Question

1.  Define Alzheimer's disease and pre-Alzheimer's disease.

2.  Identify the risk factors and prevalence of Alzheimer's disease.

3.  Outline the course of Alzheimer's disease.

4.  Compare and contrast the Global Deterioration Scale stages 1 to 7.

5.  Discuss the main screening tools for Alzheimer's disease .

6.  Identify Functional Assessment Staging stages 1 to 7.

7.  Explain the psychopathology of Alzheimer's disease

8.  Describe the potential physiological complications of Alzheimer's disease.

9.  Relate the primary and differential diagnostic implications of Alzheimer's disease.

10.Define retro-genesis, and explain the evidence for retro genesis in Alzheimer's disease.

Answer 1

Ans) 1) Alzheimer's disease is defined as progressive mental deterioration that can occur in middle or old age, due to generalized degeneration of the brain. It is the commonest cause of premature senility.

- Early-onset Alzheimer's is an uncommon form of dementia that strikes people younger than age 65.

2) The disease likely develops from multiple factors, such as genetics, lifestyle and environment. Scientists have identified factors that increase the risk of Alzheimer’s. While some risk factors — age, family history and heredity — can't be changed, emerging evidence suggests there may be other factors we can influence.

- The prevalence of Alzheimer's dementia was 9.0%.

3) Alzheimer's disease typically progresses slowly in three general stages — mild (early stage), moderate (middle stage), and severe (late stage). Since Alzheimer's affects people in different ways, the timing and severity of dementia symptoms varies as each person progresses through the stages of Alzheimer's differently.

- People with cognitive changes caused by Mild Cognitive Impairment (MCI) have an increased risk of developing Alzheimer's or another dementia. However, not all people with MCI develop Alzheimer's.

- The symptoms of Alzheimer's disease worsen over time, although the rate at which the disease progresses varies. On average, a person with Alzheimer's lives four to eight years after diagnosis, but can live as long as 20 years, depending on other factors.
Changes in the brain related to Alzheimer's begin years before any signs of the disease. This time period, which can last for years, is referred to as preclinical Alzheimer's disease.

- The stages below provide an overall idea of how abilities change once symptoms appear and should only be used as a general guide. (Dementia is a general term to describe the symptoms of mental decline that accompany Alzheimer’s and other brain diseases.)

- The stages are separated into three categories: mild Alzheimer's disease, moderate Alzheimer's disease and severe Alzheimer's disease.

4) Global Deterioration Scale:

- Some health-care professionals use the Global Deterioration Scale, also called the Reisberg Scale, to measure the progression of Alzheimer's disease.

- This scale divides Alzheimer's disease into seven stages of ability.

Stage 1: No cognitive decline
Experiences no problems in daily living.

Stage 2: Very mild cognitive decline:

Forgets names and locations of objects.
May have trouble finding words.

Stage 3: Mild cognitive decline:

Has difficulty travelling to new locations.
Has difficulty handling problems at work.

Stage 4: Moderate cognitive decline:

Has difficulty with complex tasks (finances, shopping, planning dinner for guests).

Stage 5: Moderately severe cognitive decline:

Needs help to choose clothing.
Needs prompting to bathe.

Stage 6: Severe cognitive decline:

Loss of awareness of recent events and experiences.
Requires assistance bathing; may have a fear of bathing.
Has decreased ability to use the toilet or is incontinent.

Stage 7: Very severe cognitive decline:

Vocabulary becomes limited, eventually declining to single words.
Loses ability to walk and sit.
Requires help with eating.