08a_Neurocognitive Disorders: Alzheimer's Flashcards
Major Neurocognitive Disorder:
Overview
Subsumes DSM-IV diagnosis of Dementia
Significant decline from previous level of functioning in 1+ cognitive domains
Limits independence in everyday activities
Mild Neurocognitive Disorder:
Overview
Subsumes DSM-IV diagnosis of Cognitive Disorder NOS
Modest decline from previously level functioning in 1+ cognitive domains
*DOES NOT interfere with independence in everyday activities
May require greater effort or compensatory strategies
For Both Major and Mild Neurocognitive disorder:
Various types based on etiology
Alzheimer’s disease
Frontotemporal lobar degeneration
Lewy’s body disease
Vascular disease
Traumatic brain injury
Substance/medication use
HIV infection
Prion disease
Parkinson’s disease
Huntington’s disease
Neurocognitive Disorder Due to Alzheimer’s Disease:
Diagnostic Criteria
Criteria for Major/Mild Neurocognitive disorder are met
Insidious onset of symptoms
Gradual progression of impairment in 1+ cognitive domains
MAJOR Neurocognitive Disorder:
Probable Alzheimer’s
Evidence of causative genetic mutation
Decline in memory and 1+ other cognitive domain
Progressive and gradual decline in cognition
*without extended plateaus
No evidence of a mixed etiology
MILD Neurocognitive Disorder:
Probable Alzheimer’s
Evidence of causative genetic mutation
Decline in memory and learning
(*no other domains needed for Mild dx)
Progressive and gradual decline in cognition
*without extended plateaus
No evidence of a mixed etiology
MILD Neurocognitive Disorder:
Only Difference between Probable and Possible Alzheimer’s
Possible = no evidence of genetic mutation
Alzheimer’s:
Diagnostic considerations
Difficult to obtain direct evidence of Alzheimer’s disease
Usually diagnosed when all other causes of major or mild neurocognitive disorder have been ruled out
Alzheimer’s:
Requirements for definitive diagnosis
Autopsy / Brain biopsy to confirm presence of:
Extensive neuron loss & Amyloid plaques
Alzheimer’s:
Prevalence/Course
Single-most common cause of dementia
60 to 90% of all cases
Gradual onset of symptoms
Slow, progressive decline in cognitive functioning
Late onset: 70s-80s
Alzheimer’s:
Stage 1 (1 to 3 years)
Anterograde amnesia (esp. declarative memory)
Deficits in visuospatial skills (wandering)
Indifference, irritability, and sadness
Anomia
Alzheimer’s:
Stage 2 (2 to 10 years)
Increasing retrograde amnesia
Flat or labile mood
Restlessness and agitation
Delusions
Fluent aphasia
Dyscalculia
Ideomotor apraxia (cannot translate idea into movement)
Alzheimer’s:
Stage 3 (8 to 12 years)
Severely deteriorated intellectual functioning
Apathy
Limb rigidity
Urinary and fecal incontinence
Chromosomal Abnormalities:
Early-Onset Familial Type Alzheimer’s:
Chromosomes 1, 14, 21
Chromosomal Abnormalities:
Later Onset Alzheimer’s
ApoE4 gene on chromosome 19
