Clinical features and co-morbidities in dementia due to Alzheimer’s disease Author : Gyero Reka Coordinator : Prof. Dr. Gabos Grecu Iosif Co-authors : Barmou Amani Diana, Georgescu Ion Mihai, Julia Magyar, Zoltan Kovacs

“Memory is all we are. Moments and feelings, captured in amber, strung on filaments of reason. Take a man’s memories and you take all of him. Chip away a memory at a time and you destroy him as surely as if you hammered nail after nail through his skull.”  - Mark Lawrence

Introduction of dementia due to Alzheimer’s disease (AD) Alzheimer’s disease is the prototype of a cortical degenerative disease AD is characterized pathologically by generalized atrophy of the cerebral cortex , neurofibrillary tangles, neuritic (amyloid ) plaques and granulovacuolar degeneration. A study made in 2006 estimated that 0.40% of the world population (range 11.4-59.4 million, absolute number 26.6 million) were afflicted by AD Same study predicted that this prevalence would triple and the absolute number would quadruple by 2050

What is dementia? An acquired syndrome of decline in memory and other cognitive functions suffcient to affect daily life in an alert patient Progressive and disabling NOT an inherent aspect of aging Different from normal cognitive lapses

Orientative differentiation between normal lapses and dementia Not recognizing family members Substituting inappropriate words Getting lost in own neighborhood Not recognizing numbers Rapid mood swings for no reason Sudden, dramatic personality change Forgetting a name Finding right word Forgetting date or day Losing objects (keys, glasses) Gradual changes with aging

Factors infulencing onset and progression of AD dementia Protective factors Risk factors Age Family history Head injury Educational background Estrogen replacement therapy after menopause NSAIDs Antioxidants

Alzheimer’s Disease Progresses Through Distinct Stages Mild Memory loss Language problems Mood swings Personality changes Diminished judgment Moderate Behavioral, personality changes Unable to learn/recall new info Long-term memory affected Wandering, agitation, agression, confusion Require assistence in activities of daily living Severe Gait. Incontinence, motor disturbances Bedridden Unable to perform activites of daily living Placement in long-term care needed Symptoms

Method and subjects Method and subjects Method of study Retrospective cohort study Subjects 228 patients hospitalized in 2013 146 (64.03 %) female 82 (35.96 %) male Average age of 82 years

Associated general medical conditions classified in system pathologies Cardiovascular diseases

Associated general medical conditions classified in system pathologies

Associated general medical conditions classified in system pathologies

Associated general medical conditions classified in system pathologies

Associated general medical conditions classified in system pathologies

Associated general medical conditions classified in system pathologies

Associated general medical conditions classified in system pathologies

Associated general medical conditions classified in system pathologies

Psychopathologic findings

Psychopathologic findings

Psychopathologic findings

Psychopathologic findings

Conclusion Dementias due to Alzheimer’s disease are pathologies affecting women and men in a ratio of 1.8:1 Majority of patients are diagnozed after the age of 65 years 3 most common underlying general medical conditions are: artherial hypertension, type II diabetes and chronic ischemic cardiomyopathy Clinical sympotms such as cognitive impairment, loss of memory, apraxia, aphasia, decline in self-care and so on are sever enough to interfere with the patient’s daily living

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