Alzheimer’s Disease:

Piecing Together the Evidence Click & Learn

Student Worksheet

OVERVIEW
This worksheet complements the Alzheimer’s Disease: Piecing Together the Evidence Click & Learn.

PROCEDURE
Follow the instructions below and answer the questions in the spaces provided. All answers can be found in the
Click & Learn, but you may also wish to conduct additional research.

PART 1: What you already know

Before you start the Click & Learn, share what you know about Alzheimer’s disease by answering the following
questions.
1. What are the symptoms of Alzheimer’s disease?
Dificultad para concentrarse, planificar o resolver problemas; Problemas para completar tareas
diarias en el hogar o trabajo; confusión con respecto a los lugares o el paso del tiempo;
dificultades visuales; mal juicio al tomar decisiones; cambios de humor, depresión u otros
cambios en el comportamiento y la personalidad.

2. How is Alzheimer’s disease treated?

Los medicamentos son el donepezilo, galantaminas y rivastigmina.

3. What causes Alzheimer’s disease?

La enfermedad familiar de inicio temprano la causa cualquiera de una serie de mutaciones de
un solo gen en los cromosomas 21,14 y 1.

Now begin the interactive and answer the following questions as you progress through each section.

PART 2: Introduction to Alzheimer’s Disease

1. Watch the video on the slide entitled “Do you know somebody with Alzheimer’s disease?” Then list at least
three symptoms of Alzheimer’s disease described in the video.
1.- Desorientacion
2.-Incapacidad para denominar objetos comunes
3.-Discapacidad para discriminar bien cosas o personas
4.-Delirios, alucinaciones y agitacion
5.- Afectacion de funciones basicas como la motora y regulacion de organos internos.

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2. Proceed to the next slide entitled “Alzheimer’s causes loss of memory and thinking skills” that shows a
diagram of the symptoms and stages of Alzheimer’s disease.
a. What does it mean that Alzheimer’s disease is a progressive disease?
Porque empeora con el tiempo, en la que los sintomas de demencia empeoran gradualmente
con el paso de los años.

b. Read the symptoms for mild, moderate, and severe Alzheimer’s disease. Based on the symptoms Greg
O’Brien described in the first video, at what stage is his disease? Use evidence to support your
reasoning.
moderada

3. Next, watch the video about how Alzheimer’s differs from normal aging. According to the study referenced
in the video, if you are a person who does not appear to have evidence of neurological disease or memory
loss at age 70, what is the percent chance that you will develop Alzheimer’s disease?
Tendria menos probabilidad de presentar la enfermedad ya que no hay antecedentes en mi
familia.

4. Proceed to the slide with the graph entitled “Projected Number of People with Alzheimer’s Disease in the
United States.”
a. Define the term dementia.
Es la perdida o debilitamiento de las facultades mentales, generalmente grave y progresivo,
debido a la edad o a una enfermedad.

b. Write a sentence to explain how dementia and Alzheimer’s disease are related.
La demencia no es una enfermedad especifica.

c. Currently, about how many people in the United States over the age of 65 suffer from Alzheimer’s
disease?
aproximadamente más de 20 millones de personas.

5. Click on the graph to switch the image to a second graph entitled “Projected Number of People Over the Age
of 65 in the United States.” You can switch back and forth between the graphs by clicking on the image.
a. What is projected to happen to the number of people with Alzheimer’s disease and the number of
people over age 65 in the United States over the next 40 years?
Que aumente la cantidad de personas que la padecen.

b. Based on the information provided, can you think of an explanation for the trends identified in the
question above?
Como es una enfermedad que depende mucho de la carga genetica no habrá un control para
erradicarla, si no solo llevar un tratamiento para conservación.

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6. Proceed to the next slide with the puzzle pieces and the heading: “There is no treatment for Alzheimer’s
disease.”
a. What is a drug target? Why is it important to identify a drug target to treat a disease?
Es importante el uso adecuado de los medicamentos para aliviar los sintomas que se esten
padeciendo o curar la enfermedad que se este sufriendo.

b. What are currently available treatments for Alzheimer’s able to do? Not able to do?
Los medicamentos actuales pueden ser de ayuda durante un tiempo para los sintomas que
afectan la memoria y para otros cambios cognitivos, pero no cura la enfermedad.

7. Proceed to the slide where you write down your research questions and ideas. Write down at least three
questions or ideas either in the Post-it notes in the Click & Learn or in the space below. They may go in any
of the categories listed. If you write your questions/ideas in the Click and Learn, take a screen shot of what
you wrote.
¿como ayudan los ejercicios mentales a los pacientes con alzheimer?
¿Es necesario preservar la colinesterasa?
¿Como aumentar los niveles de comunicacion entre las celulas?

PART 3: Evidence from different research areas

Work through the three modules (Anatomy, Genetics, and Histology) to examine the evidence studied in
different areas of research to better understand Alzheimer’s disease. Record your responses to the questions
from each module in the appropriate section below.

Anatomy
1. What is an autopsy and why would one be performed?
Es ele studio y examen de los organos, tejidos o huesos de un cadaver para averiguar o
investigar la cause de muerte, se realiza para seguir estudiando la enfermedad y tener un
mejor avance en los estudios y tal vez encontrar un mejor tratamiento.
2. Proceed to the slide with images of brains from Alzheimer’s patients and age-matched controls.
a. What is an age-matched control? Why is it important to include in this type of study?
Es la seleccion de controles en función de una o varias caracteristicas comunes. Tiene como
ventaja aumentar la eficiencia estadistica y disminuir el sesgo asociado a factores de confusion
conocidos.
b. Identify three difference(s) between the brain of someone with Alzheimer’s disease and a normal brain
of someone the same age.
La persona con alzheimer tiene disminuida la masa cerebral, reduccion del hipocampo,muerte
de neuronas; los ventriculos se vuelven m'as grandes.

3. Proceed to the slide with the video.

a. Where in the brain does Alzheimer’s disease start?
Parece que la enfermedad comienza en el hipocampo y la corteza entorrinal.

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b. How does this relate to the symptoms that patients with Alzheimer’s disease experience?
Como el encogimiento es severo en el hipocampo y esta es un area clave para la formacion de
nuevos recuerdos, el paciente comienza a olvidar las cosas recientes.

4. Proceed to the next slide. If you want to make any changes to your notes at the end of the section, make
sure to do so. Take a screen shot after you have added your questions/ideas or write them below.

Genetics
1. Read the information in the first three slides until the description of the APP protein.
a. Researchers have found that the gene that codes for APP is on which chromosome?
En el cromosoma 21

b. Does everyone have a copy of this gene? Explain your answer.

No, solo las personas que tengan antecedentes familiares con esta enfermedad.

2. Proceed to the slide that shows how APP is cut to produce beta amyloid. What is the relationship between
beta amyloid and APP?
La beta amiloide se produce por una escisión anomala de la proteína precursora de amiloide

3. Review the information about mutations. Which do you think would be more likely to have an effect on
protein function: a silent mutation or a missense mutation? Explain your answer.
Una mutacion sin sentido, porque la silenciosa no hace ningun efecto.

4. Compare the DNA sequences of individuals with Alzheimer’s disease and their family members. Two codons
in the APP gene sequence are different in the two patients with Alzheimer’s disease compared to individuals
without the disease. Consider the first codon that’s different and complete the table below.

Codon in Codon in
Amino Acid
DNA template strand mRNA
APP gene in individuals
without Alzheimer’s
3'end GUC-AUA-GCG- METIONINA
(CAG-TAT-CGC-TG
disease
APP gene in individuals
3'end (CAT-TAT-CG AUC-GUC-AUC ISOLEUCINA
with Alzheimer’s disease

Does the change in this codon represent a silent or a missense mutation? Explain.
Una mutacion silenciosa

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5. Consider the second codon that’s different and complete the table below.
Codon in Codon in Amino Acid
DNA template strand mRNA
APP gene in individuals
3'end GUC-AUA-GCG- METIONINA
without Alzheimer’s
(CAG-TAT-CGC-TG
disease
APP gene in individuals
3'end (CAT-TAT-CG AUC-GUC-AUC ISOLEUCINA
with Alzheimer’s disease

Does this change in codon represent a silent or a missense mutation? Explain.

Una mutación silenciosa

6. Consider what you discovered about the types of mutations in questions 4 and 5. How could these types of
mutations result in Alzheimer’s disease?
La secuencia de ADN determina la secuencia de aminoacidos en las proteinas.

7. Proceed through the rest of the interactive, until you reach the slide with a pedigree. Has Alzheimer’s
disease been associated with genes other than APP? Provide evidence from the interactive that supports
this claim.
Las mutaciones en el gen APP pueden dar lugar a un aumento de la cantidad del peptido Beta
amiloide o a una formas mas larga del peptido

8. Proceed to the next slide.

a. Does Alzheimer’s disease always have an autosomal dominant inheritance pattern? Provide evidence
that supports this claim.
solo el 1%, ya que es más probable que sea causada por la combinacion de diferentes genes.

b. Is Alzheimer’s disease always linked to a mutation in a single gene? Provide evidence that supports this
claim.
no, puede ser por la combinacion de distintos genes.

c. Do doctors always know exactly what causes an individual’s Alzheimer’s disease? Provide evidence that
supports this claim.
No, porque hay muchos factores ambientales que aumentan el riesgo de contraer la
enfermedad.

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9. Proceed to the last slide with the notes. If you want to make any changes to your notes at the end of the
section, make sure to do so. Take a screen shot after you have added your questions/ideas or write them
below.

Histology
1. Proceed to the slide with the images of the histology (tissues) of a normal brain and a brain with Alzheimer’s
disease. List two differences that you notice.
Hay menor numero de neuronas y por lo tanto menor numero de conexiones.

2. Proceed to the slide with the video. Watch the video and read the information in the following three slides.
a. How are plaques related to beta amyloid?
Que las placas estan compuestas de beta amiloides y estas interfieren en la comunicación
entre las neuronas.

b. How are tangles related to tau?

Los enredos estan formados por la proteina llamada Tau y hacen que las neuronas mueran.

c. How are plaques and tangles related to the symptoms of Alzheimer’s disease?
Las placas interfieren en la comunicación y los tangles hacen que las neuronas mueran, por lo
tanto ayudan a la enfermedad con el deterioro cerebral.

3. Proceed to the last slide with the notes. If you want to make any changes to your notes at the end of the
section, make sure to do so. Take a screen shot after you have added your questions/ideas or write them
below.

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PART 4: Drug Development (Optional)

1. Which molecules did you identify as possible targets for a drug to treat Alzheimer’s disease, and why did you
choose those targets?
Inhibidores de la colinesterasa, para retardar la degradacion metabolica de la acelticolina y así
evitar la progresión del deterioro cognitivo.

2. After watching the video, would you revise your answer above? If yes, how?
No.

3. Proceed to the slide describing the phases of the U.S. drug development process and click on the image to
expand it. List one thing that surprised you about the drug development process and explain why it was
surprising.
La fase preclinica donde se hacen estudios en animales y ver si funciona, cuales son los
efecto secundarios y así tratar de que sean lo menos dañino para el ser humano.

4. Consider the three drugs that are currently in clinical trials for the treatment of Alzheimer’s disease. Based
on what you learned in this interactive, do you think each of these drugs would be more likely to treat a
patient with symptoms of mild, moderate, or severe Alzheimer’s disease? Explain your answer.
si, porque es importante estar estudiando y actualizando la informacion, el pro de las personas
con alzheimer

5. Proceed to the slide with the video of Dr. Rudy Tanzi. How is neuroinflammation related to Alzheimer’s
disease? In your response, include how glial cells are involved in this process.
La inflamacion esta involucrada en multiples mecanismos patologicos, y estudios muestras
que la inflamacion y activación microglial preceden al daño neuronal.

6. Proceed to the final slide. If you want to make any changes to your notes at the end of the section, make
sure to do so. Take a screen shot after you have added your questions/ideas or write them below.

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PART 5: Apply Your Knowledge

After completing the Click & Learn and answering the questions in Parts 1 through 4 of this worksheet, use this
information to consider the following scenarios and answer the associated questions. (Note: These are made-up
scenarios based on published scientific studies and patient stories.)

Scenario 1
Carol recently turned 50 and is worried about developing Alzheimer’s disease. Her mother suffered from
Alzheimer’s before she passed away at age 68, but her father is now 82 years old and has never shown
symptoms. Carol has had genetic testing, and doctors found that she has the same APP mutation as her mother.
1. Based on this information, what is the likelihood (percentage) that Carol will develop Alzheimer’s disease?

2. Is it possible that Carol may develop Alzheimer’s later in life but doesn’t show any signs now? Explain.

3. Carol has a sister who has not been tested for the APP mutation. What is the likelihood (percentage) that
Carol’s sister has the same APP mutation as Carol and their mother?

Scenario 2
David is 58 and starting to lose things and forget words. Neither of David’s parents had Alzheimer’s disease.
David’s children are concerned that he might be developing Alzheimer’s disease.
1. The doctor diagnoses David with dementia. Does this mean that he has Alzheimer’s disease? Explain your
answer.

2. Given his family history, is David likely to have an APP mutation associated with Alzheimer’s disease? Explain
your answer.

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Scenario 3
Linda just turned 73 years old, and her doctor has diagnosed her with Alzheimer’s disease. Although her family
does not have a history of the disease, her children insisted that Linda get tested for genetic mutations related
to Alzheimer’s disease. The results showed that she does not have any mutations known to cause Alzheimer’s
disease.
1. How can you explain that Linda has Alzheimer’s disease but she does not have any mutations linked to the
disease nor a family history of it?

Scenario 4
Three of Jermaine’s biological grandparents suffer from Alzheimer’s disease. Although Jermaine is only 23 years
old, he is concerned that he might have the disease one day. He has had genetic testing and found that he has
two mutated copies of the gene presenilin-2.
1. What is the function of the presenilin-2 protein?

2. What is the likelihood (percentage) that Jermaine will develop Alzheimer’s disease? Explain your answer.

3. Jermaine is interested in participating in a clinical trial for treating Alzheimer’s disease before he develops
any symptoms. Describe a potential treatment for his disease and why it may or may not work.

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