Aging PD AD Notes

8/2/2019 Aging PD AD Notes

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Alzheimers disease &

Parkinsons disease


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Lecture Outline

Aging & the brain

Alzheimers disease

Parkinsons disease


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The Aging Brain

Maximum weight20 years of age

Slowly loses weight (10% over a lifetime)


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Aging Neurons

Rate of change may be slowed by

lifestyle factors

Weight

Education

Exercise

Rest

HypertensionStress

Head trauma


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Cause of Aging Brain: A Mystery

Genetic? Aging genes are turned on? Hormonalinfluences? Immune systems awry? Accumulation ofdamage caused by cell byproducts that destroy fats andproteins vital to normal cell function?

Majority are forgetful in old ageEspecially forming memories of recent events --Not a disease.

~ 1/3 population -- do well even in old age


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Cognitive Decline Associated with Aging

Park et al. Psychology & Aging, 2002


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Dementia

Deterioration of mental functioning

Common forms

Alzheimers disease

Multi-infarct dementia

Incidence


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Alzheimers Disease


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Alzheimers Disease

Progressive and fatal brain disease

Affects > 5 million Americans

Destroys brain cells

7th-leading cause of death in the United States

No cure. Treatments for symptoms.

www.alz.org


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Alzheimer's and the brain

Brains change as we age: slowed thinking and occasionalproblems remembering certain things

Serious memory loss, confusion are not a normal part of aging

May be a sign that brain cells are failing

The brain has 100 billion nerve cells.Nerve cell networks have special jobs

In Alzheimers disease, parts of the cells factory stop running well


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Signal Coding

Reading words Hearing words

Thinking about words Saying words


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Alzheimers Changes the Whole Brain


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Hallmarks of Alzheimers DiseaseTangles & Plaques

Plaques: abnormal build-ups, in spaces between nerve cells

Tangles: abnormal collections, inside neurons


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Alzheimers DiseaseA Progressive Disorder

Learning & memory

Thinking & planningSpeaking

Understanding speech

Sense of where your body

is in relation to objects around you


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10 Warning Signs of Alzheimer's

1.Memory loss.Forgetting recently learned information

What's normal?Forgetting names or appointments occasionally.

2. Difficulty performing familiar tasks.Lose track of the steps involved in preparing a meal, placing a telephone callor playing a game.

What's normal?Occasionally forgetting why you came into a room or whatyou planned to say.

3. Problems with language.Often forget simple words or substitute unusual words

What's normal?Sometimes having trouble finding the right word.

4. Disorientation to time and place.

Lost in their own neighborhoodWhat's normal? Forgetting the day of the week or where you were going.

5. Poor or decreased judgment.Dress inappropriately, give away large sums of money to telemarketers.

What's normal? Making a questionable or debatable decision from time totime.


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10 warning signs of Alzheimer's II

6. Problems with abstract thinking.Performing complex mental tasksWhat's normal? Finding it challenging to balance a checkbook.

7. Misplacing things.Put things in unusual places

What's normal? Misplacing keys or a wallet temporarily.

8. Changes in mood or behavior.Rapid mood swingsfrom calm to tears to angerfor no apparent reason.

What's normal? Occasionally feeling sad or moody.

9. Changes in personality.May become extremely confused, suspicious, fearful or dependent on a familymember.

What's normal?Peoples personalities do change somewhat with age.10. Loss of initiative.

May become very passive, sitting in front of the TV for hours, sleeping morethan usual or not wanting to do usual activities.

What's normal? Sometimes feeling weary of work or social obligations.


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The Difference Between Alzheimer's and

Normal Age-Related Memory Changes

Alzheimer's diseasesymptoms

Forgets entire experiences

Rarely remembers laterIs gradually unable to followwritten/spoken directions

Is gradually unable to use notesas reminders

Is gradually unable to care for

self

Normal age-related memorychanges

Forgets part of an experience

Often remembers laterIs usually able to followwritten/spoken directions

Is usually able to use notes asreminders

Is usually able to care for self


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Alzheimer's brainNormal brain


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Risk Factors

Age Family History

Genetics

Risk factors you may influence Head injury

Heart-head connection

Monitor: high blood pressure, heart disease, stroke, diabetes,high cholesterol

Healthy aging

Maintain weight, avoid tobacco & excess alcohol, stay sociallyconnected, exercise body & mind


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Parkinsons Disease


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Shaking Palsy


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Epidemiology

Incidence

> 1 million people in US

~1% > 55 years

Onset mean 62.4 years (35-85)

rare before age 30; 4-10% cases before age 40

Course of disease

10-25 years

Male >= Female

www.wemove.org


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Basal Ganglia


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Parkinsons Disease

Pathology


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Parkinsons DiseaseEtiology

Entirely genetic

< 15%

Entirely toxic

< 2%

Environmental factors in

susceptible individuals


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Risk Factors

Definite risk factors

Old age

MPTP

Possible risk factors

Herbicides, pesticides (mitochondrial toxins)

Heavy metal exposure

Wood preservatives

Proximity to industry, rural residence, well water use

Head trauma Possible protective factors

Smoking (risk 60% less for current smokers; risk reduction even inmonozygotic twins)

Caffeine


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PD Treatments

DrugsLevodopa (L-dopa) Dopamine neurons use l-dopa to synthesize dopamine

Dopamine Mimetics

Enzyme Inhibitors Increases dopamine availability

Transplantation

Surgery


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Transplantation:A possible therapy for PD

Normal

Parkinsons disease

Pre-transplant

Post-transplant


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Alternative Treatments for PD

Surgical Procedures

Thalamotomy

Reduces tremors

Pallidotomy

Improves tremors, rigidity, andbradykinesia

Deep Brain Stimulation

Improves bradykinesia, rigidity,tremors

Diet

Vitamin E: no obvious benefits

Exercise

Improve body strength & mobility

Documents

Aging PD AD Notes