Alzheimer’s Disease

Published on 30/05/2015 by admin

Filed under Obstetrics & Gynecology

Last modified 30/05/2015

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Chapter 10 Alzheimer’s Disease

INTRODUCTION

Description: Alzheimer’s disease is a degenerative organic mental syndrome characterized by progressive intellectual deterioration and dementia—the most common form of dementia.
Prevalence: Five million cases annually, 40% of patients older than 85, seventh leading cause of death (2004).
Predominant Age: Older than age 65.
Genetics: 2-fold to 3-fold more common in women, increased familial risk (50% of patients). Markers have been found on chromosomes 1 and 14 for early onset and 12 and 19 for late onset.

ETIOLOGY AND PATHOGENESIS

Causes: Unknown. Proposed—slow virus, aluminum exposure, accelerated aging, autoimmune process, genetic alteration in amyloid production or metabolism.
Risk Factors: Aging, head trauma, Down syndrome, and family history.

CLINICAL CHARACTERISTICS

Signs and Symptoms

• Loss of mental function (calculation, abstraction, memory, aphasia)
• Social withdrawal (anhedonia, apathy, personality change, anxiety, depression)
• Delusions and confabulation
• Dementia
• Sleep disturbances and restlessness
• Behavioral change (aphasia, disorientation, disinhibition, violence or passivity)

DIAGNOSTIC APPROACH

Differential Diagnosis

• Dementia (vascular, infarct, Parkinson’s disease)
• Multiple sclerosis
• Brain tumor (primary or metastatic)
• Alcohol or drug use/abuse
• Drug reaction
• Depression
• Hepatic or renal failure leading to toxicity
• Neurosyphilis
• Hypothyroidism

Associated Conditions: Down syndrome, depression, and insomnia.

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