236 Alzheimer's Flashcards
After how many months of symptoms can a diagnosis of dementia be given?
6 months
What is praxis?
Learned motor tasks
What is gnosis?
Ability to recognise objects/faces/sensory information
What is the prevalence of dementia in the UK?
3.5%
What is the cause of 50% of dementia?
Alzheimers
What are the features of pseudodementia?
Awareness that there is a memory loss and ability to date onset
Answering questions with ‘don’t know’
Irritation/despair
May have insomnia/other depressive symptoms
What differentiates delirium from dementia?
Delirium usually associated with a physical illness
Name 2 physical illnesses which can cause *dementia/ depression/delerium
*can be reversible
(4 listed)
Vitamin deficiencies
Thyroid disease
Hepatic/renal impairment
Normal pressure hydrocephalus
How can B12 deficiency cause dementia?
Producing nervous decay with astrocyte accumulation and haemorrhage
What is the mechanism of developing dementia in normal pressure hydrocephalus?
Abnormal CSF resorption leading to enlargement of the ventricles + compression of brain tissues. Only intermittently raises CSF pressures above normal range
What are the symptoms of normal pressure hydrocephalus?
3 listed
Gait disturbances
Dementia/mental decline
Urinary incontinence
Which allele is associated with increased risk of developing late onset Alzheimers?
Apolipoprotein E-4
What are neurofibrillary tangles and which disease are they associated with?
Tau protein acting like glue causing the microfibrils to tangle. Associated with AD
What is the consequence of neurofibrillary tangles?
The microtubules disintegrate causing cell destruction and death
What are senile plaques?
Amyloid plaques in grey matter - seen in majority of elderly by 80 y/o
Which part of the brain is most affected by cerebral cortex atrophy?
Association regions
Medial temporal lobe
Where in the brain is cholinergic system dysfunction seen in AD?
Loss of cholinergic input to hippocampus and amygdala
Which type of AD is there a mutation in presenilin?
Early onset
What is the treatment for mild/moderate Alzheimers?
Anticholinesterases e.g.
- Donepazil
- Rivastigmine
What is the treatment for moderate/severe Alzheimer’s?
memantine = NMDA antagonist
What is the MOA of memantine?
Noncompetitive NMDA receptor antagonist meaning decrease in levels of glutamate in demented brain
Name 3 risk factors for vascular demetia
5 listed
- DM
- Smoking
- Hypercholesterolaemia
- HTN
- Male sex
What is the treatment for vascular dementia?
Low dose aspirin, statin and management of HTN and glu
What are the S+S of Lewy body dementia?
- Fluctuating cognition
- Vivid visual hallucinations
- Parkinsonian features
- Falls
- Memory loss (may not be a marked feature in early disease)
