Alzheimer's

B Y: G R A C E D I C A R L O
 • Brain disease

• Neurodegenerative/ progressive

• High risk

What is it?
Biology

• Amyloid plaques

• Cognitive defects

• Loss of neurons and connections

Fig 1. Drew, L. (2018). An age-old story of dementia. Retrieved

from https://www.nature.com/articles/d41586-018-05718-5
Amyloid plaques

• Toxic to neurons

• Beta-amyloid

• APP

• Neurofibrillary tangles

Fig 2. Bailey, D. (n.d.). Amyloid plaques and neurofibrillary tangles. Retrieved

from
https://thebrain.mcgill.ca/flash/d/d_08/d_08_cl/d_08_cl_alz/d_08_cl_alz.html
Biology- Stress
• HPA axis

• Increase amyloid levels & CSF

• Stress response, stressors

• Neurodegenerative disease

Fig 3. Lundbeck Institute. (n.d.). The hypothalamic-pituitary-adrenal (HPA) axis in depression.

Retrieved from https://institute.progress.im/en/content/hypothalamic-pituitary-adrenal-hpa-axis-
depression
Biology- Diet

• MIND

• Mediterranean diet

• Vitamins

• Digestive system

Fig 4. Jones, A. (2016). The “MIND” Diet Shows the Power of Food to Protect Against Alzheimer’s. Retrieved
from: https://annajonesrd.com/2016/11/24/the-mind-diet-shows-the-power-of-food-to-protect-against-alzheimers/
Epidemiology

• Global: 44 million (75% AD)

• U.S.: 5.5 million

• 6th leading cause of death

Fig 5. NIH. (2015). NIH meeting advances Alzheimer’s research agenda. 14(2). Retrieved from:
https://www.fic.nih.gov/News/GlobalHealthMatters/march-april-2015/Pages/nih-alzheimers-
research-summit.aspx
Onset

Early
• Rare, > 10% of people

Late
• 95% of all cases
• APOE allele

Fig 6. Fading Memories. (2019). You’re Too Good Looking To Have Alzheimer’s.
[Audio Podcast]. Retrieved from:https://fadingmemoriespodcast.com/youre-too-
good-looking-to-have-alzheimers/
Epidemiology- risk factors

• Age
• Atrophy, free radicles, late onset
• 5-8% over age 65

• 15-20% 75+

• 25-50% 85+

Fig 7. Desikan RS, Fan CC, Wang Y, Schork AJ, Cabral HJ, et al. (2017) Genetic assessment

of age-associated Alzheimer disease risk: Development and validation of a polygenic hazard
score. PLOS Medicine 14(3): e1002258. https://doi.org/10.1371/journal.pmed.1002258
Risk factors
• Genetics

• Environment/ lifestyle

Fig 8. Miller, J. (2019). Scientists propose new approach to Alzheimer's research to address environmental
risks. Retrieved from: https://news.usc.edu/160629/alzheimers-environmental-risk-factors-usc-research/
Fig 9. 23andMe. (n.d.). Late-Onset Alzheimer's Disease. Retrieved from: https://www.23andme.com/en-
ca/topics/health-predispositions/late-onset-alzheimers/
Population

• 2/3rd of cases are women

• Hispanics and African Americans

Fig 10 Chene G, Beiser A, Au R, Preis SR, Wolf PA, Dufouil C, et al. Gender and incidence
of dementia in the Framingham Heart Study from mid ‐adult life. Alzheimers
Dement 2015;11(3):310‐20.
Fig 11. Alzheimer's Association. (2011). "2010 Alzheimer's Disease Facts and Figures."
Retrieved from http://www.alz.org/documents_custom/report_alzfactsfigures2010.pdf.
Socioecological model- individual

Memory problems Personality, behavioral, 24/7 assistance infections

physical changes
Socioecological model- family

Psychological impact 24/7 caregiver Burden is placed on

them
Socioecological model-
society
• Expensive
• $259 billion ‘17 and $1.1 trillion in ‘50

• Medicaid

• Research

Fig 12. Pioneer Institute. (2014). The Ugly Truth About State Healthcare Costs.
Retrieved from:https://pioneerinstitute.org/healthcare/the-ugly-truth-about-state-
healthcare-costs/
Public health problem
• Global, national, state, local

• Growing epidemic

• 145% increase in deaths

• Expensive

Fig 13. USAgainstAlzheimer’s. (n.d.). The Alzheimer’s Crisis. Retrieved

from:https://www.usagainstalzheimers.org/learn/alzheimers-crisis
Policies

• Alzheimer's Improvement Act

• BOLD infrastructure

Fig 14 Pike, J. (2017). Addressing Alzheimer's through Public Health

Interventions. Retrieved from: https://alzimpact.org/blog/post/id/105
 Policies cont.
• Healthy Brain Initiative

• RAISE

• Alzheimer's Project Act

Fig 15 Alzheimer's Association. (2015). Hope for Alzheimer's Act Introduced to Improve
Coverage and Access to Critical Care Planning. Retrieved from:
https://www.prnewswire.com/news-releases/hope-for-alzheimers-act-introduced-to-
improve-coverage-and-access-to-critical-care-planning-300056003.html
Fig 16 CDC. (2020).Healthy Brain Initiative. Retrieved from:
https://www.cdc.gov/aging/healthybrain/index.htm
Programs/ Interventions
• Behavioral therapies
• Depression and anxiety

• Occupational therapies
• Independence

Fig 17 ExploreHealthCareers.org. (n.d.). Occupational Therapist. Retrieved

from:https://explorehealthcareers.org/career/occupational-
therapy/occupational-therapist/
Fig 18 BethesdaHealth. (2017). Seniors with Dementia and Occupational
Therapy. Retrieved
from:https://www.bethesdahealth.org/blog/2017/02/20/seniors-with-
dementia-occupational-therapy/
RDAD

• Reducing Disabilities in Alzheimer's Disease

• Exercise

• Physical movement

Fig 19 TravelSiteNews. (2018). Physical Activity Can Improve

Cognition in Patients with Alzheimer's Disease. Retrieved
from:https://trialsitenews.com/physical-activity-can-improve-
cognition-in-patients-with-alzheimers-disease/
 • Ongoing research

• New findings

• Difficult etiology

Research
References:
• Alzheimer’s Association. (2020). Improving Care. Retrieved from: https://www.alz.org/get-involved-now/advocate/improving-care

• Alzheimer’s Association. (2020), Public Policy Victories. Retrieved from: https://www.alz.org/get-involved-now/advocate/victories

• Alzheimer's Association. (n.d.). Stages of Alzheimer's. Retrieved from: https://www.alz.org/alzheimers-dementia/stages

• Alzheimer's Association. (2019). 2019 Alzheimer's Disease Facts and Figures. Retrieved from:https://www.alz.org/media/documents/alzheimers-facts-and-figures-2019-r.pdf

• CDC. (2019). Alzheimer’s Disease and Healthy Aging. Retrieved from: https://www.cdc.gov/aging/about/index.htm

• Dong, H., & Csernansky, J. G. (2019). Editorial: Stress and its impact on Alzheimer's Disease. Neurobiology of stress, 10, 100167. https://doi.org/10.1016/j.ynstr.2019.100167

• Grabher, B. (2018). Effects of Alzheimer’s Disease on Patients and Their Family. JNMT.46(4). 335-340. doi: 10.2967/jnmt.118.218057

• Justice N. J. (2018). The relationship between stress and Alzheimer's disease. Neurobiology of stress, 8, 127–133. https://doi.org/10.1016/j.ynstr.2018.04.002

• Logsdon, R. G., McCurry, S. M., & Teri, L. (2007). Evidence-Based Interventions to Improve Quality of Life for Individuals with Dementia. Alzheimer's care today, 8(4), 309–318.

• Mayo Clinic. (2020). Alzheimer's’: Dealing with family conflict. Retrieved from: https://www.mayoclinic.org/healthy-lifestyle/caregivers/in-depth/alzheimers/art-20047365

• NIH. (2019). What Causes Alzheimer's Disease? Retrieved from: https://www.nia.nih.gov/health/what-causes-alzheimers-disease

• NIH. (2019). What do we know about diet and the prevention of Alzheimer's disease? Retrieved from:
https://www.nia.nih.gov/health/what-do-we-know-about-diet-and-prevention-alzheimers-disease#:~:text=Evidence%20supporting%20the%20MIND%20diet,slower%20rate%20of%20cognitive%20
decline
.

• Shabir, O. (2019). Stress and Alzheimer's Disease. Retrieved from: https://www.news-medical.net/health/Stress-and-Alzheimers-Disease.aspx

• Small, S. & Gandy, S. (2006). Sorting through the Cell Biology of Alzheimer's Disease: Intracellular Pathways to Pathogenesis. Neuron. 52(1). https://doi.org/10.1016/j.neuron.2006.09.001