10.1 Dementia Overview and Pathology Flashcards
what is the aging process?
- normal age-related decline in cognition
- age associated memory impairment
- dementia
- mild cognitive impairment
what are the domains of dementia?
complex attention, executive function, learning and memory, language, perceptual-motor, or social cognition
dementia can be due to
AD, frontotemporal lobar degeneration, levi body disease, vascular disease, TBI, substance/medication use, HIV/AIDS, prion disease, PD, HD
when diagnosing dementia you must specify…
with or without behavioral disturbance
what is the first diagnostic criteria of major neurocognitive disorder?
evidence of a significant cognitive decline from a previous level of performance in one or more cognitive domains
what does the evidence of significant decline based on?
- concern of the individual, family member, or clinician that there has been a decline
- documented by standardized neuroscience psychological testing
what is the second diagnostic criteria for major neurocognitive disorder?
cognitive deficits interfere with independence in everyday activities
what is the third diagnostic criteria for major neurocognitive disorder?
cognitive deficits do not occur exclusively int he context of delirium
what is the fourth diagnostic criteria for major neurocognitive disorder?
the cognitive deficits are not better explained by something else
what’s the difference between major neurocognitive disorder and minor?
evidence of modest decline and these effects DO NOT interfere with everyday activities
a good case history for dementia can include:
medical history
detailed family history
social history
medication list
what’s in a good medical history file?
physical respiratory function, baseline conditions, neurologic exam, detailed family hx, social history, medications list
diseases that can cause dementia
Vascular dementia Lewy body disease/dementia Huntington’s disease MS Infections Parkinson’s disease Pick disease Brain injury/tumors Chronic EtOH abuse Normal pressure Hydrocephalus Depression Others (CHF, Hypoglycemia, diabetes, etc.)
sensory memory
attention, alertness, arousal processes;
visual, auditory, tactile, olfactory;
unconscious awareness
short term working memory
involves encoding processes, temporary storage of limited capacity
long term memory
involves retrieving processes and permanent storage of information
declarative memory
(long term)
person’s base, consciousness awareness
semantic memory
(long term) knowledge of world, facts, ideas
episodic memory
knowledge of personal experiences (autobiographical)
non declarative (implicit)
procedural memory, motor memory, memory for sequenced motor tasks (unconscious)
procedural memory
sequenced motor tasks
riding a bike
when diagnosing dementia, neurologists look for
neural changes in combination with behavioral changes
what are CT scans
xray image of intracranial structures
exposer to radiation is not good.
what is cortical atrophy?
cell death
fMRI
measures blood flow during tasks to examine function (reduced blood flow in dementia)
pet scanning
measures glucose metabolism by injecting radioactive glucose (reduced metabolism in areas related to memory and cognition in dementia)
SPECT
radioactive isotope injected in bloodstream, visualized by gamma camera
(reduced blood flow in regions that are not working during a task)
EEG
measures electrical activity via surface elctrodes
we hope to diagnose before symptoms in order to…
- Halt disease progression
- Minimize disease severity
- Reverse disease symptoms
