Sindrom zalazećeg sunca u osoba oboljelih od Alzheimerove bolesti

master's thesis

• Title (english): Sundowning in patients with Alzheimer's disease
• Author: Lea Kunkera
• Mentor: Nataša Klepac (mentor)
• Committee member: Fran Borovečki (predsjednik povjerenstva)
• Committee member: Mario Habek (član povjerenstva)
• Committee member: Nataša Klepac (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Neurology); Zagreb
• Defense date and country: 2023-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Neurology

Abstract

Alzheimerova bolest (AB) progresivna je neurodegenerativna bolest i najčešća vrsta demencije, a prvi ju je opisao njemački psihijatar Alois Alzheimer 1906. godine. Iako zahvaća 50% osoba starijih od 85 godina, nije normalan dio starenja. Danas oko 50 milijuna ljudi u svijetu boluje od AB, a predviđa se kako će se taj broj utrostručiti do 2050. godine. Pretpostavka je kako ključnu ulogu u nastanku bolesti imaju nakupine tau-proteina i beta amiloida. Za liječenje ove bolesti trenutno su odobrena tri inhibitora acetilkolinesteraze, jedan antagonist N-metil-d-aspartat receptora i dva monoklonska protutijela. Glavna su njena obilježja gubitak pamćenja, mišljenja, raspoloženja i funkcioniranja. Gotovo će svi pacijenti razviti neuropsihijatrijske simptome. Sindrom zalazećeg sunca nije dijagnoza, već skupina simptoma i može se definirati kao “pojava ili egzacerbacija bihevioralnih smetnji u popodnevnim i večernjim satima“, a karakterističan je za pacijente koji boluju od srednje ili teške AB. Jasan uzrok ove pojave još uvijek nije poznat, a prvi puta se spominje 1941. godine. Glavni simptomi uključuju iritabilnost, nokturalno ponašanje, agresivnost, halucinacije i apatiju. Dijagnoza se postavlja klinički, a u liječenju se najprije pokuša nefarmakološkim pristupom, odnosno muzikoterapijom, terapijom svjetlom, aromaterapijom, edukacijom skrbnika, smanjenjem pozadinske buke i pridržavanjem jasne rutine. Farmakološki je pristup uvijek druga linija i uključuje primarno inhibitore acetilkolinesteraze i antipsihotike.

Abstract (english)

Alzheimer's disease is a progressive neurodegenerative disease and the most common type of dementia and was first described by Alois Alzheimer in 1906. Although it affects 50% of people older than 85, it is not a normal part of aging. Today, around 50 million people suffer from Alzheimer's disease and it is estimated that the number will triple by 2050. It is assumed that the aggregations of tau-protein and beta amyloid have a key role in the pathogenesis of the disease. Medications that are currently approved for treating this disease are three acetylcholinesterase inhibitors, one N-methyl-d-aspartate receptor antagonist, and two monoclonal antibodies. Its main characteristics are memory and thinking loss, mood disorder and loss of function. Almost all patients will develop neuropsychiatric symptoms. Sundowning is not a diagnosis, but a cluster of symptoms and can be defined as “occurrence or exacerbation of behavioral symptoms in afternoon or evening hours” and is characteristic for those suffering from moderate or severe Alzheimer's disease. Its etiology is still unknown and is first mentioned in 1941. Main symptoms include irritability, nocturnal behavior, aggression, hallucinations and apathy. Diagnosis is clinical, and treatment always begins with nonpharmacological approach, such as music therapy, light therapy, aromatherapy, caregiver education, background noise reduction, and following a routine. Pharmacological approach is always the second line and includes mainly acetylcholinesterase inhibitors and antipsychotics.

• Keywords: Alzheimerova bolest; demencija; sindrom zalazećeg sunca
• Keywords (english): Alzheimer's disease; dementia; sundowning
• Language: croatian
• URN:NBN: urn:nbn:hr:105:704727
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-10-25 12:42:32