Alzheimer's Disease (Abnormal Psychology)

Campaign, awareness
Neurocognitive disorders, dementia, statistic
Signs and symptoms (problem, thought, normal)
Causes
Brain visual guide
Brain imaging studies (MRI and PET)
Stages
Treatment

Transcript

1. Alzheimer’s Disease Abnormal Psychology
2. Content • Introduction • 10 Signs and Symptoms • Causes • Treatment • References (Trezvuy, 2020)
3. Introduction Alzheimer's Awareness Ribbon is Purple World Alzheimer's Month is September | World Alzheimer's Day is 21 September The campaign was launched in 2012, so the 9th World Alzheimer Month is in 2020 (World Alzheimer’s Month, 2020)
4. Alzheimer’s Disease (AD)  It is named with Dr. Alois Alzheimer, who first found on a post-mortem, and then termed the condition in 1906 (MacGrill, 2020)  It is the most common cause of dementia,  A general term for memory loss and cognitive abilities that restrict with independent function everyday (Alzheimer's Association, 2020a and Nall, 2017)  It is in the category of neurocognitive disorders, which lead to impaired mental function (Krause, 2018)  It is aging abnormally (World Health Organization, 2020)
5.  It covers about 60% - 80% (Alzheimer's Association, 2020b)  The 6th leading cause of death in the US, and the 5th among adults aged 65 years or older (Heron, 2013)  Around 50 million people have dementia in the worldwide (World Health Organization, 2020)  The National Health and Morbidity Survey 2018 of Malaysia stated that those aged 60 years and above are 8.5% have dementia  It was significant in those living far from the city areas, females, those with poor education, and lower class society (Institute for Public Health, 2019) Alzheimer’s Disease (AD)
6. 10 Signs and Symptoms (Centers for Disease Control And Prevention, 2019 and Alzheimer's Association, 2020c)
7. 1 Memory Loss that Disrupts Daily Life Problem Forgetting events, repeating yourself or depending on more aids to help you not to forget (like sticky notes or reminders) Thought --- “Have I taken medicine?” Normal At times forgetting names or appointments, but recalling them later
8. 2 Challenges in Planning or Solving Problems Problem Struggling to pay bills or cook recipes you have used for many years Thought --- “How should I solve this problem?” Normal Seldom make mistakes when managing finances or household bills
9. 3 Difficulty Completing Familiar Tasks Problem Struggling to drive places, use a cell phone, or do shopping Thought --- “How to use this mobile phone?” Normal Seldom need help to use microwave settings or to record a TV show
10. 4 Confusion with Time or Place Problem Losing track of dates, or cannot remember where they are or how they reached there Thought --- “What is this place?” Normal Forget the day of the week but remembering it later
11. 5 Trouble Understanding Visual Images and Spatial Relationships Problem Struggling to balance or judge distance, or easily dropping things quite often Thought --- “Is this place far or near to me?” Normal Vision changes due to cataracts
12. 6 New Problems with Words in Speaking or Writing Problem Struggling to follow or join a conversation, or having trouble with vocabulary Thought --- “How to write the word again?” Normal Sometimes having trouble finding the right word
13. 7 Misplacing Things and Losing the Ability to Retrace Steps Problem Placing car keys anywhere or struggling to search something Thought --- “Where are the keys?” Normal Misplacing things rarely and retracing steps to search them
14. 8 Decreased or Poor Judgment Problem Struggling to pay attention to hygiene or poor money management Thought --- “Ah, the car nearly hits me!” Normal Seldom make a bad decision or mistake, like not changing the oil in the car
15. 9 Withdrawal from Work or Social Activities Problem Struggling to follow a favorite team or activity Thought --- “What are they chatting about?” Normal From time to time feeling bored in family or social commitments
16. 10 Changes in Mood and Personality Problem Becoming anxious, confused, depressed, fearful or suspicious Thought --- “What is going on now?” Normal Making very specific ways of doing things and getting angry easily when a routine is interrupted
17. Causes • Brain Tour Visual Guide • Brain Imaging Studies • Alzheimer’s Seven Stages
18. Causes  AD develops because of the death of brain cells in a neurodegenerative condition  The brain tissue has a loss of connection between the nerve cells, or neurons, causing information cannot pass easily around inside the brain  Abnormal increase levels of tiny deposits (plaques and tangles) develop on the nerve tissue  Plaques are made from a protein called beta-amyloid, grow between the dying brain cells  Tangles are made from another protein called tau, appear within the nerve cells  It is not clear why these changes occur (MacGrill, 2020)
19. Brain Tour Visual Guide - To show what happens in the process of developing AD (Alzheimer's Association, 2020d) Brain Imaging Studies - A brief idea of how inside the AD's brain looks like • MRI Brain with T1 and VBM • PET Scans: Amyloid PET, Tau PET, FDG-PET and PiB-PET
20. Normal vs Alzheimer's Brain
21. Healthy vs Alzheimer's Brain (Keep Memory Alive, 2020)
22. MRI Brain • Top row: • Healthy brain • Bottom row: • Advanced AD brain • Severe volume loss • Enlarged ventricles • Loss of volume in the gyri and hippocampus (Koran, 2019) Sagittal Coronal Axial
23. Under the Microscope
24. More About Plaques
25. More About Tangles Orderly, parallel strands for providing key materials to the cells Tau collapses into twisted strands called tangles In healthy areas: In areas where tangles are forming: Tau helps to keep the strands straight The strands cannot stay straight and disintegrate
26. PET Scans • To check the brain deposition for amyloid plaques • Amyloid PET (Jack, 2017a) • To check the neurofibrillary tangles for pathologic tau • Tau PET (Jack, 2017b) Amyloid PET - Plaques Tau PET - Tangles
27. PET Scans for Tau and Amyloid (University of California at Berkeley, 2016)
28. T1-Weighted MRI, FDG-PET and PiB-PET Images of Four Representative Participants Notes: (A) 64yo female AD pt with +Aβ deposition on PiB-PET and “AD” type of hypometabolism on FDG-PET (B) 76yo female MCI subject with +Aβ deposition on PiB-PET and “AD” type of hypometabolism on FDG-PET (C) 78yo female AD pt with -PiB and “FTD” type of hypometabolism (D) 71yo male AD patient with - PiB and non-specific hypometabolism on FDG-PET. • FDG, F-18 fluorodeoxyglucose; PiB, Pittsburgh compound B; PET, positron emission tomography; AD, Alzheimer’s disease; MCI, mild cognitive impairment; FTD, frontotemporal dementia; Aβ deposition, beta-amyloid deposition; pt, patient. (Zhang et al., 2017) There is a difference when comparing from Participant A with moderate AD to Participant D with mild AD
29. Alzheimer’s Seven Stages Stage 1 - (Normal) No symptoms, but there might be strong family history Stage 2 - (Normal aged forgetfulness) The earliest symptoms appear Stage 3 - (Mild cognitive impairment) Mild physical and mental impairments appear, like lowered memory and focus, are noticeable by their close ones Stage 4 - (Mild AD) Memory loss and the inability to perform daily tasks Stage 5 - (Moderate AD) Need help from loved ones or caregivers Stage 6 - (Moderately severe AD) May need help with eating and putting on clothes Stage 7 - (Severe AD) May be a loss of speech and facial expressions • Moving through these stages, they will need more support from a caregiver (Herndon & MFA, 2018 and Kaufman, 2020)
30. Progression Plaques and tangles (blue areas) spread through the cortex
31. Voxel-based Morphometry (VBM) of MRI Brain (Gray Matter) • VBM analysis showed obvious atrophy in medial temporal structures at the mild cognitive impairment (MCI) stage initially. • As AD develops from early stage to late stage, atrophy of medial temporal structures becomes more noticeable. (Matsuda, 2013)
32. Treatment  Can live 4 - 8 years on average after diagnosis, but the longest is 20 years (Alzheimer’s Association, 2020e)  Currently, there is no known cure, because AD is an irreversible progressive disease, which means the symptoms will be worsen day by day (Herndon & MFA, 2018, and Centers for Disease Control and Prevention, 2020)  The support is available to help the condition includes (Alzheimer's Society, 2020):  Drug treatments:  In the mild (early) or moderate (middle) stages, a drug like donepezil (e.g., Aricept), rivastigmine (e.g., Exelon) and galantamine (e.g., Reminyl) will be prescribed to temporarily ease symptoms, or slow down their progression  Without drugs treatments:  Keeping mentally, physically and socially active can have a very positive impact  In Malaysia, support can be received from Alzheimer’s Disease Foundation Malaysia (ADFM) and Caring With You (Homage, 2020)
33.  Alzheimer's Association. (2020a). What is dementia? Retrieved from https://www.alz.org/alzheimers- dementia/what-is-dementia  Alzheimer's Association. (2020b). What is Alzheimer's? Retrieved from https://www.alz.org/alzheimers-dementia/what-is-alzheimers  Alzheimer's Association. (2020c). 10 early signs and symptoms of Alzheimer's. Retrieved from https://www.alz.org/alzheimers-dementia/10_signs  Alzheimer's Association. (2020d). Brain tour Part 2. Retrieved from https://www.alz.org/alzheimers- dementia/what-is-alzheimers/brain_tour_part_2  Alzheimer’s Association. (2020e). Stages of Alzheimer’s. Retrieved from https://www.alz.org/alzheimers- dementia/stages#:~:text=On%20average%2C%20a%20person%20with,any%20signs%20of%20the%20 disease. References
34.  Alzheimer's Society. (2020). Treatment and support of Alzheimer's disease. Retrieved from https://www.alzheimers.org.uk/about-dementia/types-dementia/treatment-support-alzheimers- disease  Centers for Disease Control and Prevention. (2019). 10 warning signs of Alzheimer's. Retrieved from https://www.cdc.gov/aging/healthybrain/ten-warning-signs.html  Centers for Disease Control and Prevention. (2020). Alzheimer's disease. Retrieved from https://www.cdc.gov/aging/aginginfo/alzheimers.html  Herndon, J., & MFA. (2018). Everything you need to know about Alzheimer’s disease. Retrieved from https://www.healthline.com/health/alzheimers-disease#stages  Heron M. (2013). Deaths: leading causes for 2010. National Vital Statistics Reports. 62(6), 1–94. Retrieved from https://www.cdc.gov/nchs/data/nvsr/nvsr62/nvsr62_06.pdf  Homage. (2020). Dementia 101: All you need to know. Retrieved from https://www.homage.com.my/care-connect/tips/dementia-101/ References
35.  Institute for Public Health (IPH), National Institutes of Health, Ministry of Health Malaysia. (2019). National Health and Morbidity Survey (NHMS) 2018: Elderly Health. Vol. II: Elderly Health Findings, 2018. Retrieved from http://iku.moh.gov.my/images/IKU/Document/REPORT/NHMS2018/NHMS2018ElderlyHealthVolume2 .pdf  Jack, C. R. (2017a). Amyloid PET - Plaques [Picture]. Retrieved from https://aspe.hhs.gov/advisory- council-july-2017-meeting-presentation-implications-biologically-based-definition  Jack, C. R. (2017b). Tau PET - Tangles [Picture]. Retrieved from https://aspe.hhs.gov/advisory-council- july-2017-meeting-presentation-implications-biologically-based-definition  Kaufman, P. (2020). What is Alzheimer's? Symptoms, causes, diagnosis, treatment, and prevention. Retrieved from https://www.everydayhealth.com/alzheimers-disease/guide/  Keep Memory Alive. (2020). [Picture]. Retrieved from https://www.keepmemoryalive.org/cc- nevada/alzheimers-brain References
36.  Koran, M. E. (2019). [Picture]. Retrieved from https://practicalneurology.com/articles/2019-nov- dec/neuroimaging-and-alzheimers-disease  Krause, L. (2018). Neurocognitive disorders (Organic brain syndrome). Retrieved from https://www.healthline.com/health/organic-brain-syndrome  Matsuda, H. (2013). [Picture]. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3570139/  MacGill, M. (2020). Alzheimer's disease: Symptoms, stages, causes, and treatments. Retrieved from https://www.medicalnewstoday.com/articles/159442#what-is-it  Nall, R. (2017). Dementia (neurocognitive disorders): Types and causes. Retrieved from https://www.medicalnewstoday.com/articles/314850 References
37.  Trezvuy. (2020). Vector modern ALZHEIMERS DISEASE awareness circles desigen [Vector]. Retrieved from https://www.123rf.com/photo_57608871_stock-vector-vector-modern-alzheimers-disease-awareness- circles-desigen-purple-ribbon-isolated-on-white-backgroun.html  University of California at Berkeley. (2016). [Picture]. Retrieved from https://www.psypost.org/2016/03/pet- scans-reveal-key-details-alzheimers-protein-growth-aging-brains-41393  World Alzheimer’s Month. (2020). 2020 Campaign Materials. Retrieved from https://www.worldalzmonth.org/  World Health Organization (2020). Dementia. Retrieved from https://www.who.int/news-room/fact- sheets/detail/dementia#:~:text=Dementia%20is%20a%20syndrome%20in,million%20new%20cases%20ever y%20year.  Zhang, N., Zhang, L., Li, Y., Gordon, M. L., Cai, L., Wang, Y., & Xing, M. (2017). T1-weighted MRI, FDG-PET and PiB-PET images of four representative participants. [Picture]. Retrieved from https://content.iospress.com/articles/journal-of-alzheimers-disease/jad170383 References
38. Thank You! Any Questions?