Alzheimer's Disease

Etiology

Diagnosis

Signs and Symptoms

Care Management Strategies

Caregiver Support

References

Post-Test

Etiology

There are over 100 conditions that can look like AD. We really don’t know what causes AD. Researchers are trying to determine what causes the characteristic senile plaques and neurofibrillary tangles found in the brains of people with AD. These brain changes eventually contribute to nerve cell death. These changes may occur as a result of a deficiency of the neurotransmitter acetylcholine or the overproduction of beta-amyloid precursor protein. Researchers are also looking at phosphorylated tau protein and apolipoprotein E as significant in causing brain damage. They are also looking at genetic components, viral etiologies and the role of head trauma in the development of AD. AD is the most common cause of dementia. Dementia is defined as a loss of intellectual capacity of sufficient severity to interfere with social and occupational functioning and the performance of activities of daily living (ADL’s). Three-fourths of the most common causes of dementia are AD (60%) and vascular dementia (15%). Some may have heard vascular dementia referred to as, “hardening of the arteries.” A more accurate term would be multi-infarct dementia or brain damage that occurs as a result of having several small strokes or brain attacks.

 Delirium is a condition that can occur when an older adult is stressed by an acute illness, surgery or hospitalization. The signs and symptoms of delirium are often confused with AD. Delirium has an acute onset. The person has a short attention span and has difficulty following directions. The person may be disoriented to person, place or time. Delirium is a reversible condition. Lamy (1980) describes some of the most common causes in the acronym DEMENTIA. Look at these when you work with a patient who has a sudden rapid change in mental status.

Drugs (analgesics, psychotropics, steroids)

Emotional disorders (depression)

Metabolic/endocrine disorders (thyroid, liver problems)

Eye/ear dysfunction

Nutritional deficiencies (B-12 deficiency)

Tumor/trauma (subdural hematoma)

Infections (urinary tract infection, pneumonia)

Arteriosclerotic complications (heart attack, congestive heart failure)

Other causes of delirium include; dehydration, hypoxia, urinary retention, fecal impaction and change in environment.