Alzhmier's Disease

1. Alzhmier's Disease
Presented By Miss Sudipta Roy
Designation : Associate Professor
East Point College Of Pharmacy , Bangalore

2. • Pathologist Alios Alzheimer first described and is
therefore named after him.
• Alzheimer's disease (AD) is the most common form
of dementia.
• Alzheimer's Disease is an irreversible progressive
neurodegenarative disease that slowly destroys
memory and thinking skills and ability to carry out
the simplest tasks.
• Alzheimer's Disease is a chronic neurodegenerative
disease that usually starts slowly and characterized
by difficulty in remembering recent events. It is
characterized by short term memory loss, poor

3. • Dementia :
• Dementia is the loss of intellectual abilities such as
thinking ,rememberin and reasoning that is severe
enough to interface with daily functioning.
• It occurs in patients above age of 65 years. A person
with AD has a gradual decline in mental functions,
begining with slight memory loss, followed by losses in
the ability to maintain employment , to plan and
execute familiar tasks and to reason and exercise
judgment.
• Communication ability , mood and personality are also
affected .AD is the fourth leading cause of death in
adults after heart disease, cancer and stroke.

4. Triggering Factors.
The cause has genetic links . AD destroys neurons
(nerve cells) of the brain that control memory ,
including hippocampus that controls short-term
memory leading to short term memory failure, and
there is a decrease in ability to perform familiar tasks.
Later on , it affects the cerebral cortex, responsible for
language and reasoning with the loss in ability to make
judgements. Personality changes occur that include
emotional outbursts, wandering and agitation. The
severity of thes changes increases with disease
progression. Slowly many other areas of the brain get
involved , the brain shrinks and loses function thus
person becomes bedridden , incontinent , helpless and
non-responsive.

5. • Other factors are :
• Age
• Gender ( Female shows more risk to develop AD)
• Family History
• Head Injury
• Genetics
• Down Syndrome (extra copy of chromosomes)

6. Pathophysiology.
• Alzheimer's disease is associated with brain
shrinkage and localized loss of neurons mainly in
the hippocampus and basal forebrain. The loss of
cholinergic neuron in the hippocampus and frontal
cortex is a feature of the disease and is thought to
underline the cognitive deficit and loss of short
term memory that occur in AD.
• Two microscopic features are characteristic of the
disease, namely extracellular amyloid plaques
consisting of extracellular deposits of β-amyloid
protein and intra neuronal neurofibrillary tangles
comprising filaments of phosphorylated from of a

7. • Due to the etiological factors : Changes occur in the
proteins of the nerve cells of the cerebral cortex :
Accumulation of neurofriabrility tangles and
plaques : Granulo vascular degeneration: loss of
cholinergic cell : Loss of memory , function and
cognition.
• Clinical Manifestation:
• The early signs of the disease include forgetting
recent events or conversations . As the disease
progresses , a person with Alzheirmer's Disease
will develop severe memory impairment and lose
the ability to carry out everyday tasks.

8. • Other symptoms include :
• Memory lapses (Forgetting)
• Repeat statements and questions over and over.
• Have trouble finding the right words to identify , express thoughts or take
part in conversations.
• Inability to perform routine tasks.
• Loss of judgement.
• Personality or behaviour changes.
• Trouble sleeping .
• Difficulty concentrating and thinking.
• Preserved skills : Many important skills are preserved for longer periods
even while symptoms worsen . Preserved skills may include reading or
listening to books , telling stories and reminiscing , singing , listening to
music , dancing , drawing or doing crafts . These skills may be preserved
longer because they are controlled by parts of the brain affected later in the
course of the disease.

9. Diagnosis.
• Physical Exam.
• Blood Test .
• To rule out other potential causes of memory loss
and confusion , such as thyroid disorder or vitamin
deficiencies.
• Brain imaging .
• Imaging of bran structure include the following:
• 1. Magnetic Resonance Imaging (MRI) : MRI uses
radio waves and a strong magnetic field to produce
detailed images of the brain. While they may show
brain shrinkage of brain regions associated with

10. Computerized Tomography . (CT)
• A CT scan , a specialized X-ray technology , produces
cross-sectional images (slices) of brain. It's usually
used to rule out tumors , strokes and head injuries.
• Positron Emission Tomography (PET) :
• Imaging of disease processes can be performed with
positron emission tomography (PET) . During a PET
scan , a low level radioactive tracer is injected into
blood to reveal a particular feature in the brain . PET
imaging may include the following :

11. • Fluorodeoxyglucose (FDG) PET : It show areas of
the brain in which nutrients are poorly metabolized
. Identifying patterns of degenaration areas of low
metabolism can help distinguish between
Alzheimer's disease and other types of dementia.
• Amyloid PET Imaging : It can measure the burden of
amyloid deposits in the brain. This imaging is
primarily used in research but may be used if a
person has unusual or very early onset of dementia
symptoms.
• Tau PET Imaging : It measures the burden
neurofibrillary tangles in the brain is generally used

12. Treatment .
• 1. Non-Pharmacological Treatment : Alzheimer's
Disease is not a preventable condition.
• Lifestyle risk factors for Alzheimer's:
• Exercise regularly.
• Eat a diet of fresh produce, healthy oils and foods low
in saturated fat such as a Mediterranean diet.
• Follow treatment guidelines to manage high blood
pressure , diabetes and high cholsterol.
• Avoid Alcohol
• Avoid Smoking
• Engaging in intellectual Activities .

13. • 2. Pharmacological Treatment.
• Alzheimer's medication can help for a time with
memory symptoms and cognitive changes. Two types
of drugs are currently used to treat cognitive
symptoms.
• 1. Cholinesterase Inhibitors :
• These drugs work by boosting levels of cell-to-cell
communication by preserving a chemical messenger
that is depleted in the brain by Alzheimer's Disease .
These are usually the first medications tried , and most
people see modest improvements in symptoms.
• Example : Donepezil , galantamine and rivastigmine.

14. • 2.Memantine (Namenda):
• This drug works in another brain cell communication
network and slows the progression of symptoms with
moderate to severe Alzheimer's Disease . It's
sometimes used in combination with a cholinesterase
inhibitor.
• Aducanumab (amyloid beta-directed monoclonal
antibody ) : In june 2021 , the Food and Drug
Administration (FDA) approved aducanumab (Aduhelm)
for the treatment of some cases of Alzheimer's disease.
This is the first drug approved in the United States to
treat the underlying cause of Alzheimer's by targetting
and removing amyloid plaques in the brain.