosis 2nd year students {group 25) Anatomy departement 5/9/2017
  • 4. Anatomy of brain memory areas 4 regions in the cerebral cortex charring in memory process 1. “prefrontal cortex in the frontal lobe; involved in conscious thought & higher mental function . has role in processing short term memories which aren’t task-based . 2. The parietal lobe>>involved in integration sensory information & manipulation of objects. 3. The occipital lobe>> involved with sense of vision. .4. The temporal lobe>> involved in sense of smell and sound, processing of semantics in both speech & vision & in the formation of long-term memory through the limbic system 5/9/2017 2nd year students {group 25) Anatomy departement
  • 5. limbic system It lies in a deep region inside the medial temporal lobe 1-The hippocampus: transference from short to long-term memory & control of spatial memory & behavior . 2-Dentate gyrus : dense dark layer of cells at the tip of the hippocampus. 3- The amygdala also performs a primary role in the processing & memory of emotional reactions. the basal ganglia” is essential for formation & retrieval of procedural memory. 5/9/20172nd year students {group 25) Anatomy departement
  • 6. Physiology of the memory Memory: processes storing and retrieving information in the brain. Retrieval of information . It is 4 types : (recollecting, recall, recognition, relearning ) Memory process 5/9/2017 2nd year students {group 25) Anatomy departement
  • 7. Classification of memory: Short term memory: stores a limited amount of information for about 30 sec. . Contain recently processed sensory input or items recently retrieved. Immediate memory: lasting less than 2 sec. . Act as buffers for stimuli received through senses like visual & auditory senses (if ignored - >forgotten .if attention is paid ->passed into STM). Long term memory: lasting for days, months, years. Can store very large quantity of information like (facts, events, attitudes, etc..)& maintain them for long time. 5/9/2017 2nd year students {group 25) Anatomy departement
  • 8. Alzheimer Disease 2nd year students (group 25) Anatomy department
  • 9.  Alzheimer‘s disease is an incurable neurological disease in which changes in the nerve cells of the brain result in the death of a large number of cells.  This destruction of brain cells Eventually leads to serious mental deterioration, dementia and death.  Alzheimer‘s cause neurons to die which leads to shrinking of the brain. This leads to a loss of functioning capabilities in almost all parts of the brain, not just the ones that affect the memory.  The cortex shrivels up, damaging areas involved in thinking, planning & remembering.  Shrinkage is especially severe in the hippocampus , An area of the cortex that plays a key role in information of new memories. Introduction 5/9/20172nd year students {group 25) Anatomy departement
  • 10.  Ancient Greek and Roman philosophers and physicians associated old age with dementia.  In 1901 that German psychiatrist Alois Alzheimer identified the first case (Auguste D; 50 ys) of what became known as Alzheimer's disease.  During the next five years, eleven similar cases were reported in the medical literature, some of them already using the term Alzheimer's disease. Historical background 5/9/20172nd year students (group25) Anatomy department
  • 11.  It’s an international disease spreads in the 7 world major markets.  US, Japan, Germany,France,Italy,Spain and UK.  In Japan specially, women are more likely to have Alzheimer‘s other than men.  This may be the result of differential survival rates between genders with increasing age.  It’s about 24 million worldwide and predicted to double every 20 years.  95% of patients are aged > 65 so it’s called late onset. Epidemiology 5/9/2017 2nd year students (group 25) Anatomy department
  • 12. • Amyloid plaques and neurofibrillary tangles. • atrophy of certain parts of the brain, • inflammation, production of unstable molecules (free radicals) • mitochondrial dysfunction. Age related changes in brain • The (APOE) gene is involved in late-onset Alzheimer‘s, it has several forms. • Most cases are caused by an inherited change in one of three genes. Genetics For example, in the relationship between congnitive decline and vascular conditions such as heart disease, strock and high blood pressure. Health, life style and environmental factors Causes
  • 13. Several mechanism involved in AD plaque formation over production of TAU protein lead to formation nerofibrally tangles Neuronal cell death Neuron and synapse loss Altered amyloid precursor protein(APP) processing Over production of βAP Plaque formation Neurodegeneration and Neuronal loss Dementia Pathogenesis
  • 16. Alzheimer‘s disease is usually diagnosed based on the person’s medical history, history from relatives and behavioral observations. The presence of characteristic neurological and neuropsychological features and the absence of alternative conditions is supportive ,. History 5/9/2017 2nd year students (group 25) Anatomy department
  • 17. Difficulty performing familiar tasks depression, withdrawal, aggressiveness, change in sleeping habits and delusion Memory loss Misplacing things: Poor or decreased judgement and decisions: Changing in personality and behavior Problems with obstract thinking Disorientation to time, place Clinical picture 5/9/2017 2nd year students (group 25) Anatomy department
  • 18. Examination  Neuropsychological screening tests can help in the diagnosis of AD. In the tests, people are instructed to copy drawings similar to the one shown in the picture, remember words, read and subtract serial numbers.  Neuropsychological tests such as the mini-mental state examination (MMSE) are widely used to evaluate the cognitive impairments needed for diagnosis. More comprehensive test arrays are necessary for high reliability of results 5/9/2017
  • 19. 5/9/2017 2nd year students {group 25) Anatomy department
  • 20. with computed tomography (CT) or magnetic resonance imaging (MRI), and with single photon emission computed tomography can be used to help exclude other cerebral pathology or subtypes of dementia .It may predict conversion from prodromal stages ( mild cognitive impairment) to Alzheimer‘s disease.  Axial, T2-weighted magnetic resonance imaging (MRI) scan of the brain reveals atrophic changes in the temporal lobes.  Coronal,T1-weighted magnetic resonance imaging (MRI)scan in a patient with moderate Alzheimer‘s disease. Brain image reveals hippocampal atrophy, especially on the right side. Investigations 5/9/2017 2nd year students (group 25) Anatomy department
  • 21. 5/9/2017 2nd year students (group 25) Anatomy department
  • 22. There’s no specific treatment for Alzheimer‘s disease completely with the prescribed medecine,as it‘s one of the most complicated diseases ever found in history. There are some prescribted medecines ,food and drugs to treat Alzheimer‘s disease, but they only stabilize the memory and brain function For limited period of time. 5/9/2017 2nd year students (group 25) Anatomy department
  • 23.  There are some drugs that Treat problems with mood, depression and irriability. These include: Citalopram, Fluoxetine & Sertraline.  For patients who have anxiety or restlessness , medecines that can help include: Alprazolam , Buspirone & Oxazepam.  Doctors also may prescribe some medications to ease confusion or hallucinations, these include: Halopericol & Arepeprazole. medical 5/9/2017 2nd year students (group 25) Anatomy department
  • 24. As we a complete lifestyle change; to slow the disease down and try to handle its symptoms. fun activities solving a puzzle keep your mind sharp and active Regular Exercis e healthy diet staying out of stress supportive
  • 25. educated about the disease. Stimulate your brain. at least 8 hours sleep Stress also puts stress on the brain Manage stress reduces the risk by 50 % Physical Exercise Genger, green tea and fatty fish are some kind of food that feed glial cells that remove toxins Healthy Diet Prevention 5/9/2017 2nd year students (group 25) Anatomy department
  • 26. Memorizing food 5/9/2017 2nd year students {group 25) Anatomy department
  • 27. Restlessness and agitation Bladder and bowl problems Depression complications 5/9/2017 2nd year students {group 25) Anatomy department
  • 28. (cont.) Malnutrition and dehydration; They refuse to eat or drink with difficult swallowing. Infections forgetting how to care with your food and drinks) Falls due to balance and coordination Wandering for their names, addresses, phone numbers and some information due to their distribution in their normal sleep patterns. Cont. 5/9/2017 2nd year students {group 25) Anatomy department
  • 29. Prognosis: NO CURE !! 5/9/2017 2nd year students {group 25) Anatomy department
  • 30. Home Massage  Alzheimer‘s disease is a neurological disease in which there is a progressive cell death, That leads eventually to serious mental deterioration, dementia and death.  There’s no specific treatment for Alzheimer‘s disease completely with the prescribed medicine, as it‘s one of the most complicated diseases ever found in history. There are some prescribed medicines ,food and drugs to treat Alzheimer‘s disease, but they only stabilize the memory and brain function For limited period of time. 5/9/20172nd year students {group 25) Anatomy department
  • 31. 5/9/2017 2nd year students Anatomy department 2nd year students {group 25) Anatomy departement