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Epidemiology of Alzheimer

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Title: Epidemiology of Alzheimer


1
Epidemiology ofAlzheimers Disease
Carla Falkenstein, MS
2
Course Content
  • Description of the disease process.
  • Possible etiology based on population studies.
  • Global prevalence.

3
What is Alzheimers Disease?
  • Neurodegenerative disease.
  • Most common form of dementia.
  • Causes impaired cognitive functioning.
  • No known cure.

4
Diagnosis of AD
  • Because it is a progressive disease with one of
    the earliest symptoms being memory loss,
    diagnosis is difficult.

5
Common Symptoms
  • Forgetting names and objects.
  • Not recognizing family friends.
  • Forgetting ones own phone number or address.
  • Difficulty finding a familiar place.
  • Noticeable language intellectual decline.

6
Common Symptoms (contd)
  • Forgetting to eat or maintain ones hygiene.
  • Poor judgment, inability to follow simple
    instructions.
  • Progressive sense of distrust.
  • Unusual agitation and irritability.

7
Age is a Primary Risk Factor
Ages Prevalence 65-74 3 75-84 18.7 85
47
8
Stages of AD
SEVERE 1-3 Years
MODERATE 2-10 Years
MILD 2-4 Years
9
Disease Process
10
Disease Process (contd)
  • 1st destroys neurons in parts of the brain that
    control memory.
  • Later attacks cerebral cortex - areas responsible
    for language and reasoning.
  • Eventually nearly the entire brain is atrophied.

11
Cause of Nerve Cell Death
  • Amyloid Plaques?
  • Neurofibrillary Tangles?

12
Amyloid Plaques
  • Insoluble deposits of beta-amyloid
  • Plaques found in the spaces between the brains
    nerve cells
  • Plaques may be a cause or a by-product of AD

13
Neurofibrillary Tangles
  • Twisted threads of a protein called tau.
  • Tau is a protein found inside nerve cells.
  • In AD, Tau changes so that it becomes 2 threads
    wound around each other.

14
Other Genetic Factors
APOE ?4 allele of the APOE gene is a major risk
factor for late-onset AD. However, much work is
being done to sort out all the potential genetic
factors involved in AD.
15
AD and Other Disorders
  • AD has similarities with other neurodegenerative
    diseases
  • Prion, Parkinsons and Huntingtons diseases all
    cause dementia.
  • All involve deposits of abnormal proteins in the
    brain.

16
Early Diagnosis
  • The earlier a correct diagnosis can be made, the
    greater the gain in managing symptoms through
    pharmaceuticals.
  • MRI
  • PET
  • SPECT

17
Causal vs. Associative Agents
  • Advanced age
  • Female gender
  • Head Injury
  • Cerebrovascular disease
  • Low education levels
  • Rural Residence
  • Blood cholesterol
  • Low blood levels of folic acid
  • Inflammation

18
A Chain of Events Leads to
Disability and Death
GENES
LIFESTYLE ENVIRONMENT
BRAIN DEVELOPMENT RESERVE
ALZHEIMERS SEVERITY IN BRAIN
NEURO- DEGENERATION
OTHER DISEASES
AGE AT ONSET OF SYMPTOMS
SEVERITY OF SYMPTOMS
19
Global Prevalence of AD
  • United States
  • Most common cause of AD
  • Current cases 4 million
  • Prevalence doubles every 5 years beyond age 65
  • Nearly 50 of those aged 85 have AD

20
Global Prevalence of AD
  • African Americans in Indianapolis are twice as
    likely as Africans in Ibadan, Nigeria to develop
    dementia AD.
  • Higher rates of AD in Japanese men who emigrated
    to US compared with those who remained in Japan.

21
Global Prevalence of AD
Europe There are currently an estimated 5.5
million people with dementia in Europe.
22
Global Prevalence of AD
Developing Countries Currently, 18 million
people in the world have dementia. 66 of
people with dementia live in developing countries.
23
Current Research
  • Continued search for causative agents and
    etiology.
  • Disease prevalence worldwide with close attention
    to cultural variations.
  • Animal and population studies that confirm
    causation and lead to preventive or curative
    measures.

24
Review Questions (Developed by the Supercourse
team)
  • What are the major risk factors for Alzheimers
    disease?
  • What can be done if one has APOE e4?
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