Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Alzheimer’s dementia ++ 331.0 Alzheimer’s disease ++ G30.9 Alzheimer’s disease, unspecified ++ 5E: Impaired motor function and sensory integrity associated with progressive disorders of the central nervous system +++ Description ++ A degenerative neurologic disorder characterized by progressive dementia Results in inability to care for oneself or interact in the environment +++ Essentials of Diagnosis ++ Insidious onsetGradual development of forgetfulness that degenerates into other failures of cerebral functionConcise pathology that accounts for 50% of all dementia cases2 +++ General Considerations ++ Definitive diagnosis is made upon autopsy Imaging in late stages of the disease reveals hippocampal and frontal lobe atrophyEarly in the disease process, all other possible causes of dementia are ruled out in order to diagnose Alzheimer’s disease +++ Demographics ++ Onset primarily occurs at age 60 years and olderWomen 3 times more likely than menWeak genetic link; most commonly idiopathic +++ Signs and Symptoms ++ Loss of cognitive function, most commonly in the following sequenceAbstract thinkingJudgment and problem-solvingLanguage for communicationPersonality changes Eventually the person loses ability to perform self-care or ADLsAlthough the ability to perform automatic movements is maintained, the understanding of purpose behind the activities is lostAs the person loses this understanding, he/she may participate in less physical activity, resulting in disuse atrophy +++ Functional Implications ++ Loss of Interaction in the environmentMemory and goal-directed behaviorIndependence with ADLsStrength and mobility +++ Possible Contributing Causes ++ Unknown, primarily idiopathic +++ Differential Diagnosis ++ Stroke (multi-infarct dementia)Tumor Subdural hematoma HydrocephalusDementia of AIDS Paraneoplastic limbic encephalitisNutritional deficiencies Metabolic disorders Pseudodementia of depression Supranuclear palsy Lewy-body disease Age-related dementia +++ Laboratory Tests ++ CSF for protein analysisNeuropsychologic testing +++ Imaging ++ CT of the BrainMRI of the BrainSPECT for hypoperfusion in the parietal and temporal regions PET scan for abnormal brain proteins +++ Diagnostic Procedures ++ EEG for brain function ++ In advanced stages of Alzheimer’s disease, MRI will show frontal lobe atrophyIn early stages, EEG may show resting alpha frequency declinesMost imaging and tests are designed to rule out other causes of the apparent dementia +++ Medication ++ Aricept ++ To neurologist for imaging, disease management, medicationTo social worker for family support and coordination of careFor occupational therapy (home management and ADLs)To hospice for end-of-life care ++ ArousalAttentionBehaviorCognitionGait training (late-stage)Wheelchair (w/c) mobility (late-stage)BalanceStatic sit (late-stage)Dynamic sit (late-stage)Static ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.