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Progressive, degenerative disorder Attacks the brain's neurons • Results in loss of memory, thinking and language skills, and behavioral changes • Confusion over time and place • • Early Onset Familial Alzheimer's Disease (FAD) genetic link Age 30 to 60 Late Onset Diagnosed when a person has cognitive decline Genetic link suspected Emerging evidence epigenetic mechanisms contribute to Alzheimer's disease ~NIH 2012 Educate yourself about the disease 2. Learn caregiving techniques. 3. Understand the experience of your loved one 4. Avoid caregiver burnout 5. Maintain your own physical and mental health. 6. Discuss the situation with family and friends. 7. Do cognitive stimulation activities with your loved one. 8. Foster communication with physicians 9. Take care of financial, legal and long-term care planning issue 10. Smile 11. Think positive 12. Reach out for care. 1. 1. Increasing forgetfulness and mild confusion. 2. Inability to speak and write coherently 3. Impaired judgment and problem solving ~Mayo 2012 Evidence indicates Use the sense of smell to determine if someone may get Alzheimer’s disease Use changes in sense of smell to begin treatments, instead of waiting until someone has issues learning and remembering Determine if therapies are working The Journal of Neuroscience, Nov. 2, 2011 Case Western Reserve Medical School Starts in the olfactory – loss of smell one of the first signs Short-term memory fails when Alzheimer's disease first destroys nerve cells in the hippocampus Language skills and judgment decline when neurons die in the cerebral cortex Atrophy and clinical stage of AD. Coronal three-dimensional T1-weighted volume MR images (repetition time msec/echo time msec/inversion time msec, 7/900/2.8/900) in three individuals in their 70s are shown. Jack C R Radiology 2012;263:344-361 ©2012 by Radiological Society of North America cross-section of the brain as seen from the front 1906 Dr. Alois Alzheimer, German physician Presented a case history of a 51-year-old woman who suffered from mental illness He identified through autopsy plaques and tangles in her brain These plaques and tangles characterize Alzheimer's Disease Plaques and tangles. Jack C R Radiology 2012;263:344-361 http://radiology.rsna.org/content/263/2/344.full ©2012 by Radiological Society of North America Integral membrane protein concentrated in the synapses of neurons. Its primary function is not known, though it has been implicated as a regulator of synapse formation, neural plasticity and iron export Mu Y, Gage FH. Mol Neurodegener. 2011; 6: 85 Main component of deposits found in the brains of patients with Alzheimer's disease Stabilizes microtubules hyperphosphorylation of tau Reddy 2011 In Alzheimer travels down the microtubule and tangles reddy Hypothetical model of the dynamic biomarkers of the AD cascade. Jack C R Radiology 2012;263:344-361 ©2012 by Radiological Society of North America Reddy Nothing prevents Some interventions don’t hurt Coffee Aspirin April 28, 2010 by NIH Anti –inflammatory Properties Aged mice bred to develop symptoms of Alzheimer's Given caffeine - the equivalent of 5 cups of coffee/day Memory impairment was reversed University of South Florida Florida Alzheimer's Disease Research Centre 2009 Aspirin? Doesn’t hurt? Increases the risk of serious bleeding Jan Dubinsky, PhD Alzheimer Foundation Mayo Clinic NIH University of Minnesota Dr. Ravinder Reddy Dr. Clifford Jack