21 - Dementia Flashcards

1
Q

Dementia

A

Term used to describe a syndrome in which there is progressive decline in multiple areas of function

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2
Q

Features of dementia

A

Decline in communication skills
Inability to carry out every day tasks
Decline in memory and reasoning

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3
Q

Behavioural and psychological symptoms of dementia

A
Agitation
Aggression 
Psychosis
Depression
Sleep disturbance
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4
Q

Types of Dementia

A
Azheimers
Mixed
Lewy body dementia
Vascular dementia
Parkinson's 
Frontal temporal
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5
Q

Risk Factors for Dementia

A

Non modifiable - Family history, genetic predisposition, Age, Downs syndrome
Modifiable - Vascular disease RF, Cognitive inactivity, Head injury, depression

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6
Q

Pathophysiology of AD

A

Extracellularly deposits of B amyloid peptide in senile plaques
Neurofibrillary tangles in cell bodies and neurites
Neuronal cell loss
Loss of cholinergic cells

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7
Q

Genes associated with early onset alzheimer’s disease

A

APP - ch 21
Presenilin 1 - ch 14
Presenilin 2 - ch 1

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8
Q

Where is APP expressed

A

Neurones
glial cells
Endothelial and smooth muscle cells

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9
Q

What diseases do mutations in APP produce

A

Cerebral Amyloid Angiopathy (CAA)

Alzheimers

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10
Q

Which APP mutation decreases AB production and is protective of AD?

A

A673T

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11
Q

Which secretase enzymes cleave APP to produce the non amyloidogenic pathway

A

A secretase

Y secretase

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12
Q

Which secretase enzymes cleave APP to produce the amyloidogenic pathway

A

B secretase

Y secretase

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13
Q

What does PSEN1 code for

A

Presenilin 1

Subunit of Y secretase responsible fro AB generation

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14
Q

MOst common cause of early onset alzheimers

A

PSEN1

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15
Q

Genes associated with late onset AD

A

Apolipoprotein E - ch 19

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16
Q

ApoE2

A

Rare and protective isoform of APOE

17
Q

ApoE3

A

AD risk

18
Q

APoE4

A

Greatest AD risk

Decreases clearance of extracellular AB

19
Q

What are neurofibrillary tangles composed of

A

Hyperphosphorylated Tau

20
Q

Normal function of Tau

A

Stabilise the microtubules

21
Q

MAPT

A

Encodes Tau

Mutations not linked to AD - can cause frontaltemporal dementia

22
Q

What occurs to the cholinergic pathways in AD

A

Cholinergic forebrain pathways innervating cortical and limbic structures degenerate in AD

23
Q

Basal forebrain Cholinergic System

A

Nucleus Basalis of Meynert
Horizontal and vertical diagonal bands of Broca
Medial Septal Nucleus

24
Q

Treatment for AD

A

Anticholinesterase inhibitors
NMDA receptor antagonist
Symptomatic - Antidepressents, antipsychotics, mood stabilisers

25
Q

Anticholinesterase examples

A

Rivastigmine
Donzepezil
Galantamine

26
Q

NMDA receptor antagonist example

A

Memantine

27
Q

Why does memantine work

A

AD may be linked to increased excitation