Alzheimers PP
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Transcript of Alzheimers PP
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@s ~fa ~i~ca sqggas~s# ~fis r|asam~`~ihm is ` sq|zay hj oq||am~ s~|qo~q|`c `mn laf`zih|`c
@ctkaika|s Nisa`sa &@N) sigms# o`qsas `mn ~|a`~kam~s- _~|qo~q| c issqas ohmoa|m
ajjao~s hj ~fa nisa`sa hm l|`im s~|qo~q|as sqof `s ma|za oaccs `mn l|`im ~issqa- Laf`zih|`cissqas imocqna ajjao~s hm kakh|y `mn ra|shm`ci~y-
Ji|s~# i~ naso|ilas @N i~sacj im gama|`c ~a|ks `mn ~fa sohra hj ~fa ikr`o~ ~fa nisa`sa f`s
hm gchl`c shoia~y- ^fasa ikr`o~s `|a jim`moi`ccy# akh~ihm`ccy# `mn lihchgio`ccy sqls~`m~i`c-
Mav~# I sfhw ~fa gama~io `mn mhm+gama~io |ise j`o~h|s jh| nazachrimg@N-
^fam# i~ av`kimas @N r`~fhrfysihchgy# imocqnimg ~fa kaof`misks ly wfiof @N imjcio~s i~s
~a||ilca ~hcc- @j~a| nacima`~img ~fa s~`gas hj @N# i~ r|asam~s ~wh o`sa s~qnias hj `jjcio~an
imnizqnq`cs- @|a yhq `lca ~h mh~a ~fa laf`zih|`c issqas8
Jim`ccy# i~ sq|zays `mn `m`cytas ~fa oq||am~cy `rr|hzan n|qg ~fa|`rias# imocqnimgrsyofh~|hrio n|qgs jh| rsyofh~io sykr~hks- Im `nni~ihm# i~ av`kimas `mn chhes jh|w`|n
~h rh~am~i`c ikkqmh~fa|`rias- @mn# c`s~cy# i~ o|i~ipqas shka hj ~fa mhm+`rr|hzan n|qg
~|a`~kam~s `mn ~|i`cs-
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@ctfaika|s nisa`sa &@N) is ` r|hg|assiza maq|hnagama|`~iza nish|na| of`|`o~a|itan ly
~fa `oo|q`c hjmaq|i~io rc`pqas `mn maq|hjil|icc`|y ~`mgcas ~f`~ |asqc~ im ` nis|qr~ihm hj
maq|hm`c jqmo~ihm `mn wfiof o`qsas ohgmi~iza `mn laf`zih|`c nysjqmo~ihm &L|``e *L|``e# 0990)-
@N o`qsas `m imsinihqs `mn r|hg|assiza chss hj ohgmi~iza jqmo~ihm `mn imnaramnamoa#
~`eimg ` fa`zy ra|shm`c `mn jim`moi`c ~hcc hm ~fa r`~iam~ `mn ~fa j`kicy- @ctfaika|'s
nisa`sa# Rioe's nisa`sa# `mn h~fa| h|g`mio jh|ks hj nakam~i` `|a gama|`ccy ohmsina|an
i||aza|silca# r|hg|assiza# `mn imoq|`lca-
@N is ~fa khs~ ohkkhm o`qsa hjnakam~i` `khmg hcna| rahrca-Nakam~i` is ` chss hj
kam~`c `lici~y saza|a amhqgf ~h im~a|ja|a wi~f mh|k`c `o~izi~ias hj n`icy cizimg# c`s~img
kh|a ~f`m siv khm~fs# mh~ r|asam~ simoa li|~f# `mn mh~ `sshoi`~an wi~f ` chss h|
`c~a|`~ihm hj ohmsoihqsmass-
Nakam~i` is ` g|hqr hj sykr~hks o`qsan ly g|`nq`c na`~f hj l|`im oaccs- ^fa chss hj ohgmi~iza`lici~ias ~f`~ hooq|s wi~f nakam~i` ca`ns ~h ikr`i|kam~s im kakh|y# |a`shmimg# rc`mmimg# `mnlaf`zih|- Wfica ~fa hza|wfackimg mqkla| hj rahrca wi~f nakam~i` |a acna|cy# nakam~i` ismh~ `m imazi~`lca r`|~ hj `gimg5 ims~a`n# nakam~i` is o`qsan ly sraoijio l|`im nisa`sas-
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Im
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Na`~fs j|hk @ctfaika|s imo|a`san :: ra|oam~ la~waam
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@ga4 Ki~hofhmn|i` laohka kh|a sqsoar~ilca ~h n`k`ga5 Imjc`kk`~ihm &swaccimg)
imo|a`sas# wfiof o`m imdq|a ma|za oaccs# sqof `s `j~a| ` fa`n imdq|y5
Hvin`~iza s~|ass# wfiof is o`qsan ly ~fa |aca`sa hj khcaoqcas o`ccan j|aa |`nio`cs j|hk
mh|k`c oaccqc`| r|hoassas# imo|a`sas-
Anqo`~ihm cazac4 \asa`|of sqggas~s ~fa kh|a ya`|s hj jh|k`c anqo`~ihm hma f`s# ~fa cass
cieacy hma is ~h nazachr @ctfaika|'s- _hka avra|~s ~fah|ita ~f`~ chmga| anqo`~ihm k`y
r|hnqoa ` namsa| ma~wh|e hj sym`rsas- ^fis k`y o|a`~a ` eimn hj,maq|`c |asa|za, ~f`~
am`lcas rahrca ~h ohkrams`~a chmga| jh| ~fa a`|cy l|`im of`mgas-
\`oa `mn A~fmioi~y4 @j|io`m+@ka|io`ms `mn Fisr`mios `|a `lhq~ ~wioa `s cieacy ~h
nazachr @ctfaika|s `s wfi~a @ka|io`ms hj ~fa s`ka `ga- Wfica ~fa |a`shms jh| ~fis `|a
qmoca`|# ~fa|a is shka sraoqc`~ihm ~f`~ i~ k`y f`za ~h nh wi~f ~fa j`o~ ~f`~ ~fasa g|hqrs
f`za ` figfa| imoinamoa hj figf lchhn r|assq|a `mn ni`la~as-
Figf lchhn r|assq|a `mn figf ofhcas~a|hc4 ^fa|a is g|hwimg azinamoa ~f`~ k`my hj ~fa
wacc+as~`lcisfan |ise j`o~h|s jh| o`|nihz`soqc`| nisa`sa# imocqnimg figf ofhcas~a|hc `mn
figf lchhn r|assq|a# k`y `csh la |ise j`o~h|s jh| @ctfaika|'s nisa`sa-
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Ni`la~as4 Ni`la~as f`s laam ikrcio`~an `s ` |ise j`o~h| jh| azam~q`ccy nazachrimg
@ctfaika|'s nisa`sa- ^fa|a `|a k`my hmghimg s~qnias `~~akr~img ~h qmna|s~`mn ~fa
ohmmao~ihm# `mn shka ni`la~as n|qgs `rra`| ~h schw ~fa ohgmi~iza naocima `sshoi`~an
wi~f @ctfaika|'s nisa`sa-
Fa`n ~|`qk`4 _hka s~qnias f`za jhqmn ~f`~ @ctfaika|'s hooq|s kh|a hj~am im rahrca
wfh f`za sqjja|an ~|`qk`~io l|`im imdq|y a`|cia| im cija- @ fis~h|y hj fa`n imdq|y is oca`|cy
` |ise j`o~h| jh| @ctfaika|'s im rahrca wfh o`||y ~fa @RHA+> @ctfaika|'s gama-
Nia~4 Hlasis~y nhqlcan ~fa |ise hj nazachrimg @N5 Jhhns figf im j`~ `mn sqg`|# `s wacc `s
c`|ga| khqm~s hj|an `mn r|hoassan ka`~s imo|a`san |ise za|sqs ca`m ka`~s &jisf `mn
rhqc~|y) `mn kh|a j|qi~s `mn zaga~`lcas-
^fa o`qsa hj @N is mh~ oca`|- Yhq| gamas `mn amzi|hmkam~`c j`o~h|s saak ~h rc`y ` |hca-
@cqkimqk# ca`n# `mn ka|oq|y im ~fa l|`im is mh chmga| laciazan ~h la ` o`qsa hj @N-
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Azam ij hmcy hma hj ~fasa gamas ~f`~ `|a imfa|i~an j|hk ` r`|am~ ohm~`ims ` kq~`~ihm# ~fa
ra|shm wicc `ckhs~ imazi~`lcy nazachr a`|cy+hmsa~ @N- &022!)
^fis gama# o`ccan @RHA# r|hnqoas ` r|h~aim o`ccan `rhcirhr|h~aim A- @RHA ohkas imsaza|`c jh|ks# h| `ccacas- @RHA > hooq|s im `lhq~ >2 ra|oam~ hj `cc
rahrca wfh nazachr c`~a+hmsa~ @N `mn is r|asam~ im `lhq~
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@ooqkqc`~ihm hj ~hvio la~` kychin wi~f ~fa jh|k`~ihm hj av~|`oaccqc`| la~``kychin+
ohm~`imimg rc`pqas4 Wa s~icc nh mh~ emhw wfa~fa| `kychin rc`pqas ~faksaczas o`qsa
@N h| wfa~fa| ~fay `|a ` ly+r|hnqo~ hj ~fa @N r|hoass- Fhwaza|# gama~io kq~`~ihms o`m
imo|a`sa r|hnqo~ihm hj la~`+`kychin `mn o`m o`qsa |`|a# imfa|i~an jh|ks hj @N-
Nazachrkam~ hj im~|`oaccqc`| maq|hjil|icc`|y ~`mgcas4 ^`mgcas `|a `lmh|k`c ohccao~ihms
hj ~wis~an r|h~aim ~f|a`ns jhqmn imsina ma|za oaccs- ^fa ofiaj ohkrhmam~ hj ~`mgcas is `
r|h~aim o`ccan ~`q-
Maq|hm`c nagama|`~ihm4 ^fa @N r|hoass mh~ hmcy imfili~s ohkkqmio`~ihm la~waammaq|hms lq~ o`m `csh n`k`ga maq|hms ~h ~fa rhim~ ~f`~ ~fay o`mmh~ jqmo~ihm r|hra|cy
`mn azam~q`ccy nia- @s maq|hms nia ~f|hqgfhq~ ~fa l|`im# `jjao~an |agihms lagim ~h sf|ime
im ` r|hoass o`ccan l|`im `~|hrfy-
^fa l|`ims hj rahrca wi~f @N f`za `m `lqmn`moa hj ~wh `lmh|k`c s~|qo~q|as`kychin
rc`pqas `mn maq|hjil|icc`|y ~`mgcas~f`~ `|a k`na hj kisjhcnan r|h~aims - ^fa ~fi|n k`im
ja`~q|a hj @N is ~fa chss hj ohmmao~ihms la~waam oaccs- ^fis ca`ns ~h nikimisfan oacc jqmo~ihm`mn oacc na`~f-
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@kychin r|aoq|sh| r|h~aim &@RR) laohkas
aklannan im oacc sq|j`oa
_raoijio amtykas smir# h| oca`za# @RR im~h
niso|a~a j|`gkam~s# shka `|a La~`+`kychin
&@) rar~inas
@gg|ag`~as hj ~wh# ~f|aa# jhq|# h| azam qr ~h `
nhtam la~`+`kychin rar~inas `|a o`ccan
hcighka|s-
@s ~fa r|hoass ohm~imqas# hcighka|s g|hw
c`|ga|# laohkimg am~i~ias o`ccan r|h~hjil|ics `mn
jil|ics- Azam~q`ccy# h~fa| r|h~aims `mn oaccqc`|k`~a|i`c `|a `nnan# `mn ~fasa imo|a`simgcy
imshcqlca am~i~ias ohklima ~h laohka ~fa wacc+
emhwm rc`pqas ~f`~ `|a of`|`o~a|is~io hj @N-
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Kqc~irca cimas hj azinamoa mhw sqggas~ ~f`~ i~ is mh~ dqs~ ~fa r|asamoa hj @ lq~ ~far|hnqo~ihm `mn(h| narhsi~ihm hj~hvio jh|ks hj la~` `kychin# `chmg wi~f ~fa schwimg hj @
oca`|`moa# ~f`~ `o~ `s ~fa oam~|`c `mn r|ik`|y azam~s im @N r`~fhgamasis# wfica maq|hjil|icc`|y~`mgca jh|k`~ihm `mn maq|hm`c oacc na`~f hooq| nhwms~|a`k im ~fis `kychin o`so`na-
La~``kychin narhsi~ihm wi~fim ~fa OM_ whqcn l|img `lhq~ ~fa `o~iz`~ihm hj kio|hgci`
`mn ~fqs imi~i`~a ` r|himjc`kk ~h|y o`so`na ca`nimg ~h |aca`sa rh~am~i`ccy maq|h~hvio
sqls~`moas &oy~heimas5 ofakheimas5 |a`o~iza hvygam `mnmi~|hgam sraoias5 r|h~ahcy~io
amtykas) `mn ~h `krcijy maq|`c n`k`ga-
Acaz`~an cazacs hj ~`q r|h~aim im ~fa oa|al|hsrim`c jcqin &O_J) `|a k`|ea|s hj `o~iza
maq|hm`c nagama|`~ihm# wfica cazacs hj `lmh|k`ccy rfhsrfh|yc ~an ~`q &R+~`q) `rra`| ~h
oh||ac ~a wi~f ~fa pq`m~i~y hj maq|hjil|icc`|y ~`mgcas im ~fa l|`im# sqggas~img ~f`~ O_J R+
~`q k`y sa|za `s `m im zizh lihk`|ea| hj ~fa maq|hjil|icc`|y r`~fhchgy hj @N-
Oaccs `mn ohkrhqmns emhwm ~h la imzhczan im imjc`kk`~ihm `|a jhqmn im @N rc`pqas-
_hka |asa`|ofa|s ~fime ~f`~ ohkrhmam~s hj ~fa imjc`kk`~h|y r|hoass k`y rc`y ` |hca im
@N- H~fa| rc`ya|s im ~fa `gimg r|hoass ~f`~ k`y la ikrh|~`m~ im @N `|a j|aa |`nio`cs#
hvygam h| mi~|hgam khcaoqcas ~f`~ ohklima a`sicy wi~f h~fa| khcaoqcas-
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^fasa ~`q ~f|a`ns jh|k s~|qo~q|as o`ccan r`i|an facio`c
jic`kam~s# wfiof o`m laohka amkasfan wi~f hma `mh~fa|#
jh|kimg ~`mgcas wi~fim ~fa oacc-
@s ` |asqc~ hj fyra|rfhsrfh|yc`~ihm# ~`q nisamg`gas j|hk
~fa kio|h~qlqcas `mn lagims ~h ohka ~hga~fa| wi~f h~fa|
~`q ~f|a`ns-
Fa`c~fy maq|hms `|a im~a|m`ccy sqrrh|~an im r`|~ ly
s~|qo~q|as o`ccan kio|h~qlqcas# wfiof facr ~|`msrh|~
mq~|iam~s `mn h~fa| oaccqc`| ohkrhmam~s# j|hk ~fa oacc lhnynhwm ~fa `vhm-
^fa kio|h~qlqcas o`m nisim~ag|`~a im ~fa r|hoass# ohcc`rsimg
~fa maq|hms im~a|m`c ~|`msrh|~ ma~wh|e- ^fis ohcc`rsa
n`k`gas ~fa `lici~y hj maq|hms ~h ohkkqmio`~a wi~f a`of
h~fa|-
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Hm ~fis scioa# ~fa `~|hrfio firrho`krqs `mn `kygn`c` o`m la saam- ^fasa
s~|qo~q|as sqlsa|za kakh|y jqmo~ihm# `mn `|a ~fa si~as hj k`dh| n`k`ga im
@ctfaika|'s nisa`sa-
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Fa|a is ` kin+zam~|ioqc`| scioa wfiof nakhms~|`~as ~fa ohkkhmas~ jimnimg im
jqmo~ihm`c ik`gimg hj @ctfaika|'s nisa`sa- ^fa n`|e lcqa |agihms im ~far`|ia~`c chlas |ar|asam~ `|a`s hj nao|a`san lchhn jchw h| ra|jqsihm- fis
|anqo~ihm im lchhn jchw is nqa im r`|~ ~h ~fa qmna|cyimg `~|hrfy# im r`|~ ~h ~fa
r|asamoa hj nisa`san l|`im# `mn im r`|~ ~h ~fa jqmo~ihm`c ,nisohmmao~ihm, hj
~fis j|hk h~fa| l|`im |agihms `jjao~an ly ~fa nisa`sa-
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^fa `sshoi`~ihm oh|~av hj ~fa r`|ia~`c chlas is hj~am saza|acy `jjao~an# `s
iccqs~|`~an im ~fis o`sa-
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K\I `mn RA^ so`m ik`ga hza|c`y jh| oh||asrhmnimg scioa sfhwimg ra|jqsihm
`mn `~|hrfy im ~fa `sshoi`~an `|a`s hj |anqoan lchhn jchw-
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Im ~fis RA^ so`m# ~fa |an `mn yacchw ohch|s
imnio`~a ~f`~ RiL qr~`ea is figfa| im ~fa
l|`im hj ~fa ra|shm wi~f @N ~f`m im ~fa
ohgmi~izacy fa`c~fy ra|shm-
_oiam~is~s nazachran ` |`nihc`lacan ohkrhqmn
o`ccan Ri~~slq|gf Ohkrhqmn L &RiL)-
RiL limns ~h la~`+`kychin rc`pqas im ~fa l|`im `mn
o`m la ik`gan qsimg RA^ so`ms-
Imi~i`c s~qnias sfhwan ~f`~ rahrca wi~f @N ~`ea qr
kh|a RiL im ~fai| l|`ims ~f`m nh ohgmi~izacy fa`c~fy
hcna| rahrca-
_imoa ~fam# soiam~is~s f`za jhqmn figf cazacs hj RiL
im shka ohgmi~izacy fa`c~fy rahrca# sqggas~img ~f`~
~fa n`k`ga j|hk la~` `kychin k`y `c|a`ny la
qmna|w`y-
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^fa ohkrams`~h|y fyrh~fasis is `m avrc`m`~ihm hj nijja|am~i`c |agihm`c &l|`im |agihms)
`o~izi~y saam im `~+|ise g|hqrs-
^fa ohkrams`~h|y fyrh~fasis fhcns ~f`~ `s @N+|ac`~an nagama|`~iza r|hoassas r|hg|ass
~fa l|`im akrchys z`|ihqs ohkrams`~h|y ka`sq|as ~h hza|ohka ~fasa r`~fhchgio
amo|h`ofkam~s qm~ic ~fa naocima im ohgmi~iza `lici~ias laohkas `rr`|am~ `mn# qc~ik`~acy#
n`icy jqmo~ihmimg is nis|qr~an-
@ooh|nimgcy# imo|a`san jqmo~ihm`c `o~izi~y f`s laam im~a|r|a~an `s ` ohkrams`~h|y
r|hoass wfa|aly g|a`~a| ohgmi~iza ajjh|~qsq`ccy |ajcao~an ly imo|a`sas im LHCN &lchhn
hvygam cazac)`o~izi~yis |apqi|an ~h ra|jh|k `~ `m apqiz`cam~ cazac ohkr`|an ~h fa`c~fy
ohm~|hc g|hqrs-
_ikic`|cy# nao|a`san `o~izi~y im fa`c~fy jqmo~ihmimg f`s laam im~a|r|a~an `s azinamoa hj
ajjioiam~ r|hoassimg &Khmn`nh|i a~ `c-#
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@N lagims naar im ~fa l|`im# im ~fa am~h|fim`c oh|~av# ` l|`im |agihm ~f`~ is ma`| ~fa
firrho`krqs `mn f`s ni|ao~ ohmmao~ihms ~h i~- Fa`c~fy maq|hms im ~fis |agihm lagim ~h
wh|e cass ajjioiam~cy# chsa ~fai| `lici~y ~h ohkkqmio`~a# `mn qc~ik`~acy nia-
^fis r|hoass g|`nq`ccy sr|a`ns ~h ~fa firrho`krqs# ~fa l|`im |agihm ~f`~ rc`ys ` k`dh|
|hca im ca`|mimg `mn is imzhczan im ohmza|~img sfh|~+~a|k kakh|ias ~h chmg+~a|k
kakh|ias- @jjao~an |agihms lagim ~h `~|hrfy-
Zam~|iocas# ~fa jcqin jiccan sr`oas imsina ~fa l|`im# lagim ~h amc`|ga `s ~fa r|hoass
ohm~imqas-
_oiam~is~s laciaza ~f`~ ~fasa l|`im of`mgas lagim 02 ~h
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@s shka rahrca g|hw hcna|# ~fay nazachr kakh|y r|hlcaks g|a`~a| ~f`m ~fhsa
avrao~an jh| ~fai| `ga- Lq~ ~fay nh mh~ avra|iamoa ~fa ra|shm`ci~y of`mgas h| h~fa|
r|hlcaks ~f`~ `|a of`|`o~a|is~io hj @N- ^fasa rahrca k`y f`za ` ohmni~ihm o`ccan kicn
ohgmi~iza ikr`i|kam~ &KOI)-
Rahrca wi~f KOI `|a ` o|i~io`ccy ikrh|~`m~ g|hqr jh| |asa`|of lao`qsa ` kqof figfa|
ra|oam~ ga hj ~fak gh hm ~h nazachr @N ~f`m nh rahrca wi~fhq~ ~fasa kakh|y
r|hlcaks- @lhq~ 6 hj aza|y 02 rahrca wfh ji~ ~fa najimi~ihm hj `kmas~io KOI gh hm ~h
nazachr @N wi~fim 7 ya`|s-
^fhsa wi~f KOI wfh f`n ch~s hj ~|hqlca khzimg ~fai| cags `mn jaa~ wa|a kh|a ~f`m
~wioa `s cieacy ~h nazachr @N `s ~fhsa wi~f ghhn chwa| lhny jqmo~ihm-
Fhwaza|# |asa`|ofa|s `|a mh~ ya~ `lca ~h s`y najimi~izacy wfy shka rahrca wi~f
`kmas~io KOI nh mh~ r|hg|ass ~h @N# mh| o`m ~fay s`y wfh wicc h| wicc mh~ gh hm ~h
nazachr @N-
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@s @N sr|a`ns ~f|hqgf ~fa l|`im# ~fa mqkla| hj rc`pqas `mn ~`mgcas g|hws# sf|ime`ga
r|hg|assas# `mn kh|a `mn kh|a hj ~fa oa|al|`c oh|~av is `jjao~an- Kakh|y chss
ohm~imqas `mn of`mgas im h~fa| ohgmi~iza `lici~ias lagim ~h aka|ga- ^fa ocimio`c ni`gmhsis
hj @N is qsq`ccy k`na nq|img ~fis s~`ga-
Im kicn @N# ` ra|shm k`y saak ~h la fa`c~fy lq~ is `o~q`ccy f`zimg kh|a `mn kh|a
~|hqlca k`eimg samsa hj ~fa wh|cn `|hqmn fik h| fa|- ^fa |a`cit`~ihm ~f`~ shka~fimg is
w|hmg hj~am ohkas g|`nq`ccy ~h ~fa ra|shm `mn fis h| fa| j`kicy-
_igms hj kicn @N o`m imocqna4 Kakh|y chss Ohmjqsihm `lhq~ ~fa cho`~ihm hj j`kici`|
rc`oas &ga~~img chs~ lagims ~h hooq|)5 ^`eimg chmga| ~f`m lajh|a ~h `oohkrcisf mh|k`c
n`icy ~`ses5 ^|hqlca f`mncimg khmay `mn r`yimg liccs5 Chss hj srhm~`mai~y `mn samsa hj
imi~i`~iza5 Khhn `mn ra|shm`ci~y of`mgas# imo|a`san `mvia~y `mn(h| `gg|assihm
@ooar~img ~fasa sigms `s shka~fimg h~fa| ~f`m mh|k`c `mn naoinimg ~h gh jh| ni`gmhs~io
~as~s o`m la ` lig fq|nca jh| rahrca `mn j`kicias-
-
7/31/2019 Alzheimers PP
25/55
Ly ~fis s~`ga# @N n`k`ga f`s sr|a`n ~h ~fa `|a`s hj ~fa oa|al|`c oh|~av ~f`~ ohm~|hc
c`mgq`ga# |a`shmimg# samsh|y r|hoassimg# mn ohmsoihqs ~fhqgf~- @jjao~an |agihms
ohm~imqa ~h sf|ime# zam~|iocas amc`|ga# `mn sigms `mn sykr~hks hj ~fa nisa`sa laohka
kh|a r|hmhqmoan mn winasr|a`n-
Laf`zih|`c r|hlcaks# sqof `s w`mna|img mn gi~`~ihm# o`m hooq|- Kh|a im~amsiza
sqra|zisihm `mn o`|a laohka maoass`|y# wfiof o`m la nijjioqc~ jh| k`my srhqsas `mn
j`kicias- _hka hj ~fasa sykr~hks k`y laohka wh|sa im ~fa azamimg &` rfamhkamhm
o`ccan sqmnhwmimg) h| nq|img n`icy |hq~imas# asraoi`ccy l`~fimg-
^fa sykr~hks hj ~fis s~`ga o`m imocqna4 Imo|a`simg kakh|y chss `mn ohmjqsihm5
Im`rr|hr|i`~a hq~lq|s~s hj `mga|5 R|hlcaks |aohgmitimg j|iamns `mn j`kicy kakla|s5
Nijjioqc~y wi~f c`mgq`ga5 \as~cassmass# `gi~`~ihm# `mvia~y# ~a`|jqcmass# w`mna|img
asraoi`ccy im ~fa c`~a `j~a|mhhm h| migf~- @mn#
F`ccqoim`~ihms# nacqsihms# sqsrioihqsmass h| r`|`mhi`# i||i~`lici~y5 Chss hj ikrqcsa ohm~|hc&sfhwm ~f|hqgf qmn|assimg `~ im`rr|hr|i`~a ~ikas h| rc`oas h| zqcg`| c`mgq`ga)5 @m
im`lici~y ~h o`||y hq~ `o~izi~ias ~f`~ imzhcza kqc~irca s~ars im sapqamoa# sqof `s n|assimg#
k`eimg ` rh~ hj ohjjaa# h| sa~~img ~fa ~`lca-
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7/31/2019 Alzheimers PP
26/55
Rahrca wi~f saza|a @N o`mmh~ |aohgmita j`kicy `mn chzan hmas h| ohkkqmio`~a im `my
w`y- ^fay `|a ohkrca~acy naramnam~ hm h~fa|s jh| o`|a-
_ykr~hks o`m imocqna4 Waigf~ chss5 _aitq|as5 _eim imjao~ihms5 Nijjioqc~y sw`cchwimg5
G|h`mimg# kh`mimg h| g|qm~img5 Imo|a`san scaarimg5 Chss hj lc`nna| h| lhwac ohm~|hc-
^h pq`cijy jh| fhsrioa lamaji~s qmna| Kanio`|a# ` rfysioi`m kqs~ ni`gmhsis ~fa ra|shm
wi~f @ctfaika|s nisa`sa `s f`zimg cass ~f`m siv khm~fs ~h ciza-
Ma`| ~fa amn# ~fa ra|shm k`y la im lan kqof h| `cc hj ~fa ~ika- ^fa khs~ j|apqam~
o`qsa hj na`~f jh| rahrca wi~f @N is `sri|`~ihm rmaqkhmi`- ^fis ~yra hj rmaqkhmi`
nazachrs wfam ` ra|shm is mh~ `lca ~h sw`cchw r|hra|cy `mn ~`eas jhhn h| cipqins im~h
~fa cqmgs ims~a`n hj `i|-
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7/31/2019 Alzheimers PP
27/55
^fis ni`g|`k |aza`cs ~fa maq|hr`~fhchgio`c f`cck`|es hj @N
~f`~ imocqna maq|i~io &`csh samica) rc`pqas# maq|hjil|icc`|y
~`mgcas &MJ^s)# `mn `kychin `mgihr`~fy-
Maq|i~io rc`pqas `|a av~|`oaccqc`| `gg|ag`~as hj la~`&
)+`kychin r|h~aim im ` kiciaq hj |a`o~iza `s~|hoy~as `mn
`o~iz`~an kio|hgci`-
MJ^s `|a im~|`maq|hm`c oy~hrc`sk`~io jic`kam~s ohkrhsan
hj fyra|rfhsrfh|yc`~an ~`q# j|apqam~cy ohmdqg`~an wi~f
qlipqi~im-
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7/31/2019 Alzheimers PP
28/55
-
7/31/2019 Alzheimers PP
29/55
-
7/31/2019 Alzheimers PP
30/55
Hma ~yra is ~fa |`|a# a`|cy+hmsa~ @ctfaika|s nisa`sa- I~ qsq`ccy `jjao~s rahrca `gan ?2
~h :2- _hka o`sas hj a`|cy+hmsa~ nisa`sa `|a imfa|i~an `mn `|a o`ccan j`kici`c @N &J@N)-
I~ is `oemhwcangan ~f`~ 71! hj rahrca wi~f @N f`za srh|`nio @N &_@N) ` jh|k hj c`~a+
hmsa~ @N &CH@N)- ^fis is khs~ cieacy ` kqc~ij`o~h|i`c ohmni~ihm# wfiof imzhczas `
ohklim`~ihm hj gama~io# cijas~yca# `mn amzi|hmkam~`c j`o~h|s-
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7/31/2019 Alzheimers PP
31/55
^fa h~fa| is c`~a+hmsa~ @ctfaika|s nisa`sa &CH@N)- I~ is ly j`| ~fa kh|a ohkkhm jh|k
`mn hooq|s im ~fhsa :2 `mn hcna|-
@s jh| CH@N# ~fa hmcy as~`lcisfan gama~io j`o~h| is `rhcirhr|h~aim A &@RHA)- @RHA
`sshoi`~an @ctfaika|s nisa`sa is nqa ~h ` sraoijio z`|i`~ihm im ~fa @RHA gama o`ccan a>
`ccaca- I~ is as~ik`~an ~f`~ >2:1! hj @N r`~iam~s f`za `~ ca`s~ hma ohry hj ~fa a> `ccaca-
Imnizinq`cs wi~f ~wh a> `ccacas f`za qr ~h mag`~iza# `mn shka@rhA>
fhkhtygh~as maza| nazachr ~fa nisa`sa-
Kh|a saza|a kani`c+~akrh|`c chla `~|hrfy k`y la r|asam~ im sykr~hk`~io @N@N &a`|cy
hmsa~) o`||ia|s ohkr`|an wi~f _@N &c`~a hmsa~)-
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7/31/2019 Alzheimers PP
32/55
Kakh|y chss ~f`~ nis|qr~s n`icy cija4 jh|ga~~img |aoam~cy ca`|man imjh|k`~ihm# ikrh|~`m~ n`~as
h| azam~s5 `seimg |ara~i~izacy jh| ~fimgs5 qsimg kakh|y `inas &a-g-# |akimna| mh~as h| acao~|hmio
nazioas) h| j`kicy kakla|s jh| ~fimgs ~fay qsan ~h f`mnca hm ~fai| hwm-
Of`ccamgas im rc`mmimg h| shczimg r|hlcaks4 _hka rahrca k`y avra|iamoa of`mgas im ~fai|
`lici~y ~h nazachr `mn jhcchw ` rc`m h| wh|e wi~f mqkla|s- ^fay k`y f`za ~|hqlca jhcchwimg `
j`kici`| |aoira h| eaarimg ~|`oe hj khm~fcy liccs- ^fay k`y f`za nijjioqc~y ohmoam~|`~img `mn
~`ea kqof chmga| ~h nh ~fimgs ~f`m ~fay nin lajh|a-
Wf`~s ^yrio`c4 _hka~ikas jh|ga~~img m`kas h| `rrhim~kam~s#
lq~ |akakla|img ~fak c`~a|-
Wf`~s ^yrio`c4 K`eimg hoo`sihm`c a||h|s wfam l`c`moimg `
ofaoelhhe-
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7/31/2019 Alzheimers PP
33/55
Nijjioqc~y ohkrca~img j`kici`| ~`ses `~ fhka# `~ wh|e h| `~ caisq|a4 Rahrca wi~f @ctfaika|s
hj~am jimn i~ f`|n ~h ohkrca~a n`icy ~`ses- _hka~ikas# rahrca k`y f`za ~|hqlca n|izimg ~h `
j`kici`| cho`~ihm# k`m`gimg ` lqnga~ `~ wh|e h| |akakla|img ~fa |qcas hj ` j`zh|i~a g`ka-
Ohmjqsihm wi~f ~ika h| rc`oa4 Rahrca wi~f @ctfaika|'s o`m chsa ~|`oe hj n`~as# sa`shms `mn ~fa
r`ss`ga hj ~ika- ^fay k`y f`za ~|hqlca qmna|s~`mnimg shka~fimg ij i~ is mh~ f`rramimg
ikkani`~acy- _hka~ikas ~fay k`y jh|ga~ wfa|a ~fay `|a h| fhw ~fay gh~ ~fa|a-
Wf`~s ^yrio`c4 Hoo`sihm`ccy maanimg facr ~h qsa ~fa sa~~imgs
hm ` kio|hw`za h| ~h |aoh|n ` ~acazisihm sfhw-
Wf`~s ^yrio`c4 Ga~~img ohmjqsan `lhq~ ~fa n`y hj ~fa waae lq~
jigq|img i~ hq~ c`~a|-
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7/31/2019 Alzheimers PP
34/55
^|hqlca qmna|s~`mnimg zisq`c ik`gas `mn sr`~i`c |ac`~ihmsfirs4 Jh| shka rahrca# f`zimg
zisihm r|hlcaks is ` sigm hj @ctfaika|'s- ^fay k`y f`za nijjioqc~y |a`nimg# dqngimg nis~`moa `mnna~a|kimimg ohch| h| ohm~|`s~- Im ~a|ks hj ra|oar~ihm# ~fay k`y r`ss ` ki||h| `mn ~fime
shkahma acsa is im ~fa |hhk- ^fay k`y mh~ |aohgmita ~fai| hwm |ajcao~ihm-
Maw r|hlcaks wi~f wh|ns im sra`eimg h| w|i~img4 Rahrca wi~f @ctfaika|'s k`y f`za ~|hqlca
jhcchwimg h| dhimimg ` ohmza|s`~ihm- ^fay k`y s~hr im ~fa kinnca hj ` ohmza|s`~ihm `mn f`za mh
ina` fhw ~h ohm~imqa h| ~fay k`y |ara`~ ~faksaczas- ^fay k`y s~|qggca wi~f zho`lqc`|y# f`za
r|hlcaks jimnimg ~fa |igf~ wh|n h| o`cc ~fimgs ly ~fa w|hmg m`ka &a-g-# o`ccimg ` w`~of ` ,f`mnochoe,)-
Wf`~s ^yrio`c4 Zisihm of`mgas |ac`~an ~h o`~`|`o~s-
Wf`~s ^yrio`c4 _hka~ikas f`zimg ~|hqlca jimnimg ~fa |igf~ wh|n-
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7/31/2019 Alzheimers PP
35/55
Kisrc`oimg ~fimgs `mn chsimg ~fa `lici~y ~h |a~|`oa s~ars4 @ ra|shm wi~f @ctfaika|s nisa`sa
k`y rq~ ~fimgs im qmqsq`c rc`oas- ^fay k`y chsa ~fimgs `mn la qm`lca ~h gh l`oe hza| ~fai|s~ars ~h jimn ~fak `g`im- _hka~ikas# ~fay k`y `ooqsa h~fa|s hj s~a`cimg- ^fis k`y hooq| kh|a
j|apqam~cy hza| ~ika-
Nao|a`san h| rhh| dqngkam~4 Rahrca wi~f @ctfaika|'s k`y avra|iamoa of`mgas im dqngkam~ h|
naoisihm k`eimg- Jh| av`krca# ~fay k`y qsa rhh| dqngkam~ wfam na`cimg wi~f khmay# gizimg
c`|ga `khqm~s ~h ~acak`|ea~a|s- ^fay k`y r`y cass `~~am~ihm ~h g|hhkimg h| eaarimg~faksaczas oca`m-
Wf`~s ^yrio`c4 Kisrc`oimg ~fimgs j|hk ~ika ~h ~ika# sqof `s `
r`i| hj gc`ssas h| ~fa |akh~a ohm~|hc-
Wf`~s ^yrio`c4 K`eimg ` l`n naoisihm hmoa im ` wfica-
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7/31/2019 Alzheimers PP
36/55
Wi~fn|`w`c j|hk wh|e h| shoi`c o~izi~ias4 @ ra|shm wi~f @ctfaika|'s k`y s~`|~ ~h |akhza
~faksaczas j|hk fhllias# shoi`c `o~izi~ias# wh|e r|hdao~s h| srh|~s- ^fay k`y f`za ~|hqlcaeaarimg qr wi~f ` j`zh|i~a srh|~s ~a`k h| |akakla|img fhw ~h ohkrca~a ` j`zh|i~a fhlly-
^fay k`y `csh `zhin laimg shoi`c lao`qsa hj ~fa of`mgas ~fay f`za avra|iamoan-
Of`mgas im khhn mn ra|shm`ci~y4 ^fa khhn `mn ra|shm`ci~ias hj rahrca wi~f @ctfaika|'s o`m
of`mga- ^fay o`m laohka ohmjqsan# sqsrioihqs# nar|assan# ja`|jqc h| `mvihqs- ^fay k`y la
a`sicy qrsa~ `~ fhka# `~ wh|e# wi~f j|iamns h| im rc`oas wfa|a ~fay `|a hq~ hj ~fai| ohkjh|~
thma-
Wf`~s ^yrio`c4 _hka~ikas jaacimg wa`|y hj wh|e# j`kicy `mn
shoi`c hlcig`~ihms-
Wf`~s ^yrio`c4 Nazachrimg za|y sraoijio w`ys hj nhimg ~fimgs
`mn laohkimg i||i~`lca wfam ` |hq~ima is nis|qr~an
-
7/31/2019 Alzheimers PP
37/55
Rsyofhsis is j|apqam~ im c`~a hmsa~
@ctfaika|s nisa`sa# wi~f ` kani`m
r|az`camoa `o|hss s~qnias hj>0!-
Rsyofhsis sigmijio`m~cy `gg|ag`~an wi~fim
c`~a hmsa~ @ctfaika|s nisa`sa j`kicias
sqggas~img ~f`~ i~ k`y inam~ijy `gama~io`ccy na~a|kiman sqlg|hqr-
Azinamoa imnio`~as ~f`~ rsyofhsis is `
k`|ea| jh| kh|a saza|a ohgmi~iza
ikr`i|kam~s `mn ` kh|a |`rincy
r|hg|assiza rfamh~yra hj c`~a hmsa~
@ctfaika|s nisa`sa-
-
7/31/2019 Alzheimers PP
38/55
@ 7? ya`| hcn whk`m# w`s l|hqgf~ ~h maq|hchgio`c az`cq`~ihm ly fa| l|h~fa|lao`qsa hj ` ? ya`| fis~h|y hj kakh|y ikr`i|kam~- _fa f`n ohkrca~an figfsofhhc `mn wh|ean im ` oca|io`c rhsi~ihm qm~ic fa| |a~i|akam~ im 0961- _fa f`n cizan`chma `mn k`im~`iman fa| hwm fhka `mn jim`moi`c `jj`i|s simoa ~fa na`~f hj fa|fqsl`mn im 0962- ^fa l|h~fa| f`n lagqm ~h mh~ioa g|`nq`ccy wh|samimg kakh|yikr`i|kam~ `mn nijjioqc~y jimnimg wh|ns# lq~ ~fa r`~iam~ lao`ka `mg|y `~ ~fa
sqggas~ihm ~f`~ sfa k`y f`za ` r|hg|assiza ikr`i|kam~- H~fa|s f`n mh~annaocima im fhqsaeaarimg `mn jim`moi`c `jj`i|s# lq~ sfa f`n mh ohkrc`im~s-
Acaz`~an |~a|i`c lchhn r|assq|a w`s nhoqkam~an hm saza|`c hoo`sihms# lq~ sfamaza| ~hhe kanio`~ihm- _fa f`n mh oficn|am `mn f`n ` fys~a|ao~hky-
_fa w`s ` wacc+g|hhkan whk`m wfh w`s `ca|~ `mn j|iamncy- Gama|`c `mnacakam~`c maq|hchgio`c av`ks wa|a mh|k`c-
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7/31/2019 Alzheimers PP
39/55
Fa| sraaof w`s figfcy `mhkio `mn r`|`rf`sio# wi~f ` ~amnamoy ~h qsa z`gqa|aja|am~s sqof `s ,~fimgs, `mn ,s~qjj,- _fa w`s `lca ~h r|hzina fa| m`ka# lq~
wfam `sean `lhq~ fa| oq||am~ `ga# sfa s`in4 ,I nhm'~ emhw - - -# `lhq~ 6 I ~fime-, _faimoh||ao~cy s~`~an fa| li|~f khm~f# lq~ ~fam lao`ka `w`|a hj ~fis- Gizam ~f|aaofhioas# sfa w`s `lca ~h giza ~fa oh||ao~ khm~f- _fa w`s qm`lca ~h giza ~fa ya`| hjfa| li|~f# ~fa oq||am~ ya`|# h| ~fa m`ka hj ~fa oq||am~ Q-_- R|asinam~-
Hm jh|k`c ~as~img# sfa soh|an wacc lachw `za|`ga im `cc ohgmi~iza nhk`ims- ^fasa
~as~s imocqnan ~fa Waofsca| Kakh|y so`ca# ~fa Waofsca| @nqc~ Im~accigamoa _o`ca#nigi~ sr`m `mn sikic`|i~ias sql~as~s# ~fa Lhs~hm M`kimg ^as~# ~fa OA\@N Wh|n Cis~Kakh|y ^as~# ~fa OA\@N Zisqh+sr`~i`c Ohms~|qo~ihm# ~fa O|hss Oi|oca ^as~s# ~faO`cijh|mi` R|hza|l ^as~# `mn ~fa G|`rfhkh~h| @c~a|m`~ihm ^as~- _fa ~amnan ~hra|saza|`~a lh~f za|l`c `mn kh~h| |asrhmsas-
^fa ohmocqsihm hj ~fa az`cq`~ihm w`s ~f`~ sfa ka~ |asa`|of o|i~a|i` jh| ,r|hl`lca,@ctfaika|'s nisa`sa# ~f`~ sfa |apqi|an ohkrca~a sqra|zisihm `|hqmn ~fa ochoe ~himsq|a fa| s`ja~y# `mn ~f`~ sfa whqcn r|hl`lcy lamaji~ j|hk shoi`c s~ikqc`~ihmr|hzinan ly ` g|hqr cizimg si~q`~ihm-
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7/31/2019 Alzheimers PP
40/55
Mh|~f @ka|io`m&JN@) `mn Aq|hra`m Qmihm&AK@) |agqc`~h|y o|i~a|i` jh| k`|ea~img
`rr|hz`c hj rq~`~iza sykr~hk`~io `mn nisa`sa+khnijyimg ~fa|`raq~io `gam~s jh| @Nl`san hm4
`mn hj~am azinamoa hj hza|`cc ocimio`c ikr|hzakam~ h| cass hza|`cc naocima `oohkr`mianly `napq`~a azinamoa hjs`ja~y-
` nakhms~|`~ihm hjajjio`oy sqrrh|~an ly ikr|hzakam~s ohkr`|an ~h rc`oalh~|a`~kam~ hm ohgmi~iza jqmo~ihm# `o~izi~ias hj n`icy cizimg &@NC)
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7/31/2019 Alzheimers PP
41/55
@ocimioi`ms gchl`c `ssasskam~ &emhwm `s ` Ocimioi`m Im~a|ziawL`san Ikr|assihm hj
Of`mga wi~f o`|agiza| imrq~ UOILIO[ h| @NO_ Ocimio`c Gchl`c Ikr|assihm hj Of`mgaUOGIO[) h| ~fa Ocimio`c Nakam~i` \`~img &ON\)# `m im~a|ziaw+l`san hza|`cc nakam~i`
saza|i~y `ssasskam~# `|a ~fa ohmzam~ihm`c hq~ohkas ka`sq|as-
s~`mn`|nitan r|h~hohcs4 kicn ~h khna|`~a @N is imnavan ly ` Kimi+ Kam~`c _~`~a
Av`kim`~ihm &KK_A) soh|a hj 02
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7/31/2019 Alzheimers PP
42/55
@oa~ycofhcimas~a|`sa imfili~h|s &@OfA+Is) `|a ~fa ji|s~ oc`ss hj `gam~s
sraoijio`ccy `rr|hzan ly ~fa Q_ Jhhn `mn N|qg @nkimis~|`~ihm
&JN@)h| ~fa ~|a`~kam~ hjkicn ~h khna|`~a @N-
^fa |asrhmsas ~h ~|a`~kam~ wi~f nijja|am~ @OfA+Is f`za
hza|c`rrimg ohmjinamoa im~a|z`cs &OI)# `mn mh imnizinq`c
ofhcimas~a|`sa imfili~h| f`s laam sfhwm ~h la sqra|ih| ~h h~fa|s im
~a|ks hj ajjio`oy
Ohm~imqimg lamaji~ j|hk qsa hj @OfA+Is f`s laam sfhwm im ~|i`cs
c`s~img qr ~h < ya`|s# `khmg r`~iam~s jhcchwan hza| ~f`~ camg~f hj
~ika &@N
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7/31/2019 Alzheimers PP
43/55
Kak`m~ima w`s qsan im Ga|k`my jh| ~fa ~|a`~kam~ hjR`|eimshms
nisa`sa r|ih| ~h i~s `rr|hz`c im ~fa Q_@ `mn gchl`ccy jh| ~|a`~kam~ hj
@N-
Kak`m~ima is `m MKN@ |aoar~h| `m~`ghmis~ ~f`~ |arc`oas rh~`ssiqk
im ~fa MKN@ |aoar~h| of`mmac ~h |anqoa am~|y hj o`coiqk im~h
maq|hms `mn `zhin o`coiqk+s~ikqc ~an rhr~h~io oacc na`~f
o`so`nas-
Ocimio`c ~|i`cs hj kak`m~ima f`za laam za|y sikic`| im nasigm ~h
~fhsa ohmnqo~an wi~f @OfA+Is# lq~ f`za imzhczan r`~iam~s wi~f
khna|`~a ~h saza|a @N# |`~fa| ~f`m kicn ~h khna|`~a @N- Kak`m~ima is mh~ `rr|hzan ly ~fa JN@ jh| r`~iam~s wi~f kicn @N-
Aq|hra`m |agqc`~h|y `q~fh|i~ias av~amnan ~fa |`mga hj `rr|hz`c jh|
qsa hj kak`m~ima ~h r`~iam~s wi~f KK_A soh|as hj 09 `mn lachw-
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7/31/2019 Alzheimers PP
44/55
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7/31/2019 Alzheimers PP
45/55
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7/31/2019 Alzheimers PP
46/55
Ofhcimas~a|`sa imfili~h|s `mn kak`m~ima `|a rh~am~i`c ~fa|`rias jh| ~fa k`m`gakam~ hj
k`my ohgmi~iza sykr~hks hj @N# lq~ ~fasa maq|h~|`mski~~a|+l`san `rr|h`ofas nh mh~
`nn|ass ~fa qmna|cyimg r`~fhchgy hj ~fa iccmass# `mn qc~ik`~acy j`ic ~h r|azam~ i~s
r|hg|assihm-
G`s~|him~as~im`c sina ajjao~s 4 @mh|avi`# m`qsa`# zhki~img# ni`||fa`# `mn waigf~ chss
k`y hooq| `mn sfhqcn la khmi~h|an im r`~iam~s ~|a`~an wi~f ~fasa `gam~s- Im `nni~ihm#
ofhcima|gio imjcqamoas k`y schw fa`|~ |`~a `mn l|`nyo`|ni` is ` ohm~|`imnio`~ihm ~h qsa
hj@OfA+Is-
Im o`sas wfa|a ~fasa n|qgs `rra`| ~h la ajjao~iza# r`~iam~s `mn o`|agiza|s |arh|~an `
schwimg im sykr~hks sqof `s kakh|y chss# |anqoan `mvia~y# ikr|hzan khhn `mn
|as~h|an ohmjinamoa cazacs- _hka r`~iam~s wicc |asrhmn `mn h~fa|s mh~ ~h @OfA+Is-
Hmoa ` r`~iam~ s~hrs ~`eimg ` n|qg# ~fai| ohmni~ihm wicc na~a|ih|`~a hza| ` ra|ihn hj > ~h
: waaes qm~ic ~fay `|a `~ ~fa s`ka rhim~ `s `m imnizinq`c wfh f`s mh~ ~`eam ~fa n|qg-
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7/31/2019 Alzheimers PP
47/55
R`ssiza ikkqmh~fa|`ry |aja|s ~h ~fa ni|ao~ `nkimis~|`~ihm hj `m~i+la~`+`kychin
`m~ilhnias# hlzi`~img ~fa maan jh| r`~iam~s ~h khqm~ `m `m~ilhny |asrhmsa- R`ssiza
ikkqmh~fa|`ry im ~fa jh|k hj sraoijio`ccy nasigman khmhochm`c `m~ilhnias `cchws jh|
~fa r|aoisa ~`|ga~img hj la~`+`kychin ari~hras-
Im ohm~|`s~# `o~iza ikkqmh~fa|`ry imzhczas ~fa `nkimis~|`~ihm hj ai~fa| jqcc+camg~f
la~``kychin rar~inas h| rar~ina j|`gkam~s ~h `o~iz`~a ~fa r`~iam~s ikkqma sys~ak im
h|na| ~h r|hnqoa `m~i+la~``kychin `m~ilhnias-
@M079
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7/31/2019 Alzheimers PP
48/55
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7/31/2019 Alzheimers PP
49/55
Rhsi~|hm akissihm ~hkhg|`rfy &RA^) o`|lhm+00+c`laccan Ri~~slq|gf ohkrhqmn L &00O+RiL) ik`gas j|hk r`~iam~s ~|a`~an wi~f l`rimaqtqk`l `mn ~fhsa gizam rc`oalh- ^fis
jimnimg oh||ac`~as ~h `m `rr|hvik`~acy
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7/31/2019 Alzheimers PP
50/55
^fa|a is `m q|gam~ maan jh| ajjao~iza# s`ja# rsyofh~|hrio `gam~s jh| ~|a`~kam~ hj
laf`zih|`c nis~q|l`moas im @N `mn h~fa| nakam~img nish|na|s-
Laf`zih|`c nis~q|l`moas `|a ohkkhm im @N# imocqnimg nar|assihm# `gi~`~ihm# i||i~`lici~y#
`la||`m~ kh~h| laf`zih|s# `mn rsyofhsis- ^fa|a `|a mh `gam~s `rr|hzan ly ~fa JN@
sraoijio`ccy jh| ~|a`~kam~ hj laf`zih|`c nis~q|l`moas im @N-
@m~irsyofh~ios lh~f ohmzam~ihm`c `mn `~yrio`c`|a `sshoi`~an wi~f imo|a`san
kh|~`ci~y `mn shka `m~irsyofh~ios `|a `sshoi`~an wi~f imo|a`san |ise jh| oa|al|hz`soqc`|
`ooinam~s h| s~|hea wfam `nkimis~a|an ~h acna|cy r`~iam~s wi~f @N- ^fa |ise hj na`~f is
imo|a`san j|hk -1! nq|img `m `za|`ga hj 02 waaes hj ~fa|`ry-
_aza|`c 00< waae chmg ocimio`c ~|i`cs sqggas~ ~f`~ |isra|inhma `mn rhssilcy h~fa| `~yrio`c
`m~irsyofh~io `gam~s im chw nhsas `|a ajjio`oihqs im |anqoimg rsyofhsis `mn `gi~`~ihm im
k`imcy mq|simg fhka r`~iam~s wi~f @N-
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7/31/2019 Alzheimers PP
51/55
_~|`~agias jh| qsa hj`m~irsyofh~ios im r`~iam~s wi~f @N imzhcza `zhinimg ~fai| qsa im
r`~iam~s wi~f o`|nihz`soqc`| h| rqckhm`|y nisa`sa &~fa ~wh khs~ ohkkhm o`qsas hj
na`~f im kh|~`ci~y s~qnias)# qsimg ~fasa `gam~s hmcy im r`~iam~s jh| wfhk
mhmrf`|k`ohchgio im~a|zam~ihms f`za j`ican `mn ~fa laf`zih|s `|a av~|aka-
Ocimio`c ~|i`cs f`za laam c`|gacy mag`~iza im sfhwimg lamaji~ jh| ~|a`~kam~ hj nar|assihm
im @N wi~f `m~inar|ass`m~ kanio`~ihms- Imnizinq`c r|`o~i~ihma|s k`y qsa r|`o~ioa+l`san
azinamoa ~h gqina ~fai| ~fa|`raq~io naoisihms-
@mvihcy~ios mn fyrmh~ios `|a gama|`ccy ~h la `zhinan im r`~iam~s wi~f @N `s ~fay k`y
imo|a`sa ohmjqsihm- _fh|~ ~a|k qsa hj lamthni`tarimas sqof `s ch|`tar`k h|
ochm`tar`k k`y la qsajqc im r`~iam~s wi~f arishnas hj `gi~`~ihm-
G|a`~a| ohgmi~iza ikr`i|kam~ is ly j`| ~fa khs~ ohmsis~am~ oh||ac`~a hj rsyofhsis im c`~a
hmsa~ @ctfaika|s nisa`sa- @csh# Azinamoa hj j`kici`c `gg|ag`~ihm hj rsyofhsis im
@ctfaika|s nisa`sa sqggas~s ~f`~ ~fis rfamh~yra is qmna| gama~io ohm~|hc-
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7/31/2019 Alzheimers PP
52/55
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7/31/2019 Alzheimers PP
53/55
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7/31/2019 Alzheimers PP
54/55
@- f~~r4((www-`ct-h|g(nhoqkam~sXoqs~hk(
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7/31/2019 Alzheimers PP
55/55