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1 New life Collage of nursing Karachi Presenter: Zafar ali shah Faculty: Raja khatri Subject: Pathophysiology Topic :Alzheimer s Disease Post RN BScN semester 2 nd

2 Objective Define Alzheimer s Describe pathophysiology Identify sign symptom List investigation AD Explore medical management Nursing care of

3 Alzheimer's disease (AD), also known as Senile Dementia of the Alzheimer Type (SDAT) or simply Alzheimer s is the most common form of dementia. This incurable, degenerative, terminal disease was first described by a German psychiatrist and neuropathologist Alois Alzheimer in 1906 and was named after him

4 Alzheimer's disease (AD) is a slowly progressive disease of the brain that is characterized by impairment of memory and eventually by disturbances in reasoning, planning, language, and perception

5

6 Alzheimer's disease is characterized by loss of neurons and synapses in the cerebral cortex and certain subcortical regions. This loss results in gross atrophy f the affected regions, including degeneration in the temporal lobe and parietal lobe, and parts of the frontal cortex and cingulate gyrus.

7 enlargement of ventricles. In presence of AD these normal changes are greatly accelerated. Brain weight is reduced further and there is marked cerebral atroph Both amyloid plaques and neurofibrillary tangles are clearly visible by microscopy in brains of those afflicted by AD.

8 Plaques are dense, mostly insoluble deposits of amyloid beta peptides and cellular material outside and around neurons. Tangles (neurofibrillary tangles) are aggregates of the microtubule-associated protein tau which has become hyper phosphorylated and accumulate inside the cells themselves.

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11 Clinical Features Loss of short-term memory and ability to create memories Concentration on past Loss of time Communication diminishes Personality changes Delusions Become immobilized and uncomprehending Death due to respiratory failure 65 and up disease lasts 8-20 years 65 and down disease lasts 5-10 years disease more rapid

12 Alzheimer's disease is usually diagnosed clinically from the patient history, collateral history from relatives, and clinical observations, based on the presence of characteristic neurological and neuropsychological features and the absence of alternative conditions. Advanced medical imaging with computed tomography (CT) or magnetic resonance imaging (MRI),

13 or positron emission tomography (PET) can be used to help exclude other cerebral pathology or subtypes of dementia

14 Aricept Donepezil Used to delay or slow the symptoms of AD Celexa Citalopram Used to reduce depression and anxiety

15 Depakote Sodium Valproate Used to treat severe aggression Also used to treat depression and anxiety Namenda Memantine Used to delay or slow the symptoms AD Used for moderate to severe stage of AD

16 Medicines used to control symptoms, allow caregivers to provide easier care. No treatment can prevent Alzheimer s

17 Nursing Care of AD Provide structured and consistent environment. Avoid distractions and noise. Objects of daily use should be kept in the same place. Pictures of family members can be placed on wall Reorient with time, place and person,)

18 date, month and year. Clocks & single date calendar may help. In later stages of AD reality orientation does not work, needs validation therapy.( recognizes & acknowledging feelings

19 References Pasternak, J. Jack. Introduction to Molecular Genetics. 2 nd edition pg Black, J.M., & Hawks. J. (2005) Medical Surgical Nursing: clinical management for positive outcomes (7th ed.). Philadelphia: W.B. Saunders Ignatavicius, D.D.,& Workman, M.L. (2009) Medical Surgical Nursing: Critical thinking for collaborative care (

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