AD & VaD Flashcards
What is dementia?
A significant loss of intellectual abilities such as memory, severe enough to interfere with social or occupational functioning. It is progressive and not a normal part of aging.
What are the criteria for diagnosing dementia?
- Impairs functioning
- Decline from previous ability
- Not due to delirium or major psychiatric disorder
- Identified via history and objective assessment
- Affects at least 2 of the following: memory, reasoning, visuospatial, language, personality/behaviour
What is Alzheimer’s disease?
The most common cause of dementia, characterized by memory impairment, personality changes, and cognitive decline due to plaques and tangle build up.
Some areas affected by Alzheimer’s disease
- Cognition
- Emotions and mood
- Behavior
- Physical abilities
*It is difficult to predict symptoms, the order they will appear, or its progression rate. Symptoms may be minimal in beginning with them slowly progressing
What are the key diagnostic features of Alzheimer’s?
- Gradual onset
- Clear history of cognitive worsening
- Amnestic or non-amnestic presentation
- Excludes cases with other neurological conditions or significant vascular disease
What are the stages of Alzheimer’s disease?
- Early (20 yrs prior): Memory loss, disorientation, poor judgment, personality changes
- Middle (2–10 yrs): Increased memory/speech problems, restlessness, loss of impulse control
- Late (1–5 yrs): Incontinence of urine, loss of motor skills, speech issues, self-care decline
What brain changes are associated with AD?
- Atrophy
- Senile plaques: buildup of beta-amyloid may interfere with neuronal communication
- Neurofibrillary tangles: threads of tau protein become twisted
Structural Changes in Alzheimer’s Disease
Structural brain changes in Alzheimer’s are characterized by:
- Amyloid build-up
- Tau build-up
- Neurodegeneration / atrophy
Structural Changes in Alzheimer’s: Cerebrovascular Disease
- Cerebrovascular disease is observed in over 70% of people with AD
- Often measured using white matter hyperintensities (WMHs)
- Similar to AD-specific pathology, cerebrovascular pathology is known to occur before declines in cognition
What are some risk factors for Alzheimer’s?
Age, heredity, mild cognitive impairment, hypertension, diabetes, high cholesterol. Education is protective.
What is Vascular Dementia?
A type of dementia caused by reduced blood flow to the brain, leading to brain cell damage and cognitive deficits that impair daily function.
What are common causes of Vascular Dementia?
- Narrowing of the small blood vessels deep inside the brain – known as subcortical vascular dementia or small vessel disease
- A stroke – called post-stroke dementia or single-infarct dementia
- Many “mini strokes” (transient ischemic attacks) that cause tiny but widespread damage to the brain – known as multi-infarct dementia
Risk factors for Vascular Dementia.
- Age
- History of stroke
- Atherosclerosis
- High blood pressure
- Diabetes
- Smoking
- High cholesterol
What are common symptoms of Vascular Dementia?
- Confusion, memory problems
- Unsteady gait
- Incontinence
- Depression
- Difficulty with attention, planning, and organizing thoughts
What imaging/pathological changes are seen in VaD?
- White matter lesions (>25%)
- Cortical infarcts
- Microbleeds
- Multiple lacunar infarcts
Subtypes in VaD
Different subtypes are associated with different
patterns of vascular brain changes that affect blood flow
