Alzheimer’s: How much does it impact your Brain’s anatomy Meghan West, Longwood University December 1st, 2015 What is It? Alzheimer’s is a degenerative, progressive disease that affects the majority of the brain as well as memory and cognitive function. Currently it is the sixth leading cause of death in the United States and approximately 5.3 million people have been diagnosed so far. Alzheimer’s is the most common form of dementia and makes up more than half of all dementia cases. The disease is broken down into three severity levels with mild, moderate, and severe. Each level gets progressively worst and in the level of severe the end result in most likely death. Alzheimer’s is fatal, but it is not the primary cause of death and is not officially diagnosed until after an autopsy. Relation to Speech-language pathology (SLP): SLP’s are often sought out to complete therapy as cognitive functions decline. There are speech disorders associated with Alzheimer’s known as apraxia and aphasia that will be defined below. Apraxia: inability to perform acts such as reading, and writing even though the systems to do so are still present and intact. Aphasia: simplification of language with a decline in forming complete thoughts, words, and sentences. SLP’s with Alzheimer’s patients would meet with the patient at an initial session and make a diagnosis and prognosis in relationship to their needs and wants. Then a treatment plan is written out and agreed upon by both the SLP and the patient. Therapy sessions are then set up based on how often the therapists wants to see the patient. Notes and progress are noted at each session and re-evaluation may take place after a certain number of weeks or if improvement is seen. The ultimate goal is to help improve their speech and overall communication so that they can voice items they need or tasks they wish to complete. Causes: Unknown cause, but multiple factors can contribute to the disease. This factors include : Genetics Age Down’s syndrome Head Injury Researchers have indicated that senile plaques and neurofibrillary tangles cause neurons cells to be destroyed and communication to be lost in-between. Figure 1: Normal Brain versus one with Alzheimer’s References: Chakrabarti, S., Khemka, V.K., Banerjee, A., Chatterjee, G., Ganguly, A., & Biswas, A. (2015). Metabolic Risk Factors of Sporadic Alzheimer’s Disease: Implications in the Pathology, Pathogenesis and Treatment. Aging & Disease, 6(4), 282-299. doi:10. 14336/AD.2014.002 Heston, L.L., White, J.A., (1991). The Vanishing Mind: A Practical Guide to Alzheimer's Disease and other dementias. New York: W:H. Freeman. Print. Khachaturian, Z.S., & Radebaugh, T.S., (1996). Alzheimer’s disease: Cause(s), Diagnosis, Treatment, and Care. Boca Raton. Print. Martone, R.L., & Piotrowski, N.P. (2015). Alzheimer’s disease. Magill’s Medical Guide (Online Edition) U.S. Department of Health and Human Services. (4 Oct, 2013). Centers for Disease Control and Prevention: Dementia and Alzheimer’s Disease Anatomy Affected: Brain (cerebral cortex & hippocampus) Neurons Nerves Nervous System The brain begins to deteriorate as neurons are destroyed. These neurons stay the same throughout most of our lifetime and are vital to the communication between cells. The brain shrinks in size as show in the pictures above and the parietal lobe is often damaged. The hippocampus tends to be affected first and the disease then spreads to the rest of the brain including the cerebral cortex and amygdala. The parts of the brain mentioned above control thought, memory, and language which is why these are the areas we see affected first. Figure 2: Midsagittal view of a normal brain versus a brain with Alzheimer's Treatment: While there are many readily available medications, none of these cure the disease they only slow the progression of the disease. The focus of treatment is to manage behavioral and cognitive symptoms and improve memory as a whole. Some of these medications include: donepezil, rivastigmine, and galantamine. Donepezil aids more in memory and reasoning with mild side effects. Rivastigmine, according to researchers, appears to be more effective with higher doses. Galantamine is the newest addition to medications and aids in improving cognition and behavior. Patients with Alzheimer’s do not need to take more than one of these medications as they all aid in the same overall task; slower progression of the disease and improvements in cognitive functions such as memory, judgement and abstract thinking. Acknowledgements: My grandparents: For supporting me and allowing me to complete this project as both of them suffer from this disease. My parents: For helping me stay strong and for letting me bounce ideas off of them. Dr. Ann Cralidis, Ph.D., CCC/SLP: For allowing me to enhance her anatomy class and helping me choose this topic. Cormier Honors College: For allowing me to have the opportunity to complete enhancements such as this one. Longwood University: For allowing me to pursue a higher education in the field that I love. Figure 3: Areas of the Brain affected by Alzheimer’s