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

2. 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

3. 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

4. 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

5. 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.

6. 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.

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

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

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