Chapter 1. Alzheimer’s Disease

Synopsis

Human Development Video Activity
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You must read each slide, and complete any questions on the slide, in sequence.
beta-amyloid
This protein fragment can form plaques in the spaces between brain cells. In the brains of people with Alzheimer’s disease, the number of beta-amyloid plaques interferes with and even destroy the transfer of nerve impulses. While best known as a building block of the plaques associated with Alzheimer's disease, evidence has revealed that this protein has a non-pathological role as well.
dementia
Dementia is not a disease itself but a term for irreversible mental decline that interferes with daily life and normal functioning. While common, dementia is not a normal part of aging. Alzheimer’s is the most common cause of dementia.
polygenic
Related to a group of genes that are responsible for hereditary variation and a distinguishing characteristic.
tau
Within a cell, the protein called tau is involved in proper transport of necessary cell materials. When tau breaks down, the protein strand tangles and prevents cells from receiving the nutrients and materials that they need to survive.
A young mother resting with her newborn in a hospital bed

Alzheimer’s Disease

A wife kissing her husband who is in a hospital bed

Author

Elaine Cassel, Marymount University & Lord Fairfax Community College
Pamela Hill, San Antonio College
Tanya Renner, Kapiolani Community College
Cathie Robertson, Grossmont College

Synopsis

Alzheimer’s disease is the most common type of dementia. The diagnosis is generally based on symptoms and on the results of cognitive and medical tests. You will watch videos of people with Alzheimer’s and listen to experts and family members describe the progression of the disease and how it affects the caregivers as well.

REFERENCES

Berger, K. S. (2011). The developing person through the life span, 8th ed. New York: Worth.

http://www.alz.org

National Institutes of Health. (2011, June). Alzheimer’s Disease Genetics: Fact Sheet (NIH Publication No. 11-6424). Retrieved from http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-genetics-fact-sheet

Introduction to Alzheimer’s Disease

Alzheimer’s disease is the most feared and most common type of dementia. Alzheimer’s accounts for 50 to 80 percent of dementia cases. Alzheimer’s disease is a progressive brain disorder that damages and destroys brain cells leading to a loss of memory, cognitive abilities, aspects of personality, and other brain functions and eventually leading to death. Current research has found effective treatments to slow down some of the memory loss and mood symptoms. In some cases, these treatments may work to a degree to prolong the physical life and preserve the quality of life for those who suffer from Alzheimer’s disease. In spite of this medical accomplishment, a cure has not yet been discovered.

Play the video to observe Alzheimer’s patients during a music therapy session at a nursing home.

Alzheimer’s Disease and the Brain

Sometimes called senile dementia of the Alzheimer type (SDAT), Alzheimer’s disease is characterized by brain abnormalities: (1) beta-amyloid plaques, (2) tangles of tau, (3) loss of connecting neurons among brain cells, and (4) brain inflammation. The interaction of these anomalies destroys the ability of neurons to effectively communicate with one another and eventually halts cortex function. While a multitude of these brain irregularities does confirm Alzheimer’s, individuals may exhibit some of these abnormalities and may not demonstrate any symptoms of Alzheimer’s.

Watch the video of Dr. Ken Davis, director of an Alzheimer’s research center at Mount Sinai School of Medicine, describing how these abnormalities in the brain lead to the loss of memory and personality. The video continues with an interview of family members who also describe the gradual cognitive and behavioral deterioration of their loved one.

Who Gets Alzheimer’s Disease?

This computer graphic shows a vertical slice through a brain with advanced Alzheimer’s disease (left) as compared to a similar slice of a healthy brain (right). You can see how the neuronal degeneration of Alzheimer’s disease has left the brain significantly more atrophied than the healthy brain.

Alzheimer’s disease is linked to genetics. The disease is rare in persons younger than age 60, but when it does occur in someone that young, it is known as early-onset Alzheimer’s disease. Early-onset Alzheimer’s is related to a mutation on one of three genes. Late-onset Alzheimer’s does not share this exact genetic association and is much more common. Researchers theorize that when Alzheimer’s disease appears in a person 60 or older, it is likely polygenic, which means that an allele on several genes contributes to the over-production of beta-amyloid protein that creates plaques around neurons. The fact that more than one gene is believed to be involved in late-onset Alzheimer’s makes it very challenging to isolate which genetic components might be involved. Even though the entire genetic profile of Alzheimer’s is not known, researchers are aware of at least one genetic risk-factor. While having one or more of the APOE ε4 allele does not guarantee that a person will develop the disease, it is considered a risk-factor gene as those who have one or more of this allele are more likely to develop Alzheimer’s.

How Alzheimer’s Progresses

Today, researchers believe that Alzheimer’s disease likely begins 10 - 20 years before they are able to definitively diagnose it probably because early symptoms may be easily explained away as normal aspects of aging. A person diagnosed with Alzheimer’s disease usually experiences gradual brain deterioration over a period of 10 to 15 years. This brain degeneration progresses through five identifiable stages that begin with symptoms as harmless-seeming as forgetfulness and end in death. Play this video to hear Dr. Ken Davis discuss the five stages of Alzheimer’s.

Match each description with one of the five stages of Alzheimer’s that Dr. Davis describes in this video clip.

How Alzheimer's Progresses (continued)

Question 1.1

Absentmindedness about recent events; forgetfulness of new information or location of things; unable to recall names of people and places; failure to remember a common wordtr6gyd2H2e4tv2YS3boytdYW0xeAemKOoVZkWyqj4eXdOFdTv5YgcHwJAiPMiEo9HxRCEIB5/n5gx6iH

Generalized confusion; deficits in concentration and short‐term memory; aimless, repetitious speech; exaggerated personality traits, such as suspiciousness, paranoia, compulsiveness; rational thought declines. Memory deficit may be so severe that patients may not think that they have a memory problem. rp0jRGo+2stzqvuCFzGes39J5L1AW2zP+a3oh88zdOgWddumiDXUv7PxAkSX0r6oyblBRQH25Up/DIBE

Memory loss becomes dangerous. Individuals can no longer manage their basic daily needs. Easily agitated; problems with behavior; likely to get lost or forget to eat or dress properly; recognition of objects becomes difficult. kVoag35nRcmrka//frz2eixoKvzKaeO9v78FrL5FebMXP05Wa0AXI1Mj1juTjYqnoX8wXDg2kt3uiuxU

Patients need full‐time care; cannot communicate clearly; speech becomes short and simple; cannot recognize family members; stares blankly into space or at TV 8rl7ttJaqAHN+UrHx9UpPP12Sbs8lyxJSHMZRVLCdHmQ2wadZ6pihAR+19vpURBzUw4Av8qvUnpptJoq

Unresponsive and/or no recognition of anyone; identity and personality are gone. Frequent incontinence is common. Requires complete personal care xk15oHoNK0+ovuMtU5femML07Nig2/uzjCsyF7yYP97piyFpeOk3oyOdQ+ucALp07OJLZQ9awKoVbrpl

Correct.
Incorrect.

Prevention and Treatment for Alzheimer’s

A cure for Alzheimer’s disease has not yet been discovered, and even halting the progression of the disease is difficult. An early preventive step is to improve overall health by reducing the risk and impact of high blood pressure, diabetes, arteriosclerosis, and emphysema, all of which disrupt the flow of oxygen to the brain and are likely to aggravate the symptoms of dementia. Two major environmental risk factors associated with Alzheimer’s disease are lack of exercise and stress. Maintaining an exercise regimen throughout life is important as it helps to reduce stress and to sustain and perhaps enhance brain capacity which will increase resistance to some cellular changes in the brain.

All experts agree that early treatment for Alzheimer’s can make a difference. In the future, the ability to diagnose Alzheimer’s earlier will help scientists to test new medications that may stop or slow the over-production of beta-amyloid and tau. In the meantime, several new medications, such as cholinesterase inhibitors (Donepezil and Memantine), help to relieve some of the problems with mood and memory. These drugs enable Alzheimer’s patients to have several more years of close-to-normal functioning.

Neurologist Richard Mayeux of Columbia University discusses treatment for Alzheimer’s disease in this video.

Prevention and Treatment for Alzheimer’s (continued)

Watch this video of Roy, a 54-year-old man who suffers from early-onset Alzheimer’s disease.

Question 1.2

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Your response should note that Roy gets regular check-ups, takes cognitive tests to gauge the progress of the disease, exercises, and keeps a positive attitude, especially with the help of his wife.

Meet Two Caregivers

In 2012, approximately 15.4 million American family members and friends provided unpaid care for someone with Alzheimer’s disease or some type of dementia. In addition to taking a financial toll on caregivers, caring for a person with Alzheimer’s also leads to great physical and emotional stress as caregivers try to cope with the mental and physical deterioration of their loved one.

Watch this video to hear the experiences of two caregivers: the husband of an older female Alzheimer’s patient and the wife of 54-year-old Roy, the male Alzheimer’s patient who appears in a previous video clip. In this clip, you will also learn about research on the effects of stress on caregivers.

Life in a Nursing Facility

Eventually, the disease progresses to the point when the Alzheimer’s patient requires full-time nursing care.

Watch this video excerpt from the movie entitled Alzheimer’s Disease: A Family Affair, in which Rochelle lives in a nursing facility for Alzheimer’s patients and is being visited by her granddaughter.

Question 1.3

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Correct! Rochelle is in the fourth stage of Alzheimer’s disease. She needs full-time care, can no longer communicate effectively, and cannot recognize family members.
Sorry. Rochelle is in the fourth stage of Alzheimer’s disease. She needs full-time care, can no longer communicate effectively, and cannot recognize family members.

Assessment: Check Your Understanding

Ronald Reagan, former President of the United States (1981-1989), announced his Alzheimer’s diagnosis in 1994 and died 10 years later at age 93.

Question 1.4

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Correct! Alzheimer’s disease is the most common type of dementia occurring in elderly adults and is characterized by the gradual deterioration of memory, thinking, and behavior. The specific cause of Alzheimer’s is unknown, but it is partly genetic due to an inheritance of specific alleles on genes.
Sorry. Alzheimer’s disease is the most common type of dementia occurring in elderly adults and is characterized by the gradual deterioration of memory, thinking, and behavior. The specific cause of Alzheimer’s is unknown, but it is partly genetic due to an inheritance of specific alleles on genes.

Assessment: Check Your Understanding

The neuronal degeneration of Alzheimer’s disease has left the brain significantly more atrophied than the healthy brain.

Question 1.5

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Alzheimer’s disease is characterized by brain abnormalities: (1) beta-amyloid protein plaques, (2) tangles of tau, (3) loss of connecting neurons among brain cells, and (4) brain inflammation.

Assessment: Check Your Understanding

Ronald Reagan, former President of the United States (1981-1989), announced his Alzheimer’s diagnosis in 1994 and died 10 years later at age 93.

Question 1.6

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Correct. At this time, there is no cure for Alzheimer’s.
Sorry. At this time, there is no cure for Alzheimer’s.

Assessment: Check Your Understanding

A wife kissing her husband who is in a hospital bed

Question 1.7

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Correct! Medication can improve some memory loss and mood in patients with Alzheimer’s.
Sorry. Medication can improve some memory loss and mood in patients with Alzheimer’s.

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