Lecture 13 Alzheimer's Disese and Related dementias Flashcards
(16 cards)
Dementia
is a clinical syndrome characterized by difficulties with memory, language, problem-solving and other thinking skills. Dementia is caused by several different types of neuropathology
Alzheimer’s Disease
is one cause of dementia. The brain changes indicative of Alzheimer’s disease are the most common contributor to dementia
Prevalence of Alzheimer’s disease
Alzheimer’s Disease is the 7th leading cause of death in the U.S.
•1 in 9 adults over age 65 and 1 in 3 adults over age 85 have Alzheimer’s Disease dementia
•Aging population is growing, making dementia a serious public health concern
Beta-Amyloid plaques:
buildup of
protein fragments between neurons
Tau tangles:
buildup of tau protein
within neurons
Neurodegeneration:
damage to and
destruction of neurons
Cognitive Resilience
the ability of
some individuals to maintain cognitive
function despite presence of
dementia-related neuropathology.
Not everyone who has Alzheimer’s
Disease neuropathology have clinical
symptoms or impairment
Dementia is a
progressive clinical syndrome involving changes
in memory and thinking
* Dementia is caused by neuropathology, which can accumulate
for years or decades before symptoms
* Not everyone with neuropathology develops dementia
* Normative cognitive aging may be due to a combination of the
aging process and disease; difficult to disentangle
Uncontrollable Risk Factors
Age
* Genes
* APOE gene — e2, e3 or e4
* Trisomy 21 in Down Syndrome
* Genetic mutations and young onset AD
* Family history of dementia
Dementia Disparities
Black older adults are ~2x as likely as White older adults to
have dementia
* Hispanic/Latino older adults are ~1.5x as likely as non-
Hispanic/Latino White older adults to have dementia
* Why?
19
Prevention:
Hispanic/Latino Dementia Disparities
* ECHAR Network
Culturally-competent network that uses community-engaged
methods to identify ways to prevent dementia by increasing
awareness in Hispanic/Latino community
* Telenovela: Recuerdos De Mi Abuel
Modifiable Risk Factors
Account for ~45% of dementia risk
* Socioeconomic factors
* Particularly education in early life
* Cardiovascular and metabolic health
indicators
* Cholesterol, hypertension, excess fat,
diabetes
* Health behaviors
* Physical inactivity, smoking, excessive
alcohol
* Psychosocial factors
* Depression, social isolation
* Environmental factors
* Air pollution
* Age-related losses
* Hearing and vision loss
Primary uncontrollable risk factors for AD are
age, genetics,
race/ethnicity, and family history
* Health disparities due to systemic injustice/oppression and
differential exposure to modifiable risk factors
* Targeting modifiable risk factors which account for ~45% of AD
risk is a promising avenue that psychologists can contribute to
Drug Treatments
The FDA has approved 8 drug treatments
* 5 affect neurotransmitters and are aimed at improving symptoms
* 3 recently approved IV infusion therapies change the underlying
biology of the disease (i.e., anti-amyloid)
* Existing treatments are not a cure
* Limitations
Non-Drug Treatments
Three general aims:
* increasing quality of life while living
with dementia
* increasing functional abilities
* reducing behavioral and
psychological symptoms
* E.g., physical activity, memory and
orientation exercises, and music-
and art-based therapies
Recent advances in biomedical treatments for dementia due to
Alzheimer’s Disease,
but currently no cure for the disease
* Psychosocial interventions and activities can support wellbeing
of people with dementia
* Aging in place safely or home-like approaches to memory care
may support wellbeing of people with dementia
