2: aging + cogn 2 Flashcards
overview of MCI: what is it? prevalence and conversion to AD rates?
observable transitional phase between NA and early/mild AD, is an asymptomatic phenotype of AD. wide variety of prevalence estimages: 1 to 30%. also a wide range of conversion to AD rates: 1 - 40%
MCI: goal? challenge? new results?
identify shifts from one trajectory or phase to the other as soon as possible. challenge: multiple approaches, definitions and terms for MCI-type phenomena in literature. new results: MCI is heterogeneous and a moving dynamic target
MCI: five clinical criteria + 1?
memory complaints, objective memory impairments, intact general cognition, preserved activities of daily living, non demented + 1: clinical judgement heavily involved in diagnosis
does clinical MCI status predict AD?
not really: 1/3 got dementia, 1/3 died, 1/3 improved or were stable
Albert et al’s 2nd consensus: what do we need to test? what is essential? what was advised?
both amnesic and non-amnesic cognition should be tested objectively. assessment of longitudinal cogn change is essential. evaluation of biomarkers + risk factors is advised
diagnosing AD: challenge?
classification challenge: no universal diganosis for preclinical AD or MCI, but there are widely accepted standards for diagnosing AD. implementation of these standards may vary by nation/region
diagnosing AD: clinical goal? early diagnosis can lead to?
important public health/clinical goal is to diagnose AD as early + correctly as possible = lead to early interventions, preparations, delay dementia
delaying dementia onset by 5 years could?
reduce prevalence of AD by 50%, and decrease dementia cases in community substantially
probably AD: how to diagnose? what information do you want?
exclusion: no other cause for symptoms can be found. detailed patient history, physical, neurological and neuropsych tests
mild AD phase: brain? overall health? cogn health?
brain: plaques and tangles spread, shrinkage progresses beyond NA. overall health stable/good, cogn health becoming noticeably impaired
typical cogn. health impairments in AD (4)
episodic memory failures. confusion about spatial location. poor judgment. mood + personality changes (decline in spontaneity + initiative)
moderate AD phase: brain? cogn symptoms? what else emerges?
AD damage spreads through cerebral cortex, plaques, shrinkage, ventricles enlarge. cogn symptoms impossible to ignore. social implications emerge.
5 cogn signs of moderate AD
diminishing episodic + semantic memory skills. recognition difficulties. decreasing global/everyday cognition. difficulties in personal/social behaviour. interacting decline processes.
severe AD: brain? health? cogn?
brain engulfed with damage. dramatic decline in health (weight loss, difficulty with everday processes like swallowing + bladder control), increased sleeping, aspiration pneumonia common cause of death. cognition tending to baseline
is AD prevention possible?
dementia, including AD can be prevented (according to journal of AD)
JAD letter: main points about AD?
irreversible, drugs relieve symptoms but not progression. modifying risk factors helped in vascular diseases. so we should identify RFs and PFs.
world wide cost of AD?
604 billion $
characteristics of large scale research (4)
multiple collaborators from multiple disciplines. longitudinal designs w/ multiple research Qs. international collaboration. integration from different disciplines
what is normal aging?
relatively healthy but not condition free: includes functional decline, but not accelerated or preciptous deisease driven drop
what is normal brain + cogn aging?
interindividual differences in intraindividual changes. non demented: includes brain + cogn decline
aging and general memory changes?
gradual memory decline: in NA from 55 to 95. common inflection point in mid to late 70s
