H.M. is a 67-year-old female, who recently retired from being a school teacher for the last 40 years. Her husband died 2 years ago due to complications of a CVA. Past medical history includes hypertension controlled with Olmesartan 20 mg by mouth once a day. Family history is not contributory. Last annual visits with PCP with normal results. She lives by herself but her children live close to her and usually visit her two or three times a week. Her daughter started noticing that her mother is having problems focusing when talking to her. She is not keeping things at home as she used to, and often she is repeating and asking the same question several times. Yesterday, she had issues remembering her way back home from the grocery store.
Case Study 2 Questions:
Name the most common risk factors for Alzheimer’s disease.
Name and describe the similarities and differences between Alzheimer’s disease, Vascular Dementia, Dementia with Lewy bodies, and Frontotemporal Dementia.
Define and describe explicit and implicit memory.
Describe the diagnosis criteria developed for Alzheimer’s disease by the National Institute of Aging and the Alzheimer’s Association.
What would be the best pharmacological and non-pharmacological therapeutic approaches for H.M.?
500 words, 2 cited sources APA format
- Common Risk Factors for Alzheimer’s Disease:
- Age: Advanced age is the greatest risk factor for Alzheimer’s disease.
- Genetics: Having a family history of Alzheimer’s increases the risk.
- Down Syndrome: People with Down syndrome have a higher risk of developing Alzheimer’s.
- Cardiovascular Risk Factors: Hypertension, high cholesterol, diabetes, and obesity are linked to an increased risk.
- Traumatic Brain Injury: History of severe head injury may elevate the risk.
- Lifestyle Factors: Lack of physical activity, poor diet, smoking, and social isolation may contribute to the risk.
- Types of Dementia:
- Alzheimer’s Disease: Characterized by the accumulation of amyloid plaques and neurofibrillary tangles in the brain, leading to memory loss, cognitive decline, and behavioral changes.
- Vascular Dementia: Caused by impaired blood flow to the brain due to strokes or small vessel disease, resulting in cognitive decline, particularly in attention and executive function.
- Dementia with Lewy Bodies: Associated with the presence of Lewy bodies in the brain, leading to cognitive fluctuations, visual hallucinations, and motor symptoms similar to Parkinson’s disease.
- Frontotemporal Dementia: A group of disorders characterized by atrophy of the frontal and temporal lobes, resulting in changes in behavior, personality, and language.
- Explicit and Implicit Memory:
- Explicit Memory: Also known as declarative memory, involves conscious recollection of information, such as facts or events. It can be further divided into semantic memory (general knowledge) and episodic memory (personal experiences).
- Implicit Memory: Also known as non-declarative memory, involves unconscious recall of information, such as skills and habits. It includes procedural memory (knowing how to do things) and priming (improved performance due to prior exposure).
- Diagnosis Criteria for Alzheimer’s Disease:
- The National Institute on Aging and Alzheimer’s Association (NIA-AA) developed criteria focusing on cognitive impairment, functional decline, and biomarker evidence.
- Criteria include the presence of significant cognitive impairment, deficits in at least two domains of cognition, progressive worsening of memory and other cognitive functions, absence of delirium or other neurologic or psychiatric disorders, and evidence of biomarker abnormalities (amyloid PET, CSF markers, or structural/functional neuroimaging).
- Therapeutic Approaches for H.M.:
- Pharmacological: Medications such as cholinesterase inhibitors (e.g., donepezil) and NMDA receptor antagonists (e.g., memantine) may help manage symptoms of Alzheimer’s disease.
- Non-pharmacological: Cognitive stimulation, social engagement, physical exercise, and nutritional interventions can support cognitive function and overall well-being. Additionally, caregiver support and education are crucial for managing daily challenges and enhancing quality of life.
Sources:
- Alzheimer’s Association. (2022). 10 Early Signs and Symptoms of Alzheimer’s. Retrieved from https://www.alz.org/alzheimers-dementia/10_signs.
- Jack, C. R., Bennett, D. A., Blennow, K., Carrillo, M. C., Dunn, B., Haeberlein, S. B., … & Dubois, B. (2018). NIA-AA Research Framework: Toward a biological definition of Alzheimer’s disease. Alzheimer’s & Dementia, 14(4), 535-562.