Wednesday, March 2, 2011
The History: Auguste D. and Dr. Alois Alzheimer
While working in a Frankfurt asylum for the mentally ill in 1901, Alois worked with a woman in her late 40's suffering from short term memory loss and "strange behavioral symptoms."
Auguste D. died in 1906. Alois performed the autopsy and, with the help of a new staining technique, he was able to identify the Beta-Amyloid Plaques and Neurofibrillary Tangles that would one day be synonymous with AD.
Alois first called this "Pre-senile Dementia."
What's AD?
AD is the most common form of Dementia, the general term to describe memory loss and the impact on cognitive functioning serious enough to effect daily life.
AD is a degenerative disease, resulting in increased impairment in the sufferer up until death.
AD has no current cure or consensus on its cause but there are a limited number of humble treatments available that can temporarily slow cognitive decline.
Causes...maybe.
There are no known causes of Alzheimer's disease, but these conditions are always present in AD sufferers.
The Amyloid Cascade Hypothesis
--Fragments of the protein Amyloid cleave off, forming the Beta-amyloid protein, that ultimately bunches and forms sticky plaques along neurons resulting in the neurons death.
Neurofibrillary Tangles
--Breakdown of the protein Tau along the microtubules ( neuro pathways) in neurons resulting in the cessation of any neural transmission. If a Train is a neurotransmitter than the tracks are the microtubules. Trains need tracks.
Breakdown of the Neurotransmitter Acetylcholine
--Most likely not a cause but most AD patients suffer from a lack of this neurotransmitter most responsible for memory and learning. Acetylcholine is broken down by the enzyme Acetylcholinesterase. The primary treatment of AD is limiting the abundance of this enzyme.
Acetylcholinesterase Inhibitors and Friend.
Aricept(donepezil)-Prevents the breakdown of acetylcholine in the brain. Mild Side Effects: Nausea, vomiting. 80% see improved cognitve functioning for up to two years.
Razadynde(galantamine)- Cholinesterase inhibitor that also can stimulate nicotonic receptors in the brain that can spur the release of more acetylcholine. Side Effects include potentially harmful effect on liver and kidneys.
Exelon(rivastigmine)-Similar to Aricept. Only 25-30% of Recipients see cognitve improvements but the drug has shown zero liver toxicity.
Namenda(memantine) Antagonist that blocks the toxic effects associated with excess glutamate and regulates glutamate activation. Side Effects include dizziness, headache, and confusion. Often prescribed with Aricept for Moderate to Severe stages.
Taking Care of the Caregivers
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