Sammanfattning Syftet med studien var att beskriva anhörigas upplevelser av att leva tillsammans med eller i närheten av en person som har drabbats av Alzheimers sjukdom. Studien utgick från ett socialt, fysiskt och psykiskt perspektiv. Studien byggde på 18 vetenskapliga artiklar som kvalitet granskades med hjälp av en granskningsmall. Artiklar söktes genom databaserna Academic Search Elite, Cinahl och Vård I Norden Online. Urvalskriterierna var att artiklarna svarade på studiens syfte, var skrivna på svenska eller engelska och publicerade mellan åren 2000 till 2008. Resultatet visade att anhöriga ställs inför en dramatisk förändring som är krävande, utmanande och de anhöriga upplevde oro, sorg, stress och skuld. Det sociala nätverket minskade och det leder oftast till ensamhet och isolering. Resultatet visade också att anhöriga är i behov av stöd från släkt och vänner samt från hälso- och sjukvården. Sammanfattningsvis upplevde majoriteten av anhöriga en ökad belastning av att vara anhörig till en person med Alzheimers sjukdom. Nyckelord: Alzheimers sjukdom, familj, anhöriga, upplevelser. / Abstract The aim of the study was to describe relative’s experiences of living with or near a person that has Alzheimer’s disease. The study builds on social, physical and psychic perspectives. The studies were based on 18 scientific articles that were quality checked with the aid of a review model. Articles were applied for through the databases Academic Search Elite, Cinahl and Vård I Norden Online. The selection criteria’s were that the articles replied on the study's aim, were written on Swedish or English and published between the years 2000 to 2008. The result showed that relatives were set to a dramatic change that were requiring, challenging and the relatives experienced dread, sorrow, stress and debt. The social network decreased and the result was often decreased loneliness and isolation. The result also showed that the relatives were in need of aid from family and friends, and from the healthcare. To summary the majority experienced that the burden increased of being relatives to a person with Alzheimer’s disease. Keywords: Alzheimer’s disease, family, relatives, experience.

Att vara anhörigvårdare till en person med Alzheimers sjukdom innebär förändringar inom familjen som kan vara svåra att hantera. Sjuksköterskan kan hjälpa anhörigvårdaren att lättare hantera rollen som vårdare genom att ge adekvat information och stöd. Syftet var att undersöka behovet av stöd och information hos anhörigvårdare till personer med Alzheimers sjukdom. Metoden var en litteraturstudie där fyra kvalitativa samt tio kvantitativa artiklar sammanställdes till ett resultat. Resultatet visade på ett stort behov av information och stöd under hela sjukdomsprocessen. Det sociala nätverket och vårdpersonal utgjorde ett stort stöd för anhörigvårdarna. Stödgrupper och stödprogram visade sig vara uppskattade av anhörigvårdare då de tillgodosåg behovet av både stöd och information. Anhörigvårdare ville ha adekvat information i ett tidigt skede av sjukdomen och det fanns ett uttalat behov av individanpassad information. Sjuksköterskans uppgift är att uppmärksamma dessa behov och tillgodose dem, genom att hjälpa anhörigvårdare att etablera kontakt med andra i samma situation. Det bör ingå i utbildningen att uppmärksamma anhörigvårdare och deras behov för att få en ökad förståelse för deras situation. Fortsatt forskning är önskvärt för att lyfta fram anhörigvårdarnas behov. / To become a caregiver to a person with Alzheimer´s disease means a lot of changes in the family that can be hard to cope with. The nurse can give adequate information and support to help the caregiver handle the role as a career. The purpose of the study was to examine the needs of information and support to caregivers of persons with Alzheimer’s disease. The literature study was based on four qualitative and ten quantitative articles. These articles were processed and compiled to a result. The result showed a great need of information and support through the whole process of the disease. The social network and health professionals were a great support to the caregivers. Support groups and support interventions were valuable to the caregivers because their needs of support and information were satisfied. The caregivers wanted information about Alzheimer's disease in its early stages and that information should be tailored individually. A task that should be provided by the nurse is to identify the needs of the caregivers and help them establish a contact with other peers in satisfying these needs. The nurse education should include the caregivers’ needs and therefore allowing the nurse a better understanding of each caregiver given situation. Therefore, there is a need for further research in highlighting the needs of caregivers.

Bakgrund: Alzheimers sjukdom är den tredje vanligaste dödsorsaken i västvärlden idag. Det är en progressiv sjukdom som drabbar hjärnan och därmed påverkar personens kognitiva förmågor. De alzheimersdrabbade blir ofta vårdade i hemmet av sina anhöriga, vilket kan innebära en stor påfrestning för dessa. För att vårdpersonal skall kunna stödja de anhöriga på bästa sätt krävs en förståelse för hur de upplever sin situation. Syfte: Syftet var att belysa anhörigas upplevelser av att leva tillsammans med en person med Alzheimers sjukdom. Metod: En empirisk studie med kvalitativ inriktning gjordes av fyra självbiografier, som analyserades med hjälp av innehållsanalys. Resultat: I resultatet framkom att de anhörigas upplevelser var till största delen negativa. Dock fanns där stunder av glädje och kärlek som gav de anhöriga styrka att kämpa vidare. De upplevde känslor som frustration, ilska, vrede, skuldkänslor och acceptans. Detta pågick i en cykel som ständigt började om. Det var som om de befann sig i ett ekorrhjul och kämpade för att ta sig ur. Slutsats: Sjuksköterskor har en viktig uppgift att fylla. De anhöriga är i en utsatt situation. Att lyssna, förstå och stödja dessa gagnar både de anhöriga och deras partners. / Background: Alzheimer's disease is the third leading cause of death in the western world. It is a progressive disease which affects the brain and the person's cognitive abilities. These people are often cared for at home by their spouses, which may be a great strain for the spouses. For professionals to be able to support the spouses in the best manner requires an understanding of how they are experiencing their situation. Aim: The purpose of this study was to illuminate the spouses´ experiences of living with a person with Alzheimer's disease. Method: An empirical study with qualitative approach was made on four autobiographies. A content analysis was used to analyze the material. Results: The results showed that the spouses´ feelings were mostly negative. However, there were moments of joy and love which gave the relatives strength to keep on fighting. They experienced feelings of frustration, anger, rage, guilt and acceptance. This went on in a repeating cycle. It was as if they were in a treadmill and struggled to get out of. Conclusion: Nurses have an important role to play. The relatives are in a vulnerable position and by listening, understanding and supporting these, it is beneficial not only for them, but also for their partners.

<p>QC 20150922</p>

Immunotherapy for Alzheimer\'s disease has emerged as a promising approach for clearing pathological tau protein conformers. To explore this kind of treatment we tested an active immunization with pseudo-phosphorylated tau fragments in P301L tangle model mice that develop neuronal tau aggregates as observed in frontotemporal dementia and Alzheimer’s disease. We found that an immunization reduces neurodegeneration in α-motor neurons in the spinal cord and slows progression of the tangle-related behavioral phenotype. Performance on behavioral assays correlated with tau pathology at the corresponding spinal cord level. Interestingly, a slowed progression of these tauopathy related characteristics were only seen in mice that received a specific immunization with pseudo-phosphorylated tau fragments, not in animals that received a non-specific activation of the immune system. An immunization witch pseudo-phosphorylated tau fragments may be a valuable therapeutic option in targeting one of the major hallmarks of Alzheimer’s disease and frontotemporal dementia.

This thesis describes the synthesis and biological evaluation of highly substituted, ring-fused 2-pyridones. The utility of the bicyclic 2-pyridones to gain fundamental insights into the disease processes of bacterial infections and Alzheimer’s disease has been investigated. The 2-pyridones have mainly been studied as a new class of anti-infective agents termed pilicides. The function of the pilicides has been explored using uropathogenic E. coli (UPEC) as a prototype pathogen and urinary tract infection as a model disease. The pilicides target the infectious ability of UPEC by inhibiting key proteins (chaperones) in the so-called chaperone-usher pathway, thus preventing the assembly of bacterial surface organelles (pili/fimbriae). Synthetic pathways to aminomethylate the 2-pyridones have been developed in order to increase their aqueous solubility while retaining biological activity. Also, the importance of a carboxylic acid has been demonstrated in studies with various carboxylate derivatives and by bioisosteric replacement. Moreover, synthetic procedures to extend the backbone of the rigid, dipeptide-mimicking 2-pyridones have been established. This rendered peptidomimetic building blocks and structures that alongside their potential use as pilicides are of more general interest in peptidomimetic-related research. The potential pilicides have been screened for chaperone affinity using relaxation-edited 1H-NMR spectroscopy. In addition, their ability to inhibit pilus biogenesis in E. coli has been demonstrated by assays of hemagglutination, biofilm formation and attachment to bladder cells, as well as with electron and atomic force microscopy. Moreover, it has been confirmed that pilicides regulate the expression of pili without affecting the biofunctional properties of the pilus rod. This was verified by measurements of individual P pili, on living bacteria, using force measuring optical tweezers. The pilicide binding site was investigated using NMR spectroscopy and X-ray crystallography of a pilicide-chaperone complex. Based on the results obtained, a mechanism whereby the pilicides may inhibit pilus assembly was proposed, which was subsequently experimentally supported by surface plasmon resonance assays and genetic analysis. Finally, based on the generic 2-pyridone scaffold, a new collection of substituted compounds has been synthesized and validated as inhibitors of Amyloid β (Aβ)-peptide aggregation, which has been suggested to be involved in Alzheimer’s disease.

Alzheimers sjukdom är mycket vanligt förekommande sett ur både ett internationellt och nationellt perspektiv. Ungefär 90 000 personer har diagnosen Alzheimers i Sverige. För att sjuksköterskan ska kunna ge god och adekvat vård behöver patientens upplevelse av sjukdomen uppmärksammas. Syftet med denna studie var att belysa patientens upplevelse av första fasen vid Alzheimers sjukdom. Studien genomfördes som en litteraturöversikt där tolv vetenskapliga artiklar bearbetades och analyserades för att sedan utgöra resultatet. I resultatet framkom fem teman, bli en främling för sig själv, acceptera och förneka, hantera livet med minnessvårigheter, leva med föreställningen om Alzheimers sjukdom och rädsla för framtiden. Flera personer med Alzheimers upplevde att sjukdomen innebar en stor förändring och en negativ påverkan på deras liv. Personerna utvecklade olika strategier för att hantera livet med sjukdomen. Personer med Alzheimers upplevde brister i mötet med hälso- och sjukvårdspersonal. Framtida forskning bör fokusera på mötet mellan patienten och sjuksköterskan samt patientens upplevelser av erhållen vård för att kunna förbättra vårdinsatserna och sjuksköterskors bemötande. / Alzheimer’s disease has, seen from an international and national perspective, high occurrence. Up to 90 000 people are diagnosed with Alzheimer’s disease in Sweden. It is important to pay attention to the patient’s experience for the nurse to be able to give good and adequate care. The purpose of this study was to highlight patient’s experience in the early stage of Alzheimer’s disease. A literature review was conducted and twelve research articles were processed and analyzed to conclude the result. The result revealed five main themes, to become a stranger in one’s life, acceptance and denial, coping with memory loss in everyday life, living with the idea of Alzheimer’s disease and fear of the future. Several persons with Alzheimer’s felt that the disease meant a big change and had a negative impact on their lives. People with Alzheimer’s developed different strategies to help them cope with the disease. People with Alzheimer’s experienced inadequacies in encounters with health care personnel. Further research should focus on health care encounters in patient perspective and their experience of received care in order to improve health care interventions and nurses’ attitudes.

<p>Diss. (sammanfattning) Umeå : Umeå universitet, 1980, härtill 5 uppsatser.</p> / digitalisering@umu

Memory dysfunction is common in association with the course of normal aging. Memory dysfunction is also obligatory in age-associated neurological disorders, such as Alzheimer’s disease. However, despite the ubiquitousness of age-related memory decline, several basic questions regarding this entity remain unanswered. The present investigation addressed two such questions: (1) Can individuals suffering from memory dysfunction due to aging and amnesia due to Alzheimer’s disease improve memory performance if contextual support is provided at the time of acquisition of to-be- remembered material or reproduction of to-be-remembered material? (2) Are memory deficits observed in ‘younger’ older adults similar to the deficits observed in ‘older’ elderly subjects, Alzheimer’s disease, and memory dysfunction in younger subjects? The outcome of this investigation suggests an affirmative answer to the first question. Given appropriate support at encoding and retrieval, even densely amnesic patients can improve their memory performance. As to the second question, a more complex pattern emerges. When attentional demands are varied, subjects of varying ages perform qualitatively similar. However, when semantic aspects of the to-be- remembered material are manipulated, age-associated qualitative differences are observed. These qualitative differences show up between older and younger adults, as well as between ‘younger’ and ‘older’ elderly subjects. / <p>Diss. (sammanfattning) Umeå : Univ., 1992, härtill 6 uppsatser</p> / digitalisering@umu

The α7 nicotinic acetylcholine receptor (nAChR) is involved in learning and memory, synaptic plasticity, neuroprotection, inflammation, and presynaptic regulation of neurotransmitter release. Alzheimer’s disease (AD), a neurodegenerative disease characterized by diminished cognitive abilities, memory loss, and neuropsychiatric disturbances, is associated with a loss of nAChRs. Similarly, traumatic brain injury (TBI) may result in long term neurobehavioral changes exemplified by cognitive dysfunction. Deficits in α7 nAChR expression have previously been shown in experimental TBI and may be related to cognitive impairment experienced in patients following TBI. The purpose of this dissertation was to investigate changes in α7 nAChR expression in models of neurodegeneration and determine if allosteric modulation of the nAChR facilitates functional recovery following experimental TBI through changes in nAChRs. Experimental models employed include a transgenic mouse model of AD that overexpresses the amyloid precursor protein (APPswe mice) and the controlled cortical impact injury model of TBI in rats. Quantitative receptor autoradiography using α-[125I]-bungarotoxin and [125I]-epibatidine and in situ hybridization were used to investigate changes in nAChR density and mRNA expression, respectively. In the first study, the effects of aging and β-amyloid on α7 nAChR expression were evaluated in APPswe mice. Hippocampal α7 nAChR density was significantly upregulated in APPswe mice compared to wild-type mice. It is postulated that elevated Aβ levels bind to the α7 nAChR resulting in upregulation. In a second study, galantamine, a medication used in the treatment of AD, was administered subchronically following experimental TBI to determine if treatment could facilitate cognitive recovery and affect nAChR expression. Interestingly, the results indicate TBI interferes with agonist mediated upregulation of nAChRs, and galantamine did not improve function in a behavioral task of learning a memory. In a third study, the regulation of TBI related deficits in α7 nAChRs was examined 48 hours following injury. α7 nAChR deficits occurred with a reduction in α7 mRNA in several hippocampal regions and non-α7 nAChR deficits occurred with a reduction in α4 mRNA in the metathalamus. The results of these studies suggest AD and TBI may involve complex but parallel processes contributing to the regulation of α7 nAChRs.