1. ALZHEIMER’S DISEASE Nicole Karakasis

2. What is Alzheimer’s Disease?  A progressive disease that attacks the brain  Most common form of dementia  Causes problems with memory, thinking, and behavior, cognitive decline, personality changes, functional capacity  For more information, visit https://www.youtube.com/watch?v=waeuks1- 3Z4#t=85 https://www.youtube.com/watch?v=waeuks1- 3Z4#t=85

3. What is dementia?  A wide range of symptoms associated with a decline in memory and other thinking skills  Severe enough to disrupt a person’s ability to perform daily activities  Caused by damage to brain cells  Interferes with the ability of brain cells to communicate with each other

4. Risk Factors of Alzheimer’s Disease  Risk factors that can’t be changed  Age- risk doubles every 5 years after the age of 65  Family History  Heredity  Risk factors that can be changed  Head trauma- Potentially a strong link between head injury and risk of Alzheimer’s  Head to heart health- Risk of developing Alzheimer’s is linked to conditions that damage the heart or blood vessels  Healthy aging- Keeping weight within healthy guidelines, exercising regularly, avoiding smoking and drinking excessively

5. Seven Stages of Alzheimer’s Disease  Stage 1-No impairment: Normal function and no evidence of symptoms of dementia  Stage 2- Very mild cognitive decline: Person experiences memory lapses, but no symptoms can be detected by a medical examination  Stage 3- Mild cognitive decline: Others begin to notice difficulties, memory and concentration issues may be detected in a medical interview  Stage 4- Moderate cognitive decline: mild or early stage Alzheimer’s disease, medical interview can detect clear cut symptoms

6. Seven Stages of Alzheimer’s Disease Continued  Stage 5- Moderately severe cognitive decline: Mid- stage Alzheimer’s, gaps in memory and thinking are noticeable, individuals need help with daily activities  Stage 6- Severe cognitive decline: Memory worsens, personality changes take place, individuals need extensive help with daily activities  Stage 7- Very severe cognitive decline: Late-stage Alzheimer’s, final stage of the disease

7. Signs of Alzheimer’s Disease  Memory loss that disrupts daily life  Challenges in problem solving and planning  Difficulty completing familiar daily tasks  Confusion with time or place  Trouble understanding visual images and spatial relationships  New problems with speaking and writing  Inability to retrace steps  Decreased judgment  Withdrawal from work or social activities  Changes in mood and personality

8. Diagnosis of Alzheimer’s Disease  Clinical Examination: clinical diagnosis is usually made during mild stage of the disease  Lumbar Puncture: measurement of tau in cerebrospinal fluid (tau is often elevated in individuals with Alzheimer’s)  Imaging Testing: rules out other types of dementia and treatable causes of progressive cognitive decline

9. Management and Medication  There is NO known cure for Alzheimer’s Disease and it not preventable  The following medications help treat secondary symptoms of the disease such as depression, agitation, hallucinations, delusions, sleeping disorders, etc.  Antidepressants  Beta-Blockers  Neuroleptics  Antiepileptic Drugs

10. The Effect of Alzheimer’s Disease on Exercise  Increasing physical activity is an approach to improving symptoms and slowing disease progression  Aerobic activity enhances cognitive function and attenuates age-related deterioration of brain structure  Exercise increases blood flow which helps prevent the progression of the disease  Regular walking has proven to improve memory performance

11. Case Study  70 year old female, Stage 4 Alzheimer’s Disease  Weight: 63.5 kg  Height: 167.64 cm  Blood Pressure: 130/88  Exercise History: In younger years, used to lift and run regularly, but doesn’t currently work out  No family history of heart disease  HDL: 40 mg/dl; LDL: 120/mg/dl; Cholesterol: 180 mg/dl  Medications: Donepezil to help improve mental function, ability to think and remember, and to slow the loss of these abilities

12. Risk Stratification  Age: (+) Yes  Family History: (-) No  Smoking: (-) No  Sedentary Lifestyle: (+) Yes  Obesity: (-) No  Hypertension: (-) No  Dyslipidemia: (-) No  Risk Factor: Client has a moderate risk factor due to two positive risk factors. She should see a doctor before partaking in prescribed physical activity.

13. Exercise Testing  Aerobic  6 Minute Walk Test Subject walks as fast as possible on a flat surface for 6 minutes; allowed to pace themselves and take breaks as needed; measures functional capacity  Flexibility  Goniometry Measures joint angles at full flexion and extension  Balance  Romberg Test Subject stands with their eyes closed and postural sway is observed

14. Exercise Prescription  Cardiovascular Training  Frequency: 3-5 times per week  Intensity: 40-60% max heart rate  Time: goal of 30 minutes per session, may need to start with less time at the beginning of workouts or may need 3 sessions lasting 10 minutes each  Type: walking, bike ergometer, swimming

15. Exercise Prescription Continued  Flexibility  Frequency: 3-5 days per week  Intensity: stretch until there is moderate tension, but not pain  Time: 10-15 minutes  Type: static stretches involving large muscle group  Balance  Frequency: 2-3 days per week  Intensity: low intensity  Time: 15-20 minutes  Type: Standing to sitting without using arms, standing in place without holding on to anything

16. Conclusion  Exercise has proven to be very beneficial for people with Alzheimer’s Disease because it can delay the start of the disease of slow the progress of it. Exercise can improve memory, reasoning, and cognitive function.  For more information, visit www.alz.orgwww.alz.org

17. References  Anderson, H. (1994, January 1). Alzheimer Disease. Retrieved January 5, 2015, from http://emedicine.medscape.com/article/1134817-overviewhttp://emedicine.medscape.com/article/1134817-overview  Ehrman, J, Gordon, P, Visich, V, Keteyian, S. (2013). Clinical Exercise Physiology. Human Kinetics.  Odochi, O., Montazari, S., Eriksen, J. L., & Yuen-Sum, L. (2014). Long-term treadmill exercise attenuates tau pathology in P301S tau transgenic mice. Molecular Neurodegeneration, 9(1), 187-217. doi:10.1186/1750-1326-9- 54  Tarumi, T., Rong, Z., Weinstein, A., & Chen, J. (2014). Cerebral hemodynamics of the aging brain: risk of Alzheimer disease and benefit of aerobic exercise. Frontiers In Psychology, 41-6. doi:10.3389/fphys.2014.00006  Overview | Alzheimer's Association. (n.d.). Retrieved January 3, 2015, from http://www.alz.org/alzheimers_disease_1973.asphttp://www.alz.org/alzheimers_disease_1973.asp