Aging and Neurodegeneration

Question 1

comment on canadian demographic trends related to aging

Answer 1

we have agrowing aging population

Question 2

are younger adults good at forecasting the experiences of older adults?

Answer 2

we believe that the aging life is much sadder than it is, we cannot predict the difficulties of aging.

Question 3

Name and describe four phsycial changes affecting the aging brain.

Answer 3

1. Volume loss: -5%
2. Neurotransmitter depletion: dopamine and serotonin levels drop
3. Decreased cerebral blood flow
4. Accumulation of white matter damage, hypertension.

Question 4

normal cognitive and physical changes of aging look like

Answer 4

Normal: Compensation, around 70 decline in longterm and working memory but semantic memory intact

Question 5

describe common socioemotional changes of aging

Answer 5

• smaller but more intentionally chosen social networks with higher proportion of emotionally close partners
• Greater emotional stability and emotional complexity in daily life.

Question 6

distinguish between MCI and AD in terms of memory performance and activities

Answer 6

1. Mild cognitive impairment
   - Changes in attention and memory serious enough to be noticed by the person, friends, and family.
   - cognitive difficulties in excess of normal aging - preserved activities of daily living.
   - conversation rate to dementia diagnosis = 5%-15% per year
   - 12-20% of individual 65+
   - Look at patient history, mental status exam, maybe imaging.
2. Alzheimers disease
   - most common cause of dementia
   - confusion, irritability, anxiety, deterioration of speech.
   - later difficulties swalling/speech

Question 7

identify symptoms of AD and predictors of progression to this illness from MCI

Answer 7

• Older age
• APOE e4 status
• medial temporal atrophy on MRI
• positive amyloid on PET scan
• Molecular markers in CSF

Question 8

Explain the clinical significance of ApO-E status

Answer 8

non-carrier < neterozygous < homozygous

Question 9

Name and describe the 3 defining characteristics of AD

Answer 9

1. Neurofibrillary tangles
   - misfolded tau proteins build up
   - cell structure is compromised
2. amyloid plaques
   - amyloids take on large, collapsed forms and build up in the extracellular space
3. Volume loss
   - progressive loss of both cells and synapses, appearing first in medial temporal lobe structures, amygdala, hippocampus, involved in memory.

Question 10

Name theories and treatments of AD

Answer 10

1. Theories:
   - Amyloid cascade hypothesis: amyloid dysfunction comes first, people with downsyndrome have higher rates of AD because of the extra 21 gene which relates to Amyloid.
   - Neyrofibillary hypothesis: not seen without Amyloid.
2. Treatements:
   - cholinergic agonists - can help prevemt decline in learning and memory.
   - NMDA receptor antagonist - can prevent damage to neurons
   - target modifiable risk factors: depression, smoking, isolation.

Question 11

Identify biomarkers for AD and consider the implications of these results for patients.

Answer 11

CSF (cerebral spinal fluid) biomarkers for AD are related to amyloid and tau are helpful but nit 100% defintive.

Can inform diagnostic, treatment, and referral decisions.