ALZHEIMER’S DISEASE CONCISE PATHOPHYSIOLOGY

WITH NURSING CONSIDERATIONS

Predisposing Factors BY GREGOR ALFONSIN C. PONDOYO Precipitating factor
Age Stroke (brain attack)
Genetic Factor (family history) Head Injury
Gender (women) Prolonged loss of consciousness (as
DM in drowning)
Down syndrome Low exercise and cigarette smoking
Small head size Lower levels of education
High blood pressure
High cholesterol levels
High homocysteine levels

Increased ROS and RNS

VITAMIN E
Lipid Peroxidation
Damages proteins,
lipids, DNA

Hyperlipidemia Hyperglycemia

(Further) insulin Oxidative Stress

Cardiovascular resistance
Diseases
Cellular starvation

Alpha and Gamma APP will then be cut

Secretase either by:
 Harmless P3 Protein Beta and Gamma
fragment Secretase

40 Amino Acid 42 Amino Acid Tau hyperphosphorylation

Cleared in the brain Not cleared in the Tau protein pair up

brain

Form helical shape

Clings between nerve Continuous production

Microscopy but Clump together
synapse
only after death or
AUTOPSY
Neurofibrillary
Clumping effect
tangles formed
Cholinesterase
Nerve Impulse Blocking
Inhibitors
Plaque build up (esp. In
Disrupts
hippocampus and cerebral
microtubules
cortex)
Nutrient transport
Acetylcholine not
system goes awry
transported

Non-usage of neuron
(Chronic) Inflammation Depletion of intrinsic
antioxidants
PET will show
Atrophy hypomebolism
CT scan and/ MRI will Generation of more
show reduction in free radicals
size of brain, widened
indentations,
Amplification of
enlarged cerebral
oxidative stress
ventricles

CELL DEATH
 Motor neuron
involvement From mild forgetfulness to inability to
generate short term memory to inability to
perform ADL to loss of long term memory
and the capability to do abstract thinking,
Paralysis reason, do arithmetical procedures, to
inability to talk, move and recognize place,
time, and person around.

Susceptibility to other
complications

Death

Legend:

Phenomenon

Manifestation

Management

Consecutively: Direction of Pathogenesis; Manifestation; Management; Direction of a Possible Phenomenon

Sources:

Alzheimer's Disease – Pathophysiology (2010). Medicine Encyclopedia. Retrieved on November 26, 2010 from
http://medicine.jrank.org/pages/80/Alzheimer-s-Disease-Pathophysiology.html

Alzheimer’s Disease: Overview of Diagnostic Tests (2005). Cleaveland Clinic.org. Retrieved on December 4, 2010 from
http://www.cchs.net/health/health-info/docs/2300/2346.asp?index=9176

Alzheimer’s Disease (2006, December 17). Great Controversies in Neurobiology. Retrieved on December 3, 2010 from
https://wiki.brown.edu/confluence/display/BN0193S04/Project+Group+3

Alzheimer’s Disease (2006). Republic of the Philippines, Department of Health. Retrieved on November 20, 2010 from
http://www.doh.gov.ph/faq/show/489.html

Alzheimer’s Disease (n.d.) Medicine. Web-books.com. Retrieved on December 8, 2010 from http://www.web-
books.com/eLibrary/Medicine/Neurological/Alzheimer.htm#Top

Anderson, Heather S. (2010, July 22). Alzheimer’s Disease. Medscape. Retrieved on December 8, 2010 from
http://emedicine.medscape.com/article/1134817-overview

APP (2010, November 7). Genetics Home Reference. Retrieved on December 5, 2010 from http://ghr.nlm.nih.gov/gene/APP
Arrasate, Montserrat, Mitra, Siddhartha, Schweitzer, Erik S., Segal, Mark R., and Finkbeiner, Steven (2004, October 14). Inclusion body
formation reduces levels of mutant huntingtin and the risk of neuronal death. Nature Publishing Group. Retrieved on December 7, 2010
from https://wiki.brown.edu/confluence/download/attachments/11719/Nature-Huntingtin's.pdf?
version=1&modificationDate=1165777192000

Askari, Famia (2009). Alzheimer’s: research on prevention, management and care. Retrieved on December 7, 2010 from
http://www.medlink-uk.org/Site/documents/Alzheimers2010/AskariF.pdf

Barglow, Raymond (2010, February 25). Alzheimer’s Disease- How Long Before We Find a Cure? The Berkley Daily Planet. Retrieved on
December 5, 2010 from http://www.berkeleydailyplanet.com/issue/2010-02-25/article/34707?headline=Alzheimer-s-Disease-How-Long-
Before-We-Find-a-Cure-

Black, Joyce M. and Hawks, Jane H. (2004). Medical-Surgical Nursing: Clinical Management for Positive Outcomes volume 2. 7 th edition.
Elsevier. Philippines. page 2162-2170

Brain Structures and Their Functions (2005, June 3). Serendip. Retrieved on November 12, 2010 from
http://serendip.brynmawr.edu/bb/kinser/Structure1.html

Bruton, Linda J (2007, February 20). Alzheimer's Disease Diagnostic Tests and Tools. Retrieved on December 2, 2010 from
http://ezinearticles.com/?Alzheimers-Disease-Diagnostic-Tests-and-Tools&id=454483
Caimi, G., Carollo, C., and Lo Presti, R. (2003). Oxidative Stress and Diabetes Mellitus. Retrieved on December 6, 2010 from
http://www.medscape.com/viewarticle/463121_4

Castellani, Rudy J., Lee, Hyoung-gon, Perry, George, and Smith, Mark A. (2006). Antioxidant protection and neurodegenerative disease: The
role of amyloid-f3 and tau. American Journal of Alzheimer's Disease and Other Dementias, Volume 21, Number 2, March/April 2006.
Retrieved from https://wiki.brown.edu/confluence/download/attachments/11719/neuro.pdf?version=1&modificationDate=1162759321000

Chronic Inflammation (n.d.). FlameEz.com. Retrieved on December 2, 2010 from http://www.flameez.com/inflammation

Fauci, Anthony S., Braunwald, Eugene, Kasper, Dennis L., Hauser, Stephen L., Longo, Dan L., Jameson, J. Larry, and Loscalzo, Joseph (2009).
Harrison’s Manual of Medicine 17th Edition. New York: McGraw Hill Medical pages 2478, 2540, 2541

Hesselink, John R. (2008). THE TEMPORAL LOBE & LIMBIC SYSTEM. UCSD Neuroradiology. Retrieved on December 8, 2010 from
http://spinwarp.ucsd.edu/NeuroWeb/Text/br-800epi.htm

Inflammation: Chronic (n.d.). Life Extension.org. Retrieved on December 1, 2010 from http://www.lef.org/protocols/prtcl-146.shtml

Morhan, Simona D., Chong, Zhao-Zhong, and Maiese, Kenneth (2008). Oxidative Stress and Diabetes. Harlem Children Society. Retrieved on
December 8, 2010 from http://www.harlemchildrensociety.org/misc/StudentInfo/MorhanSimona/paper_morhan.pdf
Nordqvist, Christian (2009, June 31). What is Alzheimer’s Disease? What Causes Alzheimer’s Disease? Medical News Today. Retrieved on
December 8, 2010 from http://www.medicalnewstoday.com/articles/159442.php

Norman, William (2009, November 27). Neuron Glucose Metabolism & Alzheimer's Disease. Retrieved on November 29, 2010 from
http://www.ehow.com/about_5693153_neuron-glucose-metabolism-alzheimer_s-disease.html

Nourish- Carbohydrates Fuel Your Brain (2004). The Franklin Institute Online. Retrieved on December 6, 2010 from
http://www.fi.edu/learn/brain/carbs.html

Olson, Scott (2008, November 12). What Sugar Does to Your Brain. Retrieved on December 6, 2010 from http://olsonnd.com/what-sugar-
does-to-your-brain/

Oxidative Stress (2010). The Free Dictionary.Retrieved on December 3, 2010 from http://medical-
dictionary.thefreedictionary.com/oxidative+stress

Prasad, Kedar N., Cole, William C., and Prasad, K. Che (2002). Risk Factors for Alzheimer’s Disease: Role of Multiple Antioxidants, Non-
Steroidal Anti-inflammatory and Cholinergic Agents Alone or in Combination in Prevention and Treatment. Journal of the American College
of Nutrition, Vol. 21, No. 6, 506-522. Retrieved on December 5, 2010 from http://www.jacn.org/cgi/content/full/21/6/506

Rand, James B. (2007). Acetylcholine. WormBook.org. Retrieved on December 6, 2010 from

http://www.wormbook.org/chapters/www_acetylcholine/acetylcholine.html
Rienstra, Douwe (November 2006). Medicine For People! Retrieved on December 4, 2010 from
http://www.rienstraclinic.com/newsletter/2006/2006Nov.html

Saint Louis University (2009, July 9). Inflammation May Trigger Alzheimer's Disease. ScienceDaily. Retrieved December 9, 2010, from
http://www.sciencedaily.com /releases/2009/07/090708181204.htm

Smeltzer, Suzanne C., Bare, Brenda G., Hinkle, Janice L., and Cheever, Kerry H. (2008). Textbook of Medical-Surgical Nursing volume 2. 11 th
Edition. Lippincott Williams and Wilkins. Philippines. Page 2320-232

Spies, Petra E., Claassen, Jurgen, Slats, Diane, Rikkert, Marcel, Verbeek, Marcel, and Kessels, Roy (2009, May 10). Cerebrospinal Fluid Tau and
Amyloid Beta Proteins Do Not Correlate With Cognitive Functioning in Cognitively Impaired Memory Clinic Patients. CNS Spectrums.
Retrieved on December 6, 2010 from http://www.cnsspectrums.com/aspx/articledetail.aspx?articleid=2836

Tavee, Jinny and Sweeney, Patrick (2010, August 1). Alzheimer’s Disease. Retrieved on December 4, 2010 from
http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/neurology/alzheimers-disease/

Adams, Amy (2000, September 8). Genes Can Cause Alzheimer’s Disease. Genetic Health. Retrieved on December 8, 2010 from
http://www.genetichealth.com/alz_genetics_of_alzheimers_disease.shtml

Aluminium and Alzheimer’s Disease (September 2008). Alheimer’s Society. Retrieved on December 8, 2010 from
http://alzheimers.org.uk/site/scripts/documents_info.php?documentID=99

 
Alzheimer’s Disease (n.d.). DNA Learning Center Home. Retrieved on November 23, 2010 from
http://www.yourgenesyourhealth.org/alz/whatisit.htm

Campbell, Denis (2009, August 4). Middle-aged smokers at higher risk of dementia. The Guardian. Retrieved on December 7, 2010 from
http://www.guardian.co.uk/lifeandstyle/2009/aug/04/middle-aged-smokers-risk-dementia

Champeau, Rachel (2006, May 22). UCLA Study Finds that Simple Lifestyle Changes May Improve Cognitive Function and Brain Efficiency.
UCLA Newsroom. Retrieved on December 7, 2010 from http://www.newsroom.ucla.edu/portal/ucla/UCLA-Study-Finds-that-Simple-Lifestyle-
7062.aspx?RelNum=7062

George, Kelly (2010, October 26). New study: Smoking can lead to Alzheimer’s and Dementia. Examiner.com Retrieved on December 8, 2010
from http://www.examiner.com/healthy-trends-in-atlanta/new-study-smoking-can-lead-to-alzheimer-s-and-dementia

Healthy Brain (2010). Alzheimer Society Columbia. Retrieved on December 8, 2010 from http://www.alzheimerbc.org/Alzheimer-s-Disease-
and-Dementia/Brain-Fitness-Plan.aspx

Lowe, Derek (2010, March 16). Beta-Amyloid: An Antibiotic? In The Pipeline. Retrieved on December 7, 2010 from
http://pipeline.corante.com/archives/2010/03/16/betaamyloid_an_antibiotic.php

Mayo Clinic Staff (2010, August 5). Alzheimer’s Disease, Alzheimer’s genes: Are you at risk? Mayo Foundation for Medical Education and
Research. Retrieved on December 7, 2010 from http://www.mayoclinic.com/health/alzheimers-genes/AZ00047
Sample, Ian (2009, September 6). Alzheimer’s research links three genes to disease. The Guardian. Retrieved on December 7, 2010 from
http://www.guardian.co.uk/science/2009/sep/06/alzheimers-disease-genes-research

Email me at:

arthascourge@gmail.com

For comments and suggestions

THANK YOU J