1. Dementia and the Brain – Introduction to Alzheimer’s disease
o Impact of dementia – growing because of more people are living to extreme old ages
o Alzheimer's disease (AD) is a form of dementia (a progressive degenerative disease affecting the brain
and the nervous system – definition that applies to all kinds of dementia).
o Characterized by:
Loss of brain cells with consequent shrinkage of the brain -> gradually getting smaller
Psychological symptoms that increase as the disease progresses
Affects primarily the cortex
o Can last 3-20 years, average 7-8 years – no onset or time for lasting
o Currently no cure (though drugs may boost performance for some people)
o Alzheimer's disease is not the only form of progressive, degenerative brain disease (dementia)
AD accounts for around 60% of cases of dementia.
Other forms of dementia include:
Vascular (multi-infarct) dementia
Focal dementias, including fronto-temporal dementia
Subcortical dementias – basal ganglia (e.g., Parkinsons disease,
Huntington’s disease).
About 820,000 people in the UK have some form of dementia.
o Consequences for society and health provision: Risk of having AD doubles
every 5 years after the age of 65
The Queen’s 100th birthday cards number is increasing
Females live longer than males -> more elderly women with AD than men
People live longer -> the number of AD patients is expected to grow steadily
42% of people in the UK have a family member or friend with AD
A leading cause of death in the UK
Annual cost of each patient to the UK economy estimated at >£25,000 per year
Total estimated cost = £23bn per annum
o Dementia is common in older age, and it can affect anyone…
o What is Alzheimer’s disease? (Mild stages) - Psychological symptoms
1. Minimal / mild dementia. - memory loss
- 'episodic' - problems remembering events from the past, or planned events in the future (‘prospective
memory’) – usually recent events
- 'semantic' - problems remembering the names of things; recognising familiar people - meaning of things
- ‘working memory’ – problems keeping information in mind; losing track of tasks and conversations
- problems thinking and making decisions
- can live independently with support
2. Moderate dementia / more severe
- confusion; disorientation in time and space
- poor judgment; apathy about life and condition – lack of emotional response
- personality changes (become withdrawn, paranoid behaviour, neglect of appearance)
- hallucinations; disturbed sleep patterns (sundowning)
3. Severe dementia:
- patients forget their own identity
- do not recognise other people
- unable to communicate
- loss of mobility; poor control over bodily functions
o Mini-mental State Exam
Quick clinical assessment: The Mini-Mental State Examination, Folstein, M.F., Folstein, S.E. and
McHugh, P.R. (1975)
Results: it affects so many areas of cognition: orientation in time/space; attentional control –
focussed cognitive activity; short-term or working memory – ability to keep info in mind; long-term
episodic memory – retrieving info after not thinking about it; language/semantic knowledge
Intersecting pentagons from MMSE
o Impact of dementia – growing because of more people are living to extreme old ages
o Alzheimer's disease (AD) is a form of dementia (a progressive degenerative disease affecting the brain
and the nervous system – definition that applies to all kinds of dementia).
o Characterized by:
Loss of brain cells with consequent shrinkage of the brain -> gradually getting smaller
Psychological symptoms that increase as the disease progresses
Affects primarily the cortex
o Can last 3-20 years, average 7-8 years – no onset or time for lasting
o Currently no cure (though drugs may boost performance for some people)
o Alzheimer's disease is not the only form of progressive, degenerative brain disease (dementia)
AD accounts for around 60% of cases of dementia.
Other forms of dementia include:
Vascular (multi-infarct) dementia
Focal dementias, including fronto-temporal dementia
Subcortical dementias – basal ganglia (e.g., Parkinsons disease,
Huntington’s disease).
About 820,000 people in the UK have some form of dementia.
o Consequences for society and health provision: Risk of having AD doubles
every 5 years after the age of 65
The Queen’s 100th birthday cards number is increasing
Females live longer than males -> more elderly women with AD than men
People live longer -> the number of AD patients is expected to grow steadily
42% of people in the UK have a family member or friend with AD
A leading cause of death in the UK
Annual cost of each patient to the UK economy estimated at >£25,000 per year
Total estimated cost = £23bn per annum
o Dementia is common in older age, and it can affect anyone…
o What is Alzheimer’s disease? (Mild stages) - Psychological symptoms
1. Minimal / mild dementia. - memory loss
- 'episodic' - problems remembering events from the past, or planned events in the future (‘prospective
memory’) – usually recent events
- 'semantic' - problems remembering the names of things; recognising familiar people - meaning of things
- ‘working memory’ – problems keeping information in mind; losing track of tasks and conversations
- problems thinking and making decisions
- can live independently with support
2. Moderate dementia / more severe
- confusion; disorientation in time and space
- poor judgment; apathy about life and condition – lack of emotional response
- personality changes (become withdrawn, paranoid behaviour, neglect of appearance)
- hallucinations; disturbed sleep patterns (sundowning)
3. Severe dementia:
- patients forget their own identity
- do not recognise other people
- unable to communicate
- loss of mobility; poor control over bodily functions
o Mini-mental State Exam
Quick clinical assessment: The Mini-Mental State Examination, Folstein, M.F., Folstein, S.E. and
McHugh, P.R. (1975)
Results: it affects so many areas of cognition: orientation in time/space; attentional control –
focussed cognitive activity; short-term or working memory – ability to keep info in mind; long-term
episodic memory – retrieving info after not thinking about it; language/semantic knowledge
Intersecting pentagons from MMSE
