here you can see a good presentation on AlzEIMER'S DISESE...

5. Objective
• To educate the people about Alzheimer's
Disease.
• To aware the people how to prevent and
control Alzheimer's Disease.
• Alzheimer's Disease is an endemic in all
the world, including Pakistan.

6. ALZHEIMER`S DISEASE: Glance of topic
• What is Alzheimer's Disease?
• Difference Between Dementia and Alzheimer's
• Alzheimer's Disease and Brain
• History of Alzheimer's disease
• Alzheimer’s in Pakistan
• Unrevealing the mystery. Who discover it..
• Cause
• Risk Factors
• Signs & Symptoms.
• Stages of Alzheimer's Disease
• pathopyhisiology and biochemistry.
• Diagnosis of Alzheimer's disease.
• Treatment after diagnosis.
• DIET, Management and Prevention.

7. What is Alzhimer`s Disease?
• Alzheimer`s disease(AD) is an incurable
neurological disease in which changes in
the nerve cells of the brain result in the
death of a large number of cells. This
destruction of brain cells eventually leads
to serious mental deterioration, dementia,
and death.
• Dementia is a broad category of brain
diseases that cause long term loss of the
ability to think and reason clearly that is
severe enough to affect a person's daily
functioning.

8. What's the Difference Between
Dementia and Alzheimer's?
Many people use the words “dementia” and
“Alzheimer’s disease” interchangeably.
Dementia is NOT A DISEASE.
Whereas, Alzheimer’s is a disease.
Dementia is a group of symptoms which
affects memory and reasoning.
 Alzheimer’s can be spotted as a cause for
dementia. Alzheimer’s Disease mainly affects
people aged between 60 & 85 .
Dementia is not a cause of Alzheimer’s.
Worldwide, 47.5 million people have dementia,
out of which more than 5 million dementia cases
are actually Alzheimer’s and there are 7.7 million
new cases every year.

9. ALZHEIMER”S Diseases AND BRAIN
The Brain of the AD have an abundance of two abnormal
structures:
• beta-amyloid plaques, which are dense deposits of
protein and cellular material that accumulate outside and
around nerve cells
• neurofibrillary tangles, which are twisted fibers that build
up inside the nerve cell
Actual Beta-amyloid plaques
Actual tangles

10. The brain state of a person having
Alzheimer’s disease
Comparison of a normal aged brain (left) and an
Alzheimer's patient's brain (right). Differential
characteristics are pointed out.

11. History of Alzheimer's disease
(AD)
Alzheimer’s disease was first discovered in 1906
by a German neurologist,
Dr. Alois Alzheimer (1864-1915).
A 51 year old woman died from a
“mental illness.”
She suffered from depression, paranoia,
hallucinations, and dementia.
Dr. Alzheimer examined her brain & found:
“peculiar formations”  amyloid plaques
“dense bundles”  neurofibrillary tangles

12. 2015 Alzheimer’s Statistics: Alzheimer’s
Worldwide
 Worldwide, nearly 44 million people have
Alzheimer’s or a related dementia.
 Only 1-in-4 people with Alzheimer’s disease have
been diagnosed.
 Alzheimer’s and dementia is most common in
Western Europe, followed by North America.
 Alzheimer’s is least prevalent in Sub-Saharan
Africa.
 Alzheimer’s and other dementias are the top
cause for disabilities in later life.
• SOURCE: Alzheimer’s Disease International
Center for Disease Control

13. Alzheimer’s in the United States
1-in-9 Americans over 65 has Alzheimer’s
disease.
One-third of Americans over age 85 are
afflicted with the illness.
5.3 million Americans are living with
Alzheimer’s disease.
Alzheimer’s disease is the 6th leading cause of
death in America.
1-in-3 seniors die with Alzheimer’s or
another kind of dementia.
Typical life expectancy after an Alzheimer’s
diagnosis is 4-to-8 years.

14. In 2014, the 85-years-and-older
population includes about 2 million
people with Alzheimer’s disease, or 40
percent of all people with Alzheimer’s
age 65 and older.
Proportion of People With
Alzheimer’s Disease in the United
States by Age: 85+ years – 38%, 75 to
84 years - 44%, 65 to 74 years - 15%, <65
years - 4%
About 3,60,000 new cases of Alzheimer’s are
diagnosed each year.
SOURCE: Alzheimer’s Association
Centers for Disease
Control

15. Renowned neurologist and president of the Pakistan Society of
Neurology, Prof Dr Wasay Shakir says that an estimated 0.2
million people are currently suffering from dementia
(Alzheimer’s) disease in Pakistan with the rising life
expectancy.
“In Pakistan there is no population base study on neurological
diseases so dementia in Pakistan has so far been under
studied,” they said. “Due to a lack of research and the cultural
context, it is very difficult to get an accurate number of people
suffering from the disease. However, the extrapolated
prevalence of people with dementia disease in Pakistan is
around 200,000.”
They claimed that by the year 2050, Pakistan will become the
third most populous country of the world with an estimated
population of 380 million, leaving behind United States,
Alzheimer’s in Pakistan

16. The estimated 36 million young people aged between 15
and 24 who currently live in Pakistan are the most that
have ever lived at any other time in its history, and they
will be at a risk for dementia and Alzheimer’s disease by
the year 2050.
Approximately around 8 million people are above 65
years of age inPakistan. Among them 160,000 to
240,000 are currently affected by dementia, out of which
80,000 to 120,000 probably have Alzheimer’s disease,
Prof. Arsalan maintained.He said currently 35.6 million
people across the globe are affected with dementia and
Alzheimer and it was expected that the number will
increase to 65.7 million by 2030 and 115.4 million by
2050
September 21 2015.

17. UNREVALING THE MYSTERY
• Dr. Aloysius "Alois"
Alzheimer was a
Bavarian-born
German psychiatrist
and neuropathologist
and a colleague of
Emil Kraepelin.
• Alzheimer is credited
with identifying the
first published case of
"presenile dementia",
which Kraepelin would
later identify as
Alzheimer’s disease.
Dr. Aloysius "Alois" Alzheimer

18. • In 1901, Dr. Alzheimer observed a
patient at the Frankfurt Asylum
named Auguste Deter. The 51-
year-old patient had strange
behavioral symptoms, including a
loss of short-term memory.
• With two Italian physicians, he
used the staining techniques to
identify amiloid plaques and
neurofibrillary tangles (it is a
primary marker of Alzheimer’s
Disease).
• Therefore it was named as
Alzheimer‘s Disease.
Alois Alzheimer's patient
Auguste Deter in 1902.
UNREVALING THE MYSTERY

19. Causes of Alzheimer’s
• Scientists generally agree that there is unlikely to be a
single clear “Cause” of Alzheimer’s.
• It is more likely the result of combination of inter-related
factors, including genetic factors, which are passed
along family lines of inheritance, and environmental
influence, which range from previous head trauma to
educational level to one’s experiences early in life.
• A growing body of research is also helping to identify
various “lifestyle factors,” such as dietary habits, high
blood pressure and high cholesterol, which may
influence one's risk of Alzheimer’s disease.
• Alzheimer’s develops as a result of complex cascade of
biological processes that take place over many years
inside the brain..

20. Risk Factors
•Age
•After age 65, and rise sharply
after age 75
•Genetics
•Family history of AD
•Sex
•Women > Men
•Having down Syndrome

21. Risk Factors
a)Down’s syndrome.
b)Family History.
c)Chronic High BP.
d)Head injuries.
e)Gender
f) Smoking and Drinking.

22. ENVIRONMENTAL FACTORS
•Cigarette smoking.
•Certain Infections.
•Metals, industrial or
other toxins.
•Use of cholesterol
lowering drugs (Strain).

23. WHO IS AFFECTED

24. SIGNS
• Ten warning signs of Alzheimer’s disease
1) Memory Loss
2) Difficulty To performing Familiar tasks.
3) Problems with languages.
4) Disorientation to time and place.
5) Poor or decreased Judgment.
6) Problems with abstract thinking.
7) Misplacing things
8) Changes in mood or behaviour.
9) Change in Personality.
10)Loss of initiative.

25. Symptoms
• Confusion.
• Disturbance in short-term memory.
• Problems with attention and spatial
orientation.
• Personality changes.
• Language difficulties.
• Unexplained mood swings.

26. Symptoms
• During the first two to four years, people
with Alzheimer’s disease generally
experience loss of memory for recent
events, and disorientation.
• Later, the person will often have problems
with progressive memory loss, judgment,
concentration and speech.
• Loss of physical abilities, similar to that
seen in Parkinson's disease, occurs in a
small proportion of affected people.

27. Symptoms
• At this point, the person may forget
to take a bath and will have
problems with once-routine
chores.
• People with Alzheimer’s may also
suffer sleeplessness,
“sundowning” (confusion or
agitation in the evening hours),
and perseveration (repetition of the
same ideas, words, movements, or

28. • Final stage disease progression includes severe
problems with eating, communication, and control of
bodily functions.
Symptoms

29. Normal Brain Alzheimer’s Brain

30. DIAGNOSIS OF AD
• Psychiatric assessments.
• Mental status examination and neuro
psychological assessment.
• Laboratory tests.
• Brain imaging : CT scan, MRI
• CSF Examination
• Electro-encephalogram (EEG)

31. Pathophysiology
Neuropathology:
• Alzheimer's disease is characterised by loss of
neurons and synapses in the cerebral cortex
and certain subcortical regions.
• Degeneration is also present in brainstem nuclei
like the locus coeruleus.
• Both amyloid plaques and neurofibrillary tangles
are clearly visible by microscopy in brains of
those afflicted by AD.

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

33. Histopathologic image of senile plaques seen in
the cerebral cortex of a person with Alzheimer's
disease of presenile onset. Silver impregnation.
Studies using MRI and PET have documented reductions in the
size of specific brain regions in people with AD as they
progressed from mild cognitive impairment to Alzheimer's
disease.
Pathophysiology

34. Biochemistry
• Alzheimer's disease has been identified as a
protein misfolding disease (proteopathy),
caused by plaque accumulation of abnormally
folded beta amyloid and tau amyloid proteins in
the brain.
• AD is also considered a tauopathy due to
abnormal aggregation of the tau protein.
• A protein called tau stabilises the microtubules
when phosphorylated, and is therefore called a
microtubule-associated protein.

35. 1
3
2
Enzymes act on the APP (amyloid precursor protein)
and cut it into fragments. The beta-amyloid fragment is
crucial in the formation of senile plaques in AD.
Biochemistry

36. The role of plaques and tangles :
• Plaques and tangles tend to spread through the
cortex as Alzheimer's progresses.
Take the Brain Tour :
• Two abnormal structures called plaques and tangles
are prime suspects in damaging and killing nerve
cells.
• Plaques are deposits of a protein fragment called
beta-amyloid (BAY-tuh AM-uh-loyd) that build up in
the spaces between nerve cells.
• Tangles are twisted fibers of another protein called
tau (rhymes with “wow”) that build up inside cells.
Biochemistry

37. 7 stages of Alzheimer’s
• Stage 1: Normal
• Stage 2: Normal aged forgetfulness
• Stage 3: Mild cognitive impairment
• Stage 4: Mild Alzheimer’s
• Stage 5: Moderate Alzheimer’s disease
• Stage 6: Moderately severe Alzheimer's
disease
• Stage 7: Severe Alzheimer's disease

38. Diagnosis of Alzheimer’s Disease
• Alzheimer's disease is usually diagnosed based
on the person's history, history from relatives, and
observations of the person's behaviours.
• The diagnosis include test like eye-drop test,
genetic tests, spinal fluid tests, various types of
neuropsychologic or cognitive tests, and brain
imaging tests.
• Advanced medical imaging with computed
tomography and with single-photon emission
computed tomography (SPECT).

39. DEIT
• People who eat a mediterranean diet have a lower
risk of AD, and it may improve outcomes in those
with the disease.
• There is tentative evidence that caffeine may be
protective.
• A number of foods high in flavonoids such as cocoa,
red wine, and tea may decrease the risk of AD.
Management
There is no cure for
Alzheimer's disease;
available treatments offer
relatively small
symptomatic benefit but
remain palliative in nature.
DEIT and Management

40. Prevention
• At present, there is no definitive evidence to
support that any particular measure is effective
in preventing AD.
• Global studies of measures to prevent or delay
the onset of AD have often produced
inconsistent results.
• Epidemiological studies have proposed
relationships between certain modifiable
factors, such as diet, cardiovascular risk,
pharmaceutical products, or intellectual
activities among others, and a population's
likelihood of developing AD.

41. Intellectual activities such as playing
chess or regular social interaction
have been linked to a reduced risk of
AD in epidemiological studies,
although no causal relationship has
been found.
Prevention

42. Treatment After Diagnosis
• New drugs for the treatment of AD are now available.
• These drugs increase the brain levels of acetylcholine, a
chemical involved in memory functions.
• The first of the drugs approved, Tacrine, requires
frequent blood tests for monitoring.
• More recently, Donepezil (Aricept) was also approved by
the FDA.
• These drugs do not cure Alzheimer's or stop its
progression, but may provide some symptomatic benefit.

43. Treatment After Diagnosis
• The person with Alzheimer’s will
need good medical follow-up
throughout the course of the
disease.
• If he/she experiences delusions or
great psychological stress, careful
use of drugs to treat these
symptoms may be indicated.

44. • The life span of someone with Alzheimer’s can range from
under five to more than twenty years
• Families caring for a loved one with end-stage Alzheimer’s
should give thoughtful consideration to placement in a skilled
nursing facility where adequate management and supervision
can be provided.
Treatment After Diagnosis

45. DRUGS

46. ThankYouFor
Attention.

47. ARE THERE ANY
QUESTIONS?

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