Alzheimer Disease Dementia: an acquired, generalized, and often progressive impairment of cognitive function that affects the content, but not the level of consciousness.

Alzheimer Disease--- Etiology and pathogenesis Neurochemical: ChAT , ACh memory,cognitive functions (hippocampus, neocortex) Genetic: Amyloid precursor protein(APP) gene presenilin 1(PS1), presenilin 2(PS2) apolipoprotein E(APOE4) FAD---autosomal dominant inherience

Alzheimer Disease--- Pathology Senile plaques: APP deposited in its center Neurofibrillary tangles(NFTs)(F1/F2) mainly the loss of cholinergic neuron in superficial cortex granulovacuolar degeneration cerebral amyloid angiopathy

Alzheimer Disease--- Clinical findings Early manifestations: recent memory impairment(typically the first sign) disoriented(time,place) leave work(aphasia, acalculia and anomia) lost easily(apraxias and visuospatial disorientation) depression primitive reflexes

Alzheimer Disease--- Clinical findings Late manifestations: lost the previously preserved social graces psychiatric symptoms may be prominent extrapyramidal rigidity and bradykinesia Mutism, incontinence and bedridden state are terminal manifestations.

Alzheimer Disease--- Investigative studies & Differential diagnosis CT or MRI scan often show cortical atrophy and enlarged ventricles(Non-special) & PET(F1/F2) Early dementia: depression, senile forget and amnesia.

Alzheimer Disease--- Investigative studies & Differential diagnosis More advanced dementia:multi-infarct dementia(step-wise progression), Creutzfeldt-Jakob disease(shorter course, characteristic EEG, prominent myoclonus).

Alzheimer Disease---Treatment & Prognosis Symptomatic treatment: cerebral vasodilators, neural protective drugs acetylcholine precursors(choline and lecithin)

Alzheimer Disease---Treatment & Prognosis AChE inhibitor, antipsychotic drugs rehabilitative management Death typically occurs from 5~10ys after the onset of symptoms.