AD - Diagnosis

Question 1

How is a definitive diagnosis of AD done

Answer 1

Can only be made on autopsy.

Question 2

What are the current tools for diagnosing AD

Answer 2

Detailed patient history – symptoms

Detailed history of illness from family/friends

R/O other non-AD causes thru physical & neurological exams and lab tests

CT or MRI to r/o strokes, tumors

Conduct neuropsychological testing to assess memory, language, & other cognitive domains

Question 3

What is the cognitive test uses to help diagnose AD

Answer 3

Mini-Mental State Exam (MMSE)

Question 4

What does a MMSE rating of 24-30 tell you

Answer 4

No cognitive impairment

Question 5

What does a MMSE rating of 18-23 tell you

Answer 5

Mild cognitive impairment

Question 6

What does a MMSE rating of 0-17 tell you

Answer 6

Severe cognitive impairment

Question 7

Severe cognitive impairment MMSE range

Answer 7

0-17

Question 8

Mild cognitive impairment MMSE range

Answer 8

18-23

Question 9

No cognitive impairment MMSE range

Answer 9

24-30

Question 10

What is the MMSE

Answer 10

Mini-Mental State Exam (MMSE)

A cognitive test including orientation, memory, thinking, attention, calculation, language, writing, drawing, reasoning, decision-making and dealing with concepts
Total of 30 points

Question 11

Untreated AD can expect to lose how many points per year on the MMSE

Answer 11

Lose 2-4 points per year on average

Question 12

Criteria for “Probable” AD

Answer 12

Dementia confirmed by clinical & neuropsych exam

Problems in at least 2 areas of cognition

Progressive worsening of memory & other cognitive domains

No disturbances of consciousness (no “blacking out”- means something else)

Sx beginning btw ages 40 to 90, usually after 65

No other d/o that can account for the dementia

Question 13

What is MCI

Answer 13

Mild Cognitive Impairment

Some aging older adults develop memory deficits greater than their expected age norm, but w/o personality changes or cognitive problems that characterize AD

But, 40% of MCI will develop AD w/in ~3 years

Question 14

Is there a test for AD

Answer 14

Skin Test for AD is an experimental diagnostic test undergoing clinical trials now

Detect enzymes (Protein Kinase C - PKCs) involved in LTM that become dysfunctional in pts w/ AD both in brain & skin cells

Bradykinin, an inflammatory molecule which activates these enzymes under normal circumstances is added to the skin cells collected