DRG Category: 57

Mean LOS: 5.0 days

Description MEDICAL: Degenerative Nervous System Disorders without Major CC

classification section:



Alzheimer's disease (AD) is a degenerative disorder of the brain that is manifested by dementia and progressive physiological impairment. It is the most common cause of dementia in the elderly but is not a normal part of aging. More than 4 million Americans suffer from AD. AD causes two-thirds of the dementia cases in the United States, and the prevalence of dementia doubles every 5 years in people older than 65, reaching 30% to 50% at age 85 years. It involves progressive decline in two or more of the following areas of cognition: memory, language, calculation, visuospatial perception, judgment, abstraction, and behavior. Dementia of the Alzheimer's type (DAT) accounts for approximately half of all dementias. The average time from onset of symptoms to death is 8 to 10 years. The pathophysiological changes that occur in DAT include the following:

• Presence of neurofibrillary tangles, neuritic plaques, and amyloid angiopathy

• Accumulation of lipofuscin granules and granulovacuolar organelles in the cytoplasm of the neurons

• Structural changes in the dendrites of the neurons and in the cell bodies

• Predominant neuronal degeneration in the cortical association areas of the basal ganglia

• Gross cortical atrophy and widening of the sulci

• Enlargement of the ventricles

• Decrease in neurotransmitters (acetylcholine, dopamine, norepinephrine, serotonin), somatostatin, and neuropeptide substance P