Pathophysiology Flow Guide for Alzheimers Disease

FLOW GUIDE
Pathophysiology Flow Guide for Alzheimer’s disease (AD)
Predisposing Factors
 Old age
 Prolonged isolated living
Precipitating Factors
 History of high blood
pressure
Glial activation
Neuronal loss
Oxidative stress
Synaptic degradation Extracellular amyloid plaques
and neurofibrillary tangles
Phosphorylaion of the Tau
proteins
Atrophy in the temporofrontal cortex
Cholinergic hypothesis
(Reduction in AchE)
 Metal ion hypothesis
 Metal dyshomeostasis
• Inability to learn new things
• Confusion
• Difficulty to learn new things
• Difficulty in organising thoughts
• languages
Memory loss
 Restlessness &
agitation
 Bladder & Bowel
problems
 Depression
 Infection
 Wandering
MRI scan shows large space occupying
lesions in the frontal lobe.
Atrophy in
the medial
temporal
lobew of the
brain
Progressive
non-fluent
aphasia is
found in left
sided
perysylvian
atrophy
Surgical intervention
• CSF shunting
• Intraventricular infusions
• Tissue grafting
• Gene therapy
• Electrical neural
stimulation
Pharmacological intervention
• Acetylcholinesterase inhibitors
(AChEI)
• Memantine
• Galantamine
• Donepezil (10-23 mg)
• Rivastigmine
Behavioral intervention
• Cognitive behavioural
treatment
• Mental and social
stimulation
• Physical exercise
programs
• Family support
• ACE inhibitors
• Angiotensin-2 receptor
blockers