R.S.

K HIGHER SECONDARY SCHOOL

affiliated to the CBSE-NEW DELHI
(Managed by DAV GROUP OF SCHOOLS)
KAILASAPURAM, TRICHY – 620014
2022-2023

Certified bonafide project of

practical work done by
miss/master ……………….
Submitted for the all India
Senior School Certificate
Practical Examination Held
On ………….. at R.S.K
Higher Secondry school
Tiruchirapalli-14
Board Roll No.
Internal Examiner External Examiner

ALZHIEMER’S AND DEMENTIA

A PROJECT SUBMITTED TO
R.S.K HIGHER SECONDARY SCHOOL
KAILASAPURAM TRICHY – 620014

In partial fulfillment of the requirement for the AISSCE – 2023

Submitted by – REVANTH .P
XII –‘A’

Under the guidance of

Mr G. Sivakumar M.Sc., M.Phil., B.Ed., P.G.D.P.M
Department of Biology

R.S.K HIGHER SECONDARY SCHOOL

KAILASAPURAM TRICHY – 620014
2022-2023
 CONTENTS
1. Certificate
2. Acknowledgement
3. Introduction about Alzheimer’s
4. Effects of Alzheimer’s
5. Prevalence
6. Stages of Alzheimer’s
7. Genetic Testing
8. Steps to diagnosis
9. Treatment Horizon
10. Conclusions
 ACKNOWLEDGEMENT

Apart from the efforts of me, the success of any project

depends largely on the encouragement and guidance of many others. I take
this opportunity to express my gratitude to the people who have been
instrumental in the successful completion of this project.

I express deep sense of gratitude to almighty God for giving me the

strength for the successful completion of this project.

I express my heartfelt gratitude to my parents for constant

encouragement while carrying out this project. I would like to thank the
DAV Management, Chennai and also like to thank our school Principal
Shri M. Karuppaiah for his inspiring and encouraging words.

I gratefully acknowledge the contribution of the individuals who

contributed in bringing this project up to this level who continues to look
after me despite flaws.

My sincere thanks to Mr. G Sivakumar. A teacher, guide, mentor

and above all a friend who critically reviewed my project and helped me in
solving every problem occurred during implementation of this project.

Last but not the least, I would like to thank my friends who
supported me in the completion of this project.
 ABSTRACT
Alzheimer's is the most common form of dementia, a
general term for memory loss and other intellectual abilities
serious enough to interfere with daily life. Alzheimer's disease
accounts for 60 to 80 percent of dementia cases.
Alzheimer's is a type of dementia that causes problems with
memory, thinking and behavior. Symptoms usually develop
slowly and get worse over time, becoming severe enough to
interfere with daily tasks
Alzheimer's is not a normal part of aging, although the
greatest known risk factor is increasing age, and the majority
of people with Alzheimer's are 65 and older. But Alzheimer's
is not just a disease of old age. Up to 5 percent of people with
the disease have early onset Alzheimer's (also known as
younger-onset), which often appears when someone is in their
40s or 50s.
Alzheimer's worsens over time. Alzheimer's is a progressive
disease, where dementia symptoms gradually worsen over a
number of years. In its early stages, memory loss is mild, but
with late-stage Alzheimer's, individuals lose the ability to
carry on a conversation and respond to their environment.
Alzheimer's is the sixth leading cause of death in the United
States. Those with Alzheimer's live an average of eight years
after their symptoms become noticeable to others, but survival
can range from four to 20 years, depending on age and other
health conditions.
Alzheimer's has no current cure, but treatments for symptoms
are available and research continues. Although current
Alzheimer's treatments cannot stop Alzheimer's from
progressing, they can temporarily slow the worsening of
dementia symptoms and improve quality of life for those with
Alzheimer's and their caregivers. Today, there is a worldwide
effort under way to find better ways to treat the disease, delay
its onset, and prevent it from developing.
Alzheimer's is not just a disease of old age. Younger-onset
(also known as early-onset) Alzheimer's affects people
younger than age 65. Up to 5 percent of the more than 5
million Americans with Alzheimer’s have younger-onset.
 INTRODUCTION
Who gets early onset Alzheimer's?
Many people with early onset are in their 40s and 50s. They
have families, careers or are even caregivers themselves when
Alzheimer's disease strikes. In the United States, it is
estimated that approximately 200,000 people have early onset.
Diagnosing early onset Alzheimer’s:
Since health care providers generally don't look for
Alzheimer's disease in younger people, getting an accurate
diagnosis of early onset Alzheimer's can be a long and
frustrating process. Symptoms may be incorrectly attributed to
stress or there may be conflicting diagnoses from different
health care professionals. People who have early onset
Alzheimer's may be in any stage of dementia – early stage,
middle stage or late stage. The disease affects each person
differently and symptoms will vary.
If you are experiencing memory problems:
Have a comprehensive medical evaluation with a doctor who
specializes in Alzheimer's disease. Getting a diagnosis
involves a medical exam and possibly cognitive tests, a
neurological exam and/or brain imaging. Call your local
chapter of the Alzheimer's Association for a referral.
Write down symptoms of memory loss or other cognitive
difficulties to share with your health care professional
Keep in mind that there is no one test that confirms
Alzheimer's disease. A diagnosis is only made after a
comprehensive medical evaluation.
 EFFECTS OF ALZHEIMER’S
 Alzheimer's disease is one of the costliest chronic
diseases to society.
 In 2015, the direct costs to American society of caring
for those with Alzheimer's will total an estimated $226
billion, with half of the costs borne by Medicare.
 Average per-person Medicare spending for people age 65
or older with Alzheimer's and other dementias is three
times higher than for seniors without dementia. Medicaid
payments are 19 times higher.
 Nearly one in every five Medicare dollars is spent on
people with Alzheimer's and other dementias. In 2050, it
will be one in every three dollars.
 Unless something is done, in 2050, Alzheimer's is
projected to cost over $1.1 trillion (in 2015 dollars). This
dramatic rise includes a five-fold increase in government
spending under Medicare and Medicaid and a nearly
five-fold increase in out-of pocket spending.

PREVALANCE
 An estimated 5.3 million Americans of all ages have
Alzheimer's disease in 2015.
 Of the 5.3 million Americans with Alzheimer's, an
estimated 5.1 million people are age 65 and older, and
approximately 200,000 individuals are under age 65
(younger-onset Alzheimer's).
 Almost two-thirds of Americans with Alzheimer's are
women. Of the 5.1 million people age 65 and older with
Alzheimer's in the United States, 3.2 million are women
and 1.9 million are men.
 Although there are more non-Hispanic whites living with
Alzheimer's and other dementias than people of any other
racial or ethnic group in the United States, older African-
Americans and Hispanics are more likely than older whites
to have Alzheimer's disease and other dementias.
 The number of Americans with Alzheimer's disease and
other dementias will grow each year as the size and
proportion of the U.S. population age 65 and older continue
to increase. By 2025, the number of people age 65 and
older with Alzheimer's disease is estimated to reach 7.1
million — a 40 percent increase from the 5.1 million age 65
and older affected in 2015. By 2050, the number of people
age 65 and older with Alzheimer's disease may nearly
triple, from 5.1 million to a projected 13.8 million, barring
the development of medical breakthroughs to prevent or
cure the disease.
Typical age-related memory loss and other changes
compared to Alzheimer's
 Signs of Alzheimer's
 Typical age-related changes
 Poor judgment and decision making
 Making a bad decision once in a while
 Inability to manage a budget
 Missing a monthly payment
 Losing track of the date or the season
 Forgetting which day it is and remembering later
 Difficulty having a conversation
 Sometimes forgetting which word to use
 Misplacing things and being unable to retrace steps to find
them
 Losing things from time to time

Have more time to plan for the future–

A diagnosis of Alzheimer's allows you to take part in
decisions about care, transportation, living options, financial
and legal matters. You can also participate in building the
right care team and social support network.
Help for you and your loved ones –
Care and support services are available, making it easier for
you and your family to live the best life possible with
Alzheimer’s or dementia.

STAGES OF ALZHEIMER’S
Alzheimer's disease typically progresses slowly in three
general stages — mild (early-stage), moderate (middle-stage),
and severe (late-stage). Since Alzheimer's affects people in
different ways, each person will experience symptoms - or
progress through Alzheimer's stages - differently.
Overview of disease progression:
 Mild Alzheimer's (early-stage)
 Moderate Alzheimer's (middle-stage)
 Severe Alzheimer's (late-stage)

Mild Alzheimer's disease (early-stage):

Although the onset of Alzheimer's disease cannot yet be stopped or reversed, an
early diagnosis can allow a person the opportunity to live well with the disease
for as long as possible and plan for the future.In the early stages of Alzheimer's,
a person may function independently. He or she may still drive, work and be
part of social activities. Despite this, the person may feel as if he or she is
having memory lapses, such as forgetting familiar words or the location of

everyday objects.

Friends, family or neighbors begin to notice difficulties. During a detailed

medical interview, doctors may be able to detect problems in memory or
concentration.

Common difficulties include:

 Problems coming up with the right word or name

 Trouble remembering names when introduced to new people
 Having greater difficulty performing tasks in social or work settings
 Forgetting material that one has just read
 Losing or misplacing a valuable object
 Increasing trouble with planning or organizing

Moderate Alzheimer's disease (middle-stage):

During the moderate stage of Alzheimer's, individuals may have greater
difficulty performing tasks such as paying bills, but they may still remember
significant details about their life.
Moderate Alzheimer's is typically the longest stage and can last for many years.
As the disease progresses, the person with Alzheimer's will require a greater
level of care.

You may notice the person with Alzheimer's confusing words, getting frustrated
or angry, or acting in unexpected ways, such as refusing to bathe. Damage to
nerve cells in the brain can make it difficult to express thoughts and perform
routine tasks.

At this point, symptoms will be noticeable to others and may include:

 Forgetfulness of events or about one's own personal history

 Feeling moody or withdrawn, especially in socially or mentally
challenging situations
 Being unable to recall their own address or telephone number or the high
school or college from which they graduated
 Confusion about where they are or what day it is
 The need for help choosing proper clothing for the season or the
occasion
 Trouble controlling bladder and bowels in some individuals
 Changes in sleep patterns, such as sleeping during the day and becoming
restless at night
 An increased risk of wandering and becoming lost
 Personality and behavioral changes, including suspiciousness and
delusions or compulsive, repetitive behavior like hand-wringing or tissue
shredding
Advanced Alzheimer’s Disease (late-stage):
Late-stage care decisions can be some of the hardest families face. Connect with
other caregivers who have been through the process on our online message
boards and get helpful resources in our Caregiver Center.
In the final stage of this disease, individuals lose the ability to respond to their
environment, to carry on a conversation and, eventually, to control movement.
They may still say words or phrases, but communicating pain becomes difficult.
As memory and cognitive skills continue to worsen, personality changes may
take place and individuals need extensive help with daily activities.

At this stage, individuals may:

 Require full-time, around-the-clock assistance with daily personal care

 Lose awareness of recent experiences as well as of their surroundings
 Require high levels of assistance with daily activities and personal care
 Experience changes in physical abilities, including the ability to walk, sit
and, eventually, swallow
 Have increasing difficulty communicating
 Become vulnerable to infections, especially pneumonia
 GENETIC TESTING
Genetic tests are available for both APOE-e4 and the rare genes that
directly cause Alzheimer’s. However, health professionals do not currently
recommend routine genetic testing for Alzheimer’s disease. Testing for
APOE-e4 is sometimes included as a part of research studies.
Risk genes increase the likelihood of developing a disease, but do not
guarantee it will happen. Scientists have so far identified several risk genes
implicated in Alzheimer's disease. The risk gene with the strongest
influence is called Apo lipoprotein E-e4 (APOE-e4). Scientists estimate
that APOE-e4 may be a factor in 20 to 25 percent of Alzheimer's cases.
APOE-e4 is one of three common forms of the APOE gene; the others are
APOE-e2 and APOE-e3. Everyone inherits a copy of some form of APOE
from each parent. Those who inherit APOE-e4 from one parent have an
increased risk of Alzheimer’s. Those who inherit APOE-e4 from both
parents have an even higher risk, but not a certainty.
Scientists are not yet certain how APOE-e4 increases risk. In addition to
raising risk, APOE-e4 may tend to make Alzheimer's symptoms appear at
a younger age than usual .Deterministic genes directly cause a disease,
guaranteeing that anyone who inherits them will develop the disorder.
Scientists have discovered variations that directly cause Alzheimer’s
disease in the genes coding three proteins: amyloid precursor protein
(APP), presenilin-1 (PS-1) and presenilin-2 (PS-2).
When Alzheimer’s disease is caused by these deterministic variations, it is
called “autosomal dominant Alzheimer’s disease (ADAD)” or “familial
Alzheimer’s disease,” and many family members in multiple generations
are affected. Symptoms nearly always develop before age 60, and may
appear as early as a person's 30s or 40s. Deterministic Alzheimer's
variations have been found in only a few hundred extended families
worldwide. True familial Alzheimer’s accounts for less than 5 percent of
cases.

STEPS TO DIAGNOSIS
There is no single test that can show whether a person has Alzheimer's. While
physicians can almost always determine if a person has dementia, it may be
difficult to determine the exact cause.
Diagnosing Alzheimer's requires careful medical evaluation, including:
 A thorough medical history
 Mental status testing
 A physical and neurological exam
 Tests (such as blood tests and brain imaging) to rule out other causes of
dementia-like symptoms
People with memory loss or other possible warning signs of Alzheimer's may
find it hard to recognize they have a problem and may resist following up on
their symptoms. Signs of dementia may be more obvious to family members or
friends.
Having trouble with memory does not mean you have Alzheimer's. Many health
issues can cause problems with memory and thinking. When dementia-like
symptoms are caused by treatable conditions — such as depression, drug
interactions, thyroid problems, excess use of alcohol or certain vitamin
deficiencies — they may be reversed during the medical workup, your health
care provider will review your medical history. He or she will want to know
about any current and past illnesses, as well as any medications you are taking.
The doctor will also ask about key medical conditions affecting other family
members, including whether they may have had Alzheimer's disease or related
dementias.
 TREATMENT HORIZON
The science of Alzheimer's has advanced to show potential underlying
drivers of the disease. And we have candidate drugs we can test
because of this basic science knowledge." - Richard Mohs, Ph.D.
A worldwide quest is under way to find new treatments to stop, slow
or even prevent Alzheimer's. Because new drugs take years to
produce from concept to market—and because drugs that seem
promising in early-stage studies may not work as hoped in large-scale
trials—it is critical that Alzheimer's and related dementias research
continue to accelerate. To ensure that the effort to find better
treatments receives the focus it deserves, the Alzheimer's Association
funds researchers looking at new treatment strategies and advocates
for more federal funding of Alzheimer's research.
The hope for future drugs:
Currently, there are five FDA-approved Alzheimer's drugs that treat
the symptoms of Alzheimer's — temporarily helping memory and
thinking problems in about half of the people who take them. But
these medications do not treat the underlying causes of Alzheimer's.
In contrast, many of the new drugs in development aim to modify the
disease process itself, by impacting one or more of the many wide-
ranging brain changes that Alzheimer's causes. These changes offer
potential "targets" for new drugs to stop or slow the progress of the
disease. Many researchers believe successful treatment will
eventually involve a "cocktail" of medications aimed at several
targets, similar to current state-of-the-art treatments for many cancers
and AIDS. Sign up for our weekly e-news and stay up-to-date on the
latest advances in Alzheimer's treatments, care and research.

CONCLUSIONS
Over the last 30 years, researchers have made remarkable progress in
understanding healthy brain function and what goes wrong in Alzheimer's
disease. The following are examples of promising targets for next-
generation drug therapies under investigation in current research studies:
Beta-amyloid is the chief component of plaques, one hallmark Alzheimer's
brain abnormality. Scientists now have a detailed understanding of how
this protein fragment is clipped from its parent compound amyloid
precursor protein (APP) by two enzymes — beta-secretase and gamma-
secretase. Researchers are developing medications aimed at virtually every
point in amyloid processing. This includes blocking activity of both
enzymes; preventing the beta-amyloid fragments from clumping into
plaques; and even using antibodies against beta-amyloid to clear it from
the brain. Several clinical trials of investigational drugs targeting beta-
amyloid are included below in the key clinical trial summary.
Tau protein is the chief component of tangles, the other hallmark brain
abnormality. Researchers are investigating strategies to keep tau molecules
from collapsing and twisting into tangles, a process that destroys a vital
cell transport system.
Inflammation is another key Alzheimer's brain abnormality. Scientists
have learned a great deal about molecules involved in the body's overall
inflammatory response and are working to better understand specific
aspects of inflammation most active in the brain. These insights may point
to novel anti-inflammatory treatments for Alzheimer's disease.
Insulin resistance and the way brain cells process insulin may be linked to
Alzheimer's disease. Researchers are exploring the role of insulin in the
brain and closely related questions of how brain cells use sugar and
produce energy. These investigations may reveal strategies to support cell
function and stave off Alzheimer-related changes.
All we have now is the hope in future.