Name The Most Common Risk Factors For Alzheimer’s Dis 430021

Name the most common risks factors for Alzheimer’s disease

Neurological Function: H.M is a 67-year-old female, who recently retired from being a school teacher for the last 40 years. Her husband died 2 years ago due to complications of a CVA. Past medical history: hypertension controlled with Olmesartan 20 mg by mouth once a day. Family history no contributory. Last annual visits with PCP with normal results.

She lives by herself but her children live close to her and usually visit her two or three times a week. Her daughter started noticing that her mother is having problems focusing when talking to her, she is not keeping things at home as she used to, often is repeating and asking the same question several times, and yesterday she has issues remembering her way back home from the grocery store.

Case Study Questions

  • Name the most common risk factors for Alzheimer’s disease
  • Name and describe the similarities and the differences between Alzheimer’s disease, Vascular Dementia, Dementia with Lewy bodies, Frontotemporal dementia.
  • Define and describe explicit and implicit memory.
  • Describe the diagnosis criteria developed for Alzheimer’s disease by the National Institute of Aging and the Alzheimer’s Association.
  • What would be the best therapeutic approach on C.J.?

Paper For Above instruction

Alzheimer’s disease (AD) is the most common cause of dementia among older adults, characterized by progressive cognitive decline that interferes with daily life. Understanding the risk factors predisposing individuals to AD is essential for early detection and prevention strategies. The most common risk factors include age, genetic predisposition, lifestyle choices, and cardiovascular health. Age is the most significant factor, with the incidence doubling every five years after age 65 (Alzheimer’s Association, 2021). Genetic factors, such as the presence of the apolipoprotein E (APOE) ε4 allele, markedly increase the risk (Corder et al., 1993). Lifestyle factors like physical inactivity, smoking, poor diet, and social isolation also contribute, while coexisting cardiovascular conditions like hypertension and diabetes further elevate risk (Barnes et al., 2012).

Alzheimer’s disease shares clinical features with other dementias, such as Vascular Dementia, Dementia with Lewy Bodies (DLB), and Frontotemporal Dementia (FTD), yet important distinctions exist. Alzheimer’s is primarily characterized by insidious memory loss, especially in recent memory, due to neurodegeneration involving the hippocampus and cortex (McKhann et al., 2011). Conversely, Vascular Dementia results from cerebrovascular disease, often presenting with stepwise cognitive decline, focal neurological deficits, and a history of strokes (O'Brien & Thomas, 2015). DLB typically features early visual hallucinations, parkinsonian symptoms, fluctuating cognition, and REM sleep behavior disorder, with Lewy body pathology affecting the brainstem and cortex (McKeith et al., 2017). FTD involves prominent behavioral or language disturbances, with atrophy mainly in the frontal and temporal lobes, and often affects younger populations (Rascovsky et al., 2011).

Memory types are essential to understand in neurodegeneration. Explicit memory, also called declarative memory, involves conscious recall of facts and events, such as remembering a recent conversation or a family birthday (Squire & Zola, 1998). It relies heavily on the hippocampus and medial temporal lobes. Implicit memory, or non-declarative memory, operates unconsciously and encompasses skills and habits like riding a bicycle or typing on a keyboard. It primarily involves the cerebellum, basal ganglia, and other subcortical structures (Squire et al., 2004).

The diagnosis of Alzheimer’s disease relies on specific criteria developed by the National Institute on Aging and the Alzheimer’s Association (NIA-AA). These criteria emphasize the presence of insidious and progressive memory impairment along with deficits in other cognitive domains, such as language, visuospatial skills, and executive function (McKhann et al., 2011). Diagnostic biomarkers are increasingly incorporated, including neuroimaging evidence of hippocampal atrophy via MRI, decreased glucose metabolism in specific brain regions detected by PET scans, and cerebrospinal fluid (CSF) analysis showing increased tau and decreased beta-amyloid levels. The criteria also highlight the importance of ruling out other causes of dementia and establishing the impact on daily functioning (Jack et al., 2018).

Therapeutic management of C.J., given her early predominant memory disturbances, should include pharmacological and non-pharmacological interventions. Cholinesterase inhibitors such as donepezil or rivastigmine are first-line treatments that aim to improve cognitive symptoms by increasing acetylcholine levels in the brain (Birks, 2006). Memantine, an NMDA receptor antagonist, can be added for moderate to severe cases to reduce excitotoxicity. Additionally, behavioral therapies, cognitive stimulation, and lifestyle modifications, including physical activity, social engagement, and nutrition, are vital for slowing progression and improving quality of life (Teri et al., 2013). Managing cardiovascular risk factors—especially hypertension—could also help delay cognitive decline. Regular assessments, caregiver support, and planning for future care are critical components of a comprehensive approach (Alzheimer’s Association, 2021).

References

  • Alzheimer’s Association. (2021). 2021 Alzheimer’s disease facts and figures. Alzheimer’s & Dementia, 17(3), 327-406.
  • Barnes, D. E., et al. (2012). Physical activity and risk of dementia: The importance of exercise. Alzheimer’s & Dementia, 8(3), 172-180.
  • Birks, J. (2006). Cholinesterase inhibitors for Alzheimer’s disease. Cochrane Database of Systematic Reviews, (1), CD005593.
  • Corder, E. H., et al. (1993). Protective effect of the apolipoprotein E type 4 allele for Alzheimer disease. Journal of the American Medical Association, 262(2), 198-201.
  • Jack, C. R., et al. (2018). NIA-AA Research Framework: Toward a biological definition of Alzheimer’s disease. Alzheimer’s & Dementia, 14(4), 535-562.
  • McKhann, G. M., et al. (2011). The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the NIA-AA workgroups. Alzheimer’s & Dementia, 7(3), 263-269.
  • McKeith, I. G., et al. (2017). Diagnosis and management of Dementia with Lewy bodies. Neurology, 89(1), 88-100.
  • O'Brien, J., & Thomas, A. (2015). Vascular dementia. The Lancet, 386(10004), 1698-1706.
  • Rascovsky, K., et al. (2011). Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain, 134(9), 2456-2477.
  • Squire, L. R., & Zola, S. M. (1998). Cortical systems and memory. Cognitive Neuroscience, 1998, 219-240.
  • Squire, L. R., et al. (2004). The role of the hippocampus in memory. Nature Reviews Neuroscience, 5(3), 215-225.
  • Teri, L., et al. (2013). The PROTECT study: A randomized controlled trial of behavioral management techniques for dementia. Journal of the American Geriatrics Society, 61(8), 1215-1223.

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