1. Explain the underlying causes of Alzheimer's disease.

Alzheimer's disease is thought to be caused by the abnormal build-up of proteins in and

around brain cells. One of the proteins involved is called amyloid, deposits of which form
plaques around brain cells. The other protein is called tau, deposits of which form tangles
within brain cells. Although it's not known exactly what causes this process to begin,
scientists now know that it begins many years before symptoms appear. As brain cells
become affected, there's also a decrease in chemical messengers involved in sending
messages, or signals, between brain cells. Levels of one neurotransmitter, acetylcholine,
are particularly low in the brains of people with Alzheimer's disease. Over time, different
areas of the brain shrink. The first areas usually affected are responsible for memories. In
more unusual forms of Alzheimer's disease, different areas of the brain are affected. The
first symptoms may be problems with vision or language rather than memory.
2. Describe the significance of physical assessment to the diagnosis of
Neurodegenerative Diseases
Neurodegenerative diseases are characterized by a progressive deterioration of brain
function, with a significantly consequent decrease in the quality of life of patients and
their families that is why it is very important to have a physical assessment to the
diagnosis of neurodegenerative disease. Due to increasing life expectancy, the incidence
of these diseases has increased over the years, and has been under research. The
significance of conducting physical assessment to the diagnosis of neurodegenerative
diseases is that neuropsychologic measures can differentiate between normal cognitive
aging and impairment that extends beyond the typical aging process. Baseline
neuropsychologic testing can also determine whether an individual is experiencing
normal age-related changes, informative for referring physician and the person referred,
who receive education about normal aging in the context of their unique cognitive
strengths and weaknesses. Evaluation of this population also provides an opportunity for
neuropsychologists to support lifestyle factors that promote healthy aging.
3. Describe changes in neurologic function associated with Neurodegenerative Diseases
and their impact on neurologic assessment findings.
Neurodegenerative disorders are illnesses that involve the death of certain parts of the
brain. They are, by far, some of the toughest diseases to cure with debilitating outcomes.
Parkinson’s and Huntington’s disease are among the most severe and common movement
disorders. Although a lot of information has been found about how and why these
diseases occur, neurodegenerative disorders remain highly mysterious and complex. For
this instance, aging changes and their effects on the nervous system. As people age, brain
and nervous system go through natural changes. Our brain and spinal cord lose nerve
cells and weight (atrophy). Nerve cells may begin to pass messages more slowly than in
the past. Waste products can collect in the brain tissue as nerve cells break down. This
can cause abnormal changes in the brain called plaques and tangles to form. A fatty
brown pigment can also build up in nerve tissue. Breakdown of nerves can affect senses.
Patients might have reduced or lost reflexes or sensation. This leads to problems with
movement and safety. Slowing of thought, memory, and thinking is a normal part of
aging. These changes are not the same in everyone. Some people have many changes in
their nerves and brain tissue. Others have few changes. These changes are not always
related to the effects on ability to think. On the other hand, structural, biochemical or
electrical abnormalities in the brain, spinal cord or other nerves can also result in a range
of symptoms. Examples of symptoms include paralysis, muscle weakness, poor
coordination, loss of sensation, seizures, confusion, pain and altered levels of
consciousness. Somewhat, this is one reason people are more likely to suffer from a
neurological problem after the age of 65. Some of the more common neurological
 disorders that affect geriatrics include strokes, neuropathy, Alzheimer's disease and
Parkinson's disease.
4. Discuss the diagnostic tests used for assessment of suspected Neurodegenerative
Diseases and the related nursing implications
 CT scan- This imaging test uses a combination of X-rays and computer technology to
make horizontal images of the body. A CT scan shows detailed images of any part of the
body, including the bones, muscles, fat, and organs. CT scans are more detailed than
general X-rays.

 Electroencephalogram (EEG)- This test records the brain's continuous electrical

activity through electrodes attached to the scalp.

 Magnetic Resonance Imaging- This test uses a combination of large magnets, radio
waves, and a computer to make detailed images of organs and structures within the body.

 Electrodiagnostic tests, such as electromyography (EMG) and nerve conduction

velocity (NCV)-These tests evaluate and diagnose disorders of the muscles and motor
neurons. Electrodes are inserted into the muscle or placed on the skin overlying a muscle
or muscle group. Electrical activity and muscle response are recorded.

 Positron emission tomography (PET) - This test measures the metabolic activity of
cells.

 Arteriogram (angiogram) - This X-ray of the arteries and veins detects blockage or
narrowing of the vessels.

 Spinal tap (lumbar puncture) - During this test, a special needle is placed into the lower
back, into the spinal canal. This is the area around the spinal cord. The pressure in the
spinal canal and brain can then be measured. A small amount of cerebrospinal fluid
(CSF) can be removed and sent for testing to find out if there is an infection or other
problems. CSF is the fluid that bathes the brain and spinal cord.

 Evoked potentials- This test records the brain's electrical response to visual, auditory,
and sensory stimuli.

 Myelogram- This test uses dye injected into the spinal canal to make the structure clearly
visible on X-rays.

 Neurosonography- This test uses ultra-high-frequency sound waves. It allows the

healthcare provider to analyze blood flow in cases of possible stroke.

 Ultrasound (sonography) - This imaging test uses high-frequency sound waves and a
computer to make images of blood vessels, tissues, and organs. Ultrasounds are used to
view internal organs as they function. They also assess blood flow through various
vessels.
 Instruction:  Identify the signs and symptoms and explain the prognosis to complete the table.

Neurodegenerative Disorders Signs/Symptoms Prognosis

 Motor and cognitive skill loss
Does not typically impact life
Parkinson’s Disease due to decrease in dopamine
expectancy.
 Resting tremor
 Most common form of
8-10 year life expectancy after
dementia
diagnosis but there are some people
Alzheimer's Disease   Progressive memory loss
live longer depending on age of
 Self-care loss
diagnosis and other factors.
 Eating skill loss
 Motor and cognitive skill loss
 Fatigue
People with MS live 5-10 years less
Multiple Sclerosis.  Weakness
than the average.
 Relapsing/ Remitting
 Intention tremors
 Hereditary progressive
cognitive and motor disability 15-20 year life expectancy after the
Huntington's Disease
 Chorea- irregular rapid diagnosis.
movements
 Fatigue
2-5 year life expectancy after
Amyotrophic Lateral Sclerosis (ALS)  Weakness that leads to muscle diagnosis; some people live longer
paralysis that starts distally
 Symmetrical flaccid paralysis
50% of people fully recover, 15%
Guillain-Barré Syndrome (GBS)  Muscle weakness with minor
permanent disability
cognitive difficulties