Question

After review of K.B.'s history and diagnostic test results, K.B. is diagnosed with Alzheimer's dementia. The physician calls a family conference to discuss the implications with K.B. and his daughter.

8. What neuroanatomic changes are seen in individuals with Alzheimer's disease?

9. List at least three interventions you would plan for K.B.

Answer 1

Answer 8:- Alzheimer's disease is a neurodegenerative disease characterized by cognitive and behavioral impairment that significantly disturbs patients social and occupational function. The neuranatomical changes seen in Alzheimer's disease are:-

1. Brain is macroscopically atrophic, particularly the cerebral cortex ( major part of brain that helps in thinking, doing voulntary actions and making decisions) and hippocampus ( a structure deep in the brain that helps to encode memories).

2. Histologically, the disease is characterised by the presence of senile plaques and neurofibrillary tangles in cerebral cortex and hippocampus. Presence of amyloid in plaques in significant quantity are found on histochemical staining. These amyloid stain positive for ubiquitin, which is involved in targeting unwanted or damaged proteins for degradation. This has led to suggestion that the disease may be due to defects in the ability of neuronal cells to degrade unwanted proteins.

Answer 9:- Interventions that I would plan for KB who is a known case of Alzheimer's disease are as follows:-

1.Since there is no known drug that can treat the cause of Alzheimer's disease but symptomatic treatment is available. I will prescribe K.B with anticholinesterases such as donepezil, rivastigmine and galantamine and N-methyl-D-aspartate receptor antagonist which have shown to be of some benefit for Alzheimer's disease.

2. I will ask his family to provide familiar, cheerful environment around K.B and support for the carers.

3.I will also advice K.B daily physical exercise and memory exercise to improve his cognitive activity and physical performance.

4. In addition if sypmtoms of depression, psychosis are present in K.B then Antidepressant and Antipsychosis medication will also be added to prescription.