hi i'm professor fink and this is our short video lecture review of alzheimer's disease and other forms of dementia let's take a look at our lecture outline so in the uh lecture outline so what is dementia in general of which alzheimer's is simply the most common type dementia is associated with memory loss loss of language skills personality changes loss of ability to recognize objects and people a loss of motor activity to the point where eventually many of the patients with dementia including alzheimer's are not able to care for themselves uh the memory loss is just obviously disruptive to their daily life it uh makes it difficult uh there's confusion with time and place uh there is a misplacing of things uh and uh withdrawal from social activities and eventually even difficulty in speaking or writing and uh even recognizing uh family members and so on as well as being able to take care of themselves uh as we said alzheimer's is one of several types of dementia the most common form it is the fifth leading cause of death among those individuals 65 years or older alzheimer's is uh more common in women than in men about two-thirds of the cases are women one-third in men and alzheimer's is more common in individuals of african-american or hispanic descent uh it is associated with uh the buildup of abnormal proteins both between the neurons uh in the hippocampus and other parts of the brain as well as abnormal proteins inside certain neurons the cholinergic neurons themselves uh there it does seem to be a genetic significant genetic component that increases the risk of developing alzheimer's disease specifically another type of dementia that is not alzheimer's is called vascular dementia it is characterized by a reduced blood flow through the small blood vessels and capillaries in the brain uh it is seems to be associated with having a very high blood pressure uh over an extended period of time and a history of strokes a third type of dementia is called frontal temporal dementia is characterized by loss of what's called the executive function uh in the frontal lobe of the brain and what that means the executive function is kind of our self-consciousness uh that it controls us or allows us to uh filter uh what are the naked filter between our thoughts and what we say and the way we act uh we all rely upon that and when there is a breakdown dysfunctioning of the executive function and the frontal lobe uh the person basically loses their filter and whatever their thoughts are that's what they say and how they behave uh this also runs in families meaning there's a strong genetic component returning back to the treatment of alzheimer's disease and dementia in general fewer than half of the patients with alzheimer's disease show any market response to any drug therapy that is used basically meaning that we don't have very effective drugs currently to uh deal with this dementia in general in alzheimer's specifically the main goal of the drugs that are used or tried uh is to increase the excitatory neurotransmitter acetylcholine in the brain and the more common drugs that are used to raise the amount of acetylcholine in the brain which is excitatory uh are acetylcholinesterase inhibitors that just means that these are drugs that inhibit the enzyme acetylcholinesterase that normally would break down acetylcholine and the result is the acetylcholine levels rise in the brain these include the nezipil uh uh sorry donepezzo rivastigmine galantamine uh and they go under the brand names that reception excellent and remnant another approach that's used in alzheimer's in general and in other dementia in general is drugs that uh inhibit uh the glutamate uh neurotransmitter glutamate is an inhibitory neurotransmitter and by decreasing its action uh the result is an increase in excitatory activity in the brain uh and the this includes the use of momentum amantine uh for moderate to severe uh alzheimer's disease and it may delay the progress or progression of some of the symptoms of alzheimer's disease uh sedative and anti-anxiety drugs uh such as uh uh adivan and cerex uh are sometimes used to control and reduce agitation and aggression uh and sleep disorders and depression so these are called anxiolytic drugs or sedative anti-anxiety drugs antidepressants are also commonly included with uh the in the management of dementia in general and alzheimer's specifically uh to uh reduce depression and irritability uh and antipsychotic medications are used to reduce hallucinations delusions aggressive behavior hostility and uncooperativeness factors that may reduce the risk of developing alzheimer's disease include stay active uh even into uh old age uh the classic mediterranean diet and uh the use of vitamin e which seems to be uh recommended for a lot of things nowadays including covid19 reducing increasing or enhancing your immune response and other benefits as well in summarizing oral health considerations for your patients with alzheimer's disease or other forms of dementia patients may have difficulty in verbalizing oral pain or discomfort they may the condition may lead to refusal to eat pulling at their face or mouth refusal to wear dentures and increased restlessness or shouting so there may be agitation patients may forget how to brush their teeth they are more at risk of developing periodontal disease dental caries tooth loss tooth mobility or facial pain impaired swallowing sores in their mouth cracked lips coated tongue and halitosis they may also exhibit xerostomia glossitis mucositis and candidiasis as well as involuntary repetitive tongue and jawed movements or dyskinesia uh and uh finally uh we just might point out or suggest that if a patient uh who has dementia is unable to provide a valid informed consent and a guardian has not been identified or consented then probably treatment procedures should not be initiated until you do get a consent by a guardian if not the patient themselves that summarizes our completes our a brief uh summary or review of alzheimer's disease and dementia in general and its treatment we'll see you in our next video