Alzheimer’s

Disease
Integrated Biology Assignment:
Disease/Disorder Research
Table of Contents
01 02 03
Alzheimer’s on the Living With Alzheimer's
Nervous System Alzheimer’s Disease Diagnosis

04 05
Alzheimer’s
References
Treatment
 01
Alzheimer’s on the
Nervous System
 Effects on the
Brain & Nervous System
The main organ system affected by Alzheimer’s disease is the
nervous system. The cause of this disease stems from the damage
and loss of neurons (nervous tissue) in the brain, which hinders
the nervous system to communicate signals properly - behavior,
thinking, and feeling are all altered. This abnormal development
affects different parts of the brain from early stages to later stages,
and damage to each part of the brain causes a specific issue.

● A damaged hippocampus (temporal lobe) causes the patient

to lose memories and create difficulty in creating new
memories
● Damage to the frontal lobe causes major behavior and
personality changes (such as impulsivity).
 How it Distorts the
Nervous System
The nervous system transmits signals throughout the body to control
the body’s movements and internal organs. The nervous system uses
neurons connected throughout the body to the brain to send and
receive chemical or electric signals. The nervous system is how the body
parts communicate with each other, through the brain and the neurons.

● From mild to moderate stages, cognitive functions (controlled by

the cerebral cortex) are affected the first and the most, causing
issues in thinking, memory, and speech.
● In later stages, it reaches the brain stem (controls involuntary
functions), it affects the function of organs (and their systems)
such as the heart and lungs; which is how Alzheimer’s kills.
● Alzheimer’s Journey: Cerebral Cortex, Cerebellum, Brain Stem
 How it Distorts the
Nervous System (Cont.)
There are two causes, both involving the abnormal formation of proteins in the
brain that has a toxic effect, disrupts the neuron’s functions, and lead to the loss
of neurons.

1. Protein #1: beta-amyloid, which clump together to form amyloid platelets,

that disrupt communication between neurons while having a toxic effect.
2. Protein #2: Tau proteins, which help the transportation of nutrients and
other crucial substances, tangle themselves to form neurofibrillary tangles;
consequently, the neurons’ transportation system suffers

Root Causes for Damaging Protein Formations:

Old age, genetics, and previous health conditions (down syndrome, head trauma,
cognitive impairment, etc.), poor lifestyles, such as poor sleep patterns, stress,
drug intake (smoking and alcohol), and lack of exercise.
 How it Distorts the
Nervous System (Videos)

Overview of Alzheimer’s on the Brain How Exactly Amyloid & Tau Proteins Kill Neurons
 02
Living With
Alzheimer's Disease
 Living With Alzheimer’s:
General Symptoms Overview
The effects of the disease depend on the stage of the disease, and its development (where it spreads in the brain and
how fast) varies between different individuals. It usually starts in the Hippocampus (cerebral cortex: temporal lobe),
spreads throughout the cerebral cortex in mild to moderate stages (causing cognitive issues), and reaches the cerebellum
and brain stem in the final stages. Each part of the brain begins to lose its function in turn.

General Symptoms (Worsens Over Time)

● Memory Loss (Short Term & Long Term) & Difficult Making New Memories or Learning
● Confusion, and Trouble Thinking, Reasoning, Planning decision-making, and Focusing
● Changing/Swinging Personality and Behavior
● Paranoia, Delusions, Hallucinations, etc.
● Difficulty in Expression/Communication (Speech), and Loss of Sensations
● Restricted/Difficult in Controlling Physical Movements & Poor Reflexes (Late Stage)
● Hinders Functions in Other Systems, Such as Digestive (Late Stage)
● Seizures, Weight Loss, Skin Infection (Late Stage)
 Living With Alzheimer’s:
Stage 1 & 2 - Preclinical & MCI
Preclinical Stage

● Very minor to no cognitive symptoms, and the patient and

those around them would not notice any issues. The quality of
life is basically unaffected.
● Lasts for years, and even decades; beta-amyloid and tau take a
long time to build up and kill neurons, and can be reversed

Mild Cognitive Impairment (MCI)

● Has noticeable minor cognitive symptoms involving thinking

(difficulty making, deciding, and planning for tasks), memory
(forgets info previously easily remembered, such as
conversation or how to perform a daily task). It starts to make
daily life more difficult, but the patient is still independent. Experiences on MCI/Early Alzheimer’s
● Lasts a few years, and still can be reversed
 Living With Alzheimer’s:
Stage 3 - Early/Mild
Symptoms at this stage revolve around thinking and memory, with possible
behavior changes. Patients will regularly have lapses in thinking, recalling, and
expression that makes daily tasks more difficult/take longer, but the rest of the
body is functioning well. They struggle to make sense of the world around them.

● Memory: struggles to remember names, recent learning, where he/she

misplaced an object, recent events, and how to approach tasks
● Thinking: Difficulty in speech (can’t find the right word), repeats questions,
and has poor judgment/organization/planning skills, especially for
complex tasks (e.g. managing money)
● Personality: Shift in behavior, often resulting in increased aggression,
irritability, anxiety, and a decrease in motivation.
● Alzheimer’s is often diagnosed at this stage diagnosis is very mentally
taxing for patients, knowing that they’ll lose connection to things and Alzheimer's Patient Shares Daily
people he/she cared about, and that Alzheimer’s can not be cured Experiences (Mild Stage)
● Supervision recommended
 Living With Alzheimer’s:
Stage 4 - Moderate
Symptoms at this stage still revolve around thinking, memory, and behavior,
which have all worsened; signs of physical difficulties may start, such as difficulty
in controlling the bladder. Patients grow more forgetful, confused, frustrated, act
in unreasonable ways, and require greater supervision and care for daily tasks.

● Memory: Forgets personal history/events, forgets names (of themselves

and their family), fails to recognize people, loses the ability to learn new
things, and loses track of time and location (they often wander & get lost).
● Thinking: Difficulty in literary & math skills, performing daily activities like
dressing or bathing, having a shorter attention span, and confusion
between people (who’s who). Their ability to organize thoughts, make
decisions logically, and express them effectively continues to decline
● Personality: Becomes moody/withdrawn, restless, tearful, has impulsive
and bursts of anger, inappropriate actions/language, and experiences
hallucinations, paranoia, suspicions, and delusions Moderate Stage Alzheimer’s Expectations
● Still can participate well in brain-engaging activities with assistance
 Living With Alzheimer’s:
Stage 5 - Late
Symptoms become very severe - not only cognitive abilities, but physical abilities. At this stage, the patient can not do
much of any activity, and require constant and intense assistance with everything. At this point, they just sit there
silently, basically unable to interact much with people/environment, as their body shuts down - 1 to 2 years before death.

● Memories: Loses almost all memories, even about their family and caregiver - only has loose fragments of
memories. They are oblivious to recent events and their surroundings, like they’re constantly living in the present
● Thinking: Difficult/no communication through speech - can not hold a conversation, only knows a few
words/phrases (often relies on other senses for communication, such as touch)
● Personality: Major personality and behavioral swings, involving grunting, groaning, moaning
● Physical: Requires total assistance for dressing, going to the washroom, eating, moving around, and other self-care
tasks. They have difficulty swallowing, walking/sitting, and controlling bladder and bowel movements ( helpless :( )
● Little engagement in activities, but can still benefit from them (e.g. listening to music improves mood)
● Very prone to infections/conditions that lead to death, such as aspiration pneumonia, where food/liquids enter
the lungs. Other issues include skin infection and seizures.
 Living With Alzheimer’s:
Stage 5 - Late (Videos)

How Last Stage Alzheimer’s Feels Like Assisting a Patient With Late Stage Alzheimer’s
 Alzheimer’s
Thought Experiment
Alzheimer’s Thought Experiment - Moderate to Late Stage (Quote):

“There is a drug called midazolam (Versed) that is used for minor surgeries… This drug induces sleep and
inhibits your ability to make short-term memories… Someone who has been given Versed will have no
recollection of anything that has happened in the ensuing minutes or even hours. Imagine giving this drug to
someone. Then, have them awaken in a building they have never been in before that is full of furniture and
items they do not recognize. Give them five minutes alone in this unfamiliar place, and then, one by one, have
complete strangers enter the room and talk to the person as if they have known each other their entire lives.
Have these strangers talk to the person as if each one of them is their daughter, their spouse or their pastor.
Have these strangers express concern for the person’s loss and assure them that everything is going to be
alright. The entire time, this person will be wondering what in the world is going on. Then, have all of the
strangers exit the room. Leave the person entirely alone to ponder what just transpired” (Phelps, 2022).
 03
Alzheimer's
Diagnosis
(These Methods Are Used Together for
Better Accuracy)
 Diagnosis Method
#1: Examinations
Physical Examinations look at the physical health and lifestyle of the patient.
Questions are asked about the patient's diet, if they use drugs (alcohol,
smoking), their medications, and their blood pressure, temperature, pulse, etc.
are checked. This helps rule out other illnesses that share symptoms with
Alzheimer's by having an effect on cognitive function, and help identify the root
causes (e.g. medication error) of the patient’s symptoms (and correct them).

Neurological Examination includes testing the nerves around the body for motor
functions, balance, coordination reflexes, eye movement, sensory feedback, and
speech. Exercise often includes a tuning fork (vibration and hearing sensory), Commonly Used Physical and
and a reflex hammer (reflexes). Through these tests, neurologists can tell if the Neurological Examination Tools
symptoms are caused by another issue, like a brain tumor or stroke.
 Diagnosis Method
#1: Examinations (Cont.)
Cognitive/Neuropsychological Examinations
test memory, attention, following commands,
and thinking/problem-solving skills. Examples
of tests include math/language tests
(problem-solving), asking patients to explain
their symptoms and history with proposed
symptoms of Alzheimer’s (tests thinking and
memory), asking patients to remember words
(memory), and asking for info on their setting.
This test shows if patients actually have
cognitive abnormalities for Alzheimer's, its
severity, and if the patient requires further
evaluation/diagnostics. Sections of the Brain (Cerebral
Cortex) Evaluated by Worksheet Cognitive Examination Worksheet
 Diagnosis Method
#1: Examinations (Demo Videos)

Physical Examination Cognitive Examination Neurological Examination

 Diagnosis Method
#2: Brain Imaging/Scans
Brain Imaging/Scans can display any issues or
abnormalities in the brain and are very accurate. There are
many imaging technologies, and each has its own purpose.
Magnetic resonance imaging (MRI - radio waves) and
Computerized tomography (CT - X-ray) produces a detailed
image of the brain, pointing out possible brain shrinkage
for Alzheimer’s, or tumor, trauma, or bleeding in the brain
that would suggest the patient does not have Alzheimer’s.
Positron emission tomography (PET) is also used to display
activity in the brain. They can show changes in glucose
metabolism, oxygen metabolism, blood flow, amyloid
deposits (Amyloid PET Imaging), and neurofibrillary tangles Types of Brain Imaging MRI and PET Scans of
(Tau PET Imaging); which can all reveal abnormalities that (CT & MRI have Similar Normal vs.
hint at the actual illness. Results and Purposes) Alzheimer’s Brain
 Diagnosis Method
#3: Fluid Lab Tests
Fluid Lab Tests from blood and urine can show if the patients
really have dementia, and that their symptoms are not caused by
other conditions such as vitamin deficiency or hormone
imbalance. For example, a deficiency in vitamin B12 or thyroid
hormone also affects brain functions, and shares symptoms with
Alzheimer’s disease. Specific tests include blood count,
urinalysis, blood glucose, toxicology screen, and thyroid analysis.

From recent innovations (2021), a highly accurate blood test has

been developed that can detect the beta-amyloid and tau
proteins in the blood. If this technology continues to prove itself
successful through trials, it would be a much easier and cheaper Video on the Blood Test Breakthrough
method to detect Alzheimer’s (than Brain imaging/scans). (Why it is Game-Changing)
 Diagnosis
Benefits vs. Drawbacks/Risks
Diagnosis Benefits

An accurate diagnosis is always good (as early as possible); it means the patient can receive professional support and
treatment. While Alzheimer's can not be cured, early diagnosis help professionals plan/prepare for treatment and coping
methods, diagnosing Alzheimer’s in its early to mid stages can slow down its progression, and diagnosing mild cognitive
impairment can lead to treatment/measures that prevent further progression into Alzheimer's. Each diagnosis method
contributes (hints) at the truth (individual method benefits included on previous slides) - If the patient really has
Alzheimer’s, what are the root causes, and treatment methods.

Diagnosis Risks/Drawbacks

● None of the diagnostic methods have any major and direct health drawbacks (including brain imaging).
● Poor performance or results in methods can lead to more stress and anxiety for the patient
● An Alzheimer’s diagnosis is only 100% accurate in an autopsy; accuracy through all current methods is about 90%
 04
Alzheimer's
Treatment
 Cure for Alzheimer's?
There is currently no cure for Alzheimer’s (even in early
stages*), but there are measures and medications to
slow down the development of Alzheimer’s, and
temporarily improve the symptoms (cognitive function,
mood, behaviors, etc.). In addition, patients should
develop a healthy and stable sleep, nutrition, and
exercise lifestyle, and caregivers should create a safe,
supportive, and supervised environment.

*Abnormal protein formation of beta-amyloid and Tau

can be detected years before any signs of cognitive
decline, and they take a long time before they began to
cause issues; if recognised this early, measures can be
cured to prevent Alzheimer's. In addition, if the patient
only has mild cognitive impairment, this can also be Recent Breakthrough in Curing Alzheimer's
cured (the line drawn is not very clear).
 Treatment Method
#1. Medications
Cholinesterase Inhibitors boost the effectiveness of cell-to-cell
communication (neurons) by increasing the amount for chemical
messengers (Acetyl Coa) - its amount is greatly decreased for Alzheimer’s
patients. This drug helps treat cognitive and neuropsychiatric symptoms
(such as extreme emotions and behavior: e.g. agitation). Widely used
cholinesterase inhibitors include donepezil (Aricept), rivastigmine
(Exelon), and galantamine (Razadyne ER). This increase in the chemical
messenger can result in overstimulation, causing side effects such as
disturbances in sleep and appetite, nausea/headaches, diarrhea,
vomiting, and fatigue.

Memantine (NMDA Receptor Antagonist) (Namenda) regulates (blocking

and reducing the effects) glutamate stimulation of nerve cells, which
supports memory and learning and helps slow down the progression of Video on How Exactly Cholinesterase
Alzheimer’s in its middle to later stages. Side effects are minor, rare, and Inhibitors and Memantine Work
very temporary; they include dizziness, drowsiness, and confusion.
 Treatment Method
#1. Medications (Cont.)

● Specific Drug
● Proprietary name
● Stage it should be
used in
● Forms the medication
comes in.
 Treatment Method
#2. Therapy/Activities
These activities keep the brain active, and routinely practice its functions to
reduce the effects Alzheimer's has on them. They have no risk/downsides.

Cognitive Stimulation Therapy (CST) has patients involved in group activities

to practice, unrust, and improve mental abilities like memory and problem
solving (slowing down the impacts of Alzheimer’s).

Cognitive Rehabilitation Therapy (CRT) involves professionals helping

patients to achieve simple, everyday tasks like using a smartphone. This
practices parts of your brain that work, so that they continue to function
properly, and can help other parts that do not.

Reminiscence involves asking the patients to recall past events or items,

including positive memories, photos, and important possessions; these
Cognitive Stimulation Therapy ideas stimulate/practice mental abilities, while uplifting mood and
well-being.