Alzheimer's disease is a progressive condition, which means the symptoms develop gradually over many years and eventually become more severe. It affects multiple brain functions. The first sign of Alzheimer's disease is usually minor memory problems. For example, this could be forgetting about recent conversations or events, and forgetting the names of places and objects. As the condition develops, memory problems become more severe and further symptoms can develop, such as: confusion, disorientation and getting lost in familiar places difficulty planning or making decisions problems with speech and language problems moving around without assistance or performing self-care tasks personality changes, such as becoming aggressive, demanding and suspicious of others hallucinations (seeing or hearing things that are not there) and delusions (believing things that are untrue) low mood or anxiety

1. Alzheimer’s Disease
Presented to : Sir. Asif Shahzad
Presented by : Mahnoor Shahzad
Lyallpur institute of management & sciences
Department of biochemistry

2. Contents
 Introduction to Alzheimer’s disease
 Origin of Alzheimer’s disease
 Meaning
 Incidence
 Etiology
 Mechanism of action
 Risk factors
 Symptoms
 Prevention
 Treatment
 Drugs against Alzheimer’s disease

3. Introduction to Alzheimer’s disease:
 Alzheimer’s disease is a degenerative
brain disorder of unknown etiology
which is most common form of
dementia, that usually starts in late
middle age or in old age, results in
progressivememory loss, impaired
thinking, disorientation and changes
in personality and mood. There is a
degeneration in the brain neurons
especially in the cerebral cortex and
presence of neurofibrillarytangles
and plaques containing beta-amyloid
cells.

4. Origin of Alzheimer’s disease:
 The disease was first described by Dr. Alois Alzheimer,
a German physician, in 1906
 Alzheimer had a patient named Auguste D in her
fifties who suffered from what seems to be a mental
illness. But when she died in 1906, an autopsy
revealed dense deposits, now called neuritic plaques
outside and around the nerve cells in her brain. Inside
the cells were twisted strands of fibre, or neurofibrillary
tangles. Since Dr. Alois Alzheimer was the first person
who discovered the disease, AD was named after it.

5. Meaning:
 Alzheimer’s disease is a chronic, irreversible
disease that affects the cells of the brain
and cause progressive impairment of
memory and cognition functioning.
 Alzheimer’s disease is a brain disorder
which gradually destroys the ability to
reason, remember, imagine and learn.

6. Incidence:
 About 3 percent of men and women ages 65-
74 have AD, and nearly half of those age 85
and older may have the disease.
 About 3,60,000 new cases of Alzheimer’s
disease are diagnosed each year.

7. Etiology:
 The exact causes of Alzheimer’s diseasearen’t fullyunderstood. But at a basic
level, brain proteins fail to function normally,whichdisrupts the work of brain
cells (neurons)and triggers a series of toxic events. Neurons are damaged, lose
connections to each other and eventually die.
 Researchers trying to understandthe cause of Alzheimer’s disease are focused
on the role of two proteins:
 Plaques:
Beta-amyloidis a fragment of a larger protein.When these fragments
cluster together, they appear to have a toxic effect on neurons and to disrupt
cell-to-cell communication. These clusters form larger deposits called amyloid
plaques or Senile plaques. Beta-amyloidprotein is formedfrom the breakdown of
a larger protein,called amyloid precursor protein (APP).

8.  Role of Chaperone Enzyme
 Pin I: Recently an enzyme Pin I has been found which is necessary for
formation of normal Tau protein. Absence of Pin I in this condition produces
the abnormal Tau protein.
 Tangles: Tau proteins play a part in a neuron’s internal support and
transport system to carry nutrients and other essential materials. In
Alzheimer’s disease, tau proteins change shape and organize themselves
into structures called neurofibrillarytangles. The tangles disrupt the
transport system and are toxic to cells. The synthesis of acetylcholine is
reduced leading to memory loss which affects the cholinergic neurons.

10. Mechanism of action:

11. Risk factors:
 Age:
 Increasing age is the greatest known risk factor for Alzheimer’s disease.Alzheimer’s is
not a part of normal aging, but as you grow older the likelihoodof developing
Alzheimer’s diseaseincreases.
 Family history and genetic:
 Your risk of developingAlzheimer’s is somewhat higher if a first-degreerelative—
your parent or sibling — has the disease. Most geneticmechanisms of Alzheimer’s
among families remain largely unexplained, and the geneticfactors are likely
complex.
 One better understoodgeneticfactor is a form of the apolipoproteinE gene (APOE).
A variation of the gene, APOE e4, increases the risk of Alzheimer’s disease.

12.  Down syndrome:
 Many people with Down syndrome develop Alzheimer’s disease. This is
likelyrelated to having three copies of chromosome 21 — and
subsequently three copies of the gene for the protein that leads to the
creation of beta-amyloid.
 Head trauma:
 People who’ve had a severe head trauma have a greater risk of
Alzheimer’s disease.
 Several large studies found that in people age 50 years or older who had a
traumatic brain injury (TBI), the risk of dementia and Alzheimer’sdisease
increased. The risk increases in people with more-

13.  Air pollution:
 Studies in animals have indicated that air pollution particulates can speed
degeneration of the nervous system. And human studies have found that air
pollution exposure — particularlyfrom traffic exhaust and burning wood — is
associated with greater dementia risk.
 Excessive alcohol consumption:
 Drinking large amounts of alcohol has long been known to cause brain changes.
Several large studies and reviews found that alcohol use disorders were linked to
an increased risk of dementia.
 Poor sleep patterns:
 Research has shown that poor sleep patterns, such as difficulty falling asleep or
staying asleep, are associated with an increased risk of Alzheimer’sdisease.

14.  Lifestyle and heart health:
 Research has shown that the same risk factors associated with heart
disease may also increase the risk of Alzheimer’s disease. These include:
 Lack of exercise
 Obesity
 Smoking
 High blood pressure
 High cholesterol
 Poorly controlled type 2 diabetes

15. Symptoms:
 People with Alzheimer’s may:
1. Loss of memory with inability to recall.
2. Difficulty in performing similar tasks.
3. Forget time, place, way and purpose.
4. Poor judgement.
5. Misplacing objects e.g wallet, key, mobile etc
6. Depression, anxiety and insomnia.
7. Have trouble finding the right words to identify objects, express
thoughts or take part in conversations.
8. Eventually forget the names of family members and everyday
objects.
9. Repeat statements and questions over and over

16. Prevention:
 Alzheimer’s disease is not a preventable condition. However, a number of lifestyle risk
factors for Alzheimer’s can be modified. Evidence suggests that changes in diet, exercise
and habits — steps to reduce the risk of cardiovascular disease — may also lower your risk
of developing Alzheimer’s disease and other disorders that cause dementia. Heart-
healthy lifestyle choices that may reduce the risk of Alzheimer’s include the following:
1. Prevent and manage high blood pressure.
2. Manage blood sugar.
3. Maintain a healthy weight.
4. Be physically active.
5. Quit smoking.
6. Exercising regularly.
7. Get enough sleep

17. Treatment:
 Alzheimer’s Disease can be treated either
by
1. Increasing the level of Acetylcholine
2. Inhibiting the destruction of Acetylcholine
by decreasing concentration of Acetyl
cholinesterase.

18. Drugs against Alzheimer’s disease:
 Cholinesterase inhibitors:
Tacrine, was a first drug approved to treat Alzheimer’s disease but this drug is
not used yet because it causes hepatotoxicity and as well as nausea,
vomiting and abdominal cramps.
Rivastigmine, is a newer drug with minimum side effects.
 Nootropic Agent:
Drugs used to specifically facilitate learning or memory. These drugs stimulate
happiness.
For example, Piracetam.
 Galantamine

19. Thank you!
Any questions?