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Alzheimer’s Disease

Alzheimer’s Disease. ….And other dementias…. AD. Can be divided into Early Onset (< 60) and Late Onset (>60). Perhaps two different etiologies After age 65, the number of cases doubles every 5 years. 3% of people 65-74 have the disease Approx. 50% of people over 85 have the disease.

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Alzheimer’s Disease

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  1. Alzheimer’s Disease ….And other dementias….

  2. AD • Can be divided into Early Onset (< 60) and Late Onset (>60). • Perhaps two different etiologies • After age 65, the number of cases doubles every 5 years. • 3% of people 65-74 have the disease • Approx. 50% of people over 85 have the disease.

  3. GRADING SYSTEM Grade 1 (top row of 4 images) corresponds to mild cerebral atrophy and ventricular dilatation. Note this degree of change may be assessed as compatible with normal aging. Thus, grade 1 accomodates scoring of brains from nondemented control subjects with minimal or no gross neuropathology. Grade 2 (middle row of 4 images) corresponds to moderately severe cerebral atrophy and ventricular dilatation. Note widening of sulci, rounding of frontal horns, and expansion of the area of the body and 3rd ventricle. Grade 3 (bottom row of 4 images) corresponds to severe cerebral atrophy and ventricular dilatation. Dramatic shrinkage of gyri, gaping of some sulci, and extreme ventricular dilatation is obvious. Note also the white matter area is markedly diminished from the amount noted in grade 1 brains.

  4. Plaques • Extracellular • Contain A-beta (sequence cleaved from APP) • Metals (aluminum, zinc) • Immunoglobulin G • Amyloid P • apoE • ETC….over 30 other proteins

  5. Tangles • Intracellular • Bundles of long unbranched elements that form a fibrous twisted pair of filaments • Consist of tau protein (a protein that ordinarily stabilizes cellular microtubules) • Are somewhat correlated with degree of dementia – post-mortem.

  6. Axis of Diagnosis 1- Memory 2- Orientation3- Judgment4- Community Affairs5- Home & Hobbies6- Personal Care

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