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)
