Persons with Down Syndrome and the Alzheimers Connection

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Persons with Down Syndrome and the Alzheimers
Connection
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Memory

• Just a line to say Im living, that Im not among
  the dead though Im getting more forgetful and
  mixed up in my head.

For sometimes I cant remember when I stand at
the foot of the stairs if I must go up for
something or Ive just come down from there.
And before the refrigerator, so often my poor
mind is filled with doubt, have I just put food
away or have I come to take some out?
Ive got used to my arthritis, to my dentures Im
resigned, I can manage by bifocals, but, Oh God,
I miss my mind!
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What is Alzheimers?
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Definition

• Progressive, degenerative disease of the
  neurological system
• Irreversible deterioration of the intellect
  and emotions
• It affects over 4 million American adults
• It is the fourth leading cause of death in
  adults after heart disease, cancer, and stroke
• Pre-senile and senile dementia are used to
  describe any diminished capacity to think and
  to understand

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Symptoms

• Cells of the brain are affected, causing severe
  intellectual impairment and changes in mental and
  neurological functioning

• Changes occur in the cerebral cortex the outer
  layer of the brain

• An accumulation of protein called tangles occur
  in the area of the brain that control recent
  short-term memory. This area of the brain is the
  hippocampus. This protein is located in the
  skin and intestines as well as the brain.

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Healthy Neuron
Synapse
Axon
Nucleus
Cell Body
Bendrites
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Plaques
Granulovacuolar Degeneration
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DISINTEGRATION
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Stages
stages for the generic population
There are
There are
Stages for persons with Down Syndrome
Each stage can last up to
years
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Stage One

• Anxiety or depression over memory loss
• Decreased efficiency in performance
• Defensiveness

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Stage Two

• Marked disorientation
• Reduced capacity for speech
• Decreased motor dexterity

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Stage Three

• Loss of self-help skills
• Incontinence
• Seizures develop
• Delusional, persectory and hallucinatory
  behavior is exhibited

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Causes

• The cause is unknown
• Suspected causes are

A gene in the 21st gene
Slow virus or other infectious agent
Accumulation of aluminum or other toxins
Changes in immune system relating to aging
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Diagnosis

• There is no single clinical test to identify
  Alzheimers
• Other conditions must be ruled out

Depression
Head injuries or brain tumor
Adverse drug reaction
Nutrition deficiencies
Menopause
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Diagnosis

• A diagnosis of Alzheimers can be confirmed only
  after death by performing an autopsy

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Alzheimers Losses
Language skills

• Short Term Memory

New learning ability
Judgment, planning and foresight
Inhibition/impulse control
Reasoning and abstracting
Sense of intimacy
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Behavioral Changes
Pacing
Fearfulness
Rummaging
Sexual comments
Hand wringing
Hallucinations/Delusions
Agitation
Withdrawal
Insistence
Public Masturbation
Repeating questions
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Physical Factors

• Urinary tract infections
• Bowel impaction
• Dehydration
• Seizures
• Pain/discomfort
• Mood swings

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Strategies

• Provide quiet time
• Alleviate boredom
• Avoid many changes
• Keep choices simple
• keep consistent schedule
• Reduce stimuli
• Provide decaf beverages
• Limit length of conversation

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Communication Techniques

• Make direct eye contact

• Identify yourself
• Use calm, clear voice
• Eliminate background noise
• Use short, simple sentences
• Use one-step commands
• Ask yes/no questions
• Use word cues

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• Written Communication
• Label the environment
• Keep a schedule of the day
• Use notes as reminders

• Non-Verbal Communications
• Use an open, gentle approach
• Hold out items
• Wave goodbye
• Use expression of concern
• Nod your head

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Increasing Quality of Life
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Use the Rs

• Remain calm
• Respond to feelings
• Reassure the person
• Remove yourself
• Return later

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And Also

• Be aware of client needs, information and
  resources available
• Identify aspects of disease and screen their
  problems
• Provide treatment through program development
• Advocate and refer for further treatment

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Programming

• Reality Orientation Brings information
  regarding time, place, person, and things
• Sensory Stimulation Activities are presented to
  accentuate a particular sense
• Re-socialization Uses group techniques to
  stress interpersonal relationships

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Attitude!