2. Difference between
Alzheimer’s disease and
Dementia ?
Dementia is a symptom
and
Alzheimer’s disease is the cause of the symptom
Patient can have a form of dementia that is
completely unrelated to Alzheimer’s disease
3. What is Alzheimer’s
disease ?
An irreversible, progressive brain disease that slowly
destroys cognitive functions.
Gradual impairment of higher intellectual functions.
Severe Cortical dysfunction → Memory loss &
Aphasia.
In 10-15 years, patient becomes profoundly
disabled, mute & immobile.
4. Introduction
• First case studied in 1906 by German
Psychiatrist and neuropathologist Alois
Alzheimer.
• Most cases are Sporadic
5-10 % are Familial.
• Diagnosed in people over 65 yrs of
age.
• Scientists estimate that around 4.5
million people now have AD.
Dr. Alois Alzheimer
9. Neuritic plaques
Spherical collections of dilated, twisted neuritic processes
around the central core
20 – 200 μm
Periphery → Microglial cells & Astrocyts
Central core → β amyloid (Aβ)
peptide,Cytokines, Complement cascade, Apolipoprotiens
10. Neurofibrillary tangles
Bundles of filaments in cytoplasm which displace or
encircle the nucleus.
Commonly found in cortical neurons in entorhinal
cortex, hippocampus & basal fore brain.
Insoluble & resistant to clearance.
They are made up of paired
helical filaments of
hyperphosphorylated ‘tau’
protein.
11.
12. Pathogenesis and Molecular
Genetics
• Amyloid β is critical molecule in pathogenesis of AD.
• It is derived through processing of Amyloid Precurssor
Protein.
• APP : transmembrane protein & it has cleavage sites for 3
enzymes (α,β & γ Secretase)
• α-Secretase activity give rise to soluble form of APP which
do not lead to plaque formation but
β & γ Secretase when act togetherly on APP they form
Amyloid β fragments which further give rise to plaques.
• Gene for APP is present on 21st chromosome . Mutations in
this gene results in increased formation of Aβ.
13. ApoE allele & AD
Gene for Apolipoprotein E → on 19th chromosome.
In humans, there are three alleles of this gene encoding
Apolipoprotein E.
ApoE
ApoE2 ApoE3 ApoE4
People with ApoE4 allele show larger content of Amyloid β in
their brain.
14. Clinical features
• Memory loss & forgetfulness
• Difficulty in performing familiar tasks
• Problems with language
• Disorientation to time or place
• Poor or decreased judgment
• Problems with abstract thinking
• Misplacing things
• Changes in mood or behavior
• In severe stage patient becomes mute
& immobile
15. Diagnosis
AD is diagnosed from :
Patient’s history
Collateral history from relatives
Clinical & pathologic features
Advanced imaging techniques
used :
Computed tomography (CT)
Magnetic Resonance Imaging
(MRI)
Positron Emission tomography
(PET)
17. BIBLIOGRAPHY
Books
Pathologic Basis of Disease – 7th edition -
by Kumar, Abbas, Fausto.
Lehninger Principles of Biochemistry, 5th edition -
David L. Nelson, Michael M. Cox
Websites
http://en.wikipedia.org/wiki/Alzheimer's_disease
http://www.dementiaguide.com/community/dementia-
articles/Difference_Alzheimer's_and_Dementia