Clinical meaning
Alzheimer disease is characterized by progressive accumulation of extracellular beta-amyloid plaques and intracellular neurofibrillary tangles of hyperphosphorylated tau protein. These pathological changes trigger chronic neuroinflammation, oxidative stress, synaptic dysfunction, and widespread neuronal death, particularly in the hippocampus and cerebral cortex. Cholinergic neurotransmission is severely impaired as the nucleus basalis of Meynert degenerates. The disease progresses through predictable stages, from mild cognitive impairment to complete functional dependence. The nurse performs comprehensive cognitive assessments, manages pharmacological therapy, coordinates multidisciplinary care, implements safety interventions, and provides caregiver education and support.
Exam relevance
Risk factors: - Advanced age (prevalence doubles every 5 years after age 65) - Apolipoprotein E4 (APOE4) genotype - Family history of early-onset Alzheimer disease - Down syndrome (trisomy 21) - Female sex (longer lifespan and hormonal factors) - Cardiovascular risk factors: hypertension, diabetes, hyperlipidemia - History of traumatic brain injury - Chronic social isolation and depression