MCDB27 1

MCDB27 1 - ALZHEIMER’S DISEASE Dementia Senility • 0.8%...

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Unformatted text preview: ALZHEIMER’S DISEASE Dementia Senility • 0.8% of those 45–65 • 12% of those over 65 • 40-50% of those over 85 yr • Duration of AD is 3-20 yr; average = 8-10 yr Dementia irreversible & progressive decline in two or more spheres of cognition that affect activities of daily living memory loss impaired reasoning or judgment disorientation difficulty learning loss of language skills reduced ability to perform routine tasks--apraxia changes in personality and behavioral problems: agitation, anxiety, delusions, hallucinations Neurodegeneration Source: Terry et al. Alzheimer’s Disease. 1994: 179-196. Normal Brain Alzheimer’s Brain Brain weighed 1255 grams (2.77 lbs) Parasagittal atrophy Sulcal widening Senile plaques Neurofibrillary tangle Alois Alzheimer 1864-1915 1907—presented his case report Emil Kraepelin-named the disease in Book Psychiatrie in 1910 Auguste Deter died in 1906 at age 55 presenile dementia (early onset) Some quotes & terms: “I retain general, largely categorical memories of the past (a year spent in Spain; various visits to Indian restaurants on East 6th street), but relatively few specific episodic memories.” It seems to me lovely and post-modern. …after he retired, in 1981, they commenced a round-the-clock performance of “No Exit” in their comfortably furnished suburban house.” ….passivity…. sundowner …the medicalization of human experience… amnesic patients with primary damage to the hippocampus bilaterally were impaired in constructing new imagined experiences when given short verbal cues about simple commonplace scenarios. Willem de Kooning Mild Cognitive Impairment All definitions share the feature of cognitive impairment that does not impair instrumental activities of daily living (e.g., shopping, finances, cooking, household maintenance, and finding familiar locations). “…old age he was discovering arrived in increments of uncertainty. Street signs, rearview mirrors, and one’s own ability to improvise could no longer be trusted. He asked direction three times…” John Updike “Free” The New Yorker Jan 8, 2000 Typical PiB subjects Jack, C. R. et al. Brain 2008 The Nun Study People who challenge themselves intellectually can apparently delay or prevent the onset of Alzheimer's symptoms. 678 nuns — 7 convents in the same order, Sisters of Notre Dame prospectively followed for 15 years about half developed Alzheimer’s disease Sisters Claverine and Nicolette with their sibling Sister Mary Ursula, who has Alzheimer's symptoms. Sister Anne with UK First Lady Patsy Todd; UK President Dr. Lee T. Todd, Jr.; and Dr. David Snowdon, Director of the Nun Study Sometimes I feel like I'm 150, but I just made up my mind I'm not going to give up," says Sister Esther Boor, right, who is a dementia-free 106. Dr. David A. Snowdon examining brain sections. The study involves not only pathology on nuns, but also a study of autobiographical essays the nuns wrote in their 20's. idea density grammatical complexity 1. Sister Nicolette's essay:, "After I finished the eighth grade in 1921 I desired to become an aspirant at Mankato but I myself did not have the courage to ask the permission of my parents so Sister Agreda did it in my stead and they readily gave their consent." 2. Another Mankato nun in her late 90's with declining memory test scores. The nun’s essay: "After I left school, I worked in the postoffice." Education and dementia: what lies behind the association? 1. Brain reserve hypothesis--innate or early life factors 2. Brain-battering hypothesis: better-educated people may exercise more and eat better than poorly educated people, and therefore be better protected from dementia risk factors such as cerebrovascular infarcts. 3. Diagnostic bias: more highly schooled patients may score higher on dementia screening tests of cognitive ability Transgenic mice with senile plaques Enriched environment large cages, running wheels, colored tunnels, toys, and chewable material. A control group of animals was maintained for 5 months in standard housing conditions. Lemere Lab (unpublished Frontotemporal Lobar Degeneration • • • • • • • • • • Language disorder Perceptual disorder—prosopagnosia, other agnosias Loss of sympathy and empathy, narrowed preoccupations Loss of impulse control, lack of judgement Euphoria Early decline in social interpersonal conduct Repetitive compulsive behavior Akinesia, rigidity, tremor Decline in personal hygiene Apathy ...
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This note was uploaded on 01/25/2011 for the course MCDB 27 taught by Professor Kosik during the Winter '10 term at UCSB.

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MCDB27 1 - ALZHEIMER’S DISEASE Dementia Senility • 0.8%...

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