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Neuroscience IV - Sara > Aging & Dementia > Flashcards

Aging & Dementia Flashcards

1
Q

Life expectancy & aging

A
  • Maximum number of years a human can live has not increased

- Average life expectancy has increased

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2
Q

Aging Theories

A
  1. Cellular theories
  2. DNA Mutation theories
  3. Inherited factors
  4. Stress related theories
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3
Q

Do the aging theories occur individually or happen simultaneously?

A

Aging theories can happen simultaneously

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4
Q

Cellular Theory of Aging

A
  • Maximum lifespan is predetermined (genetically)
  • Varies according to species
  • Studies of fibroblasts show that if a lifespan of the species is longer, the fibroblasts will divide many more cycles
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5
Q

DNA Mutation Theories of Aging

A
  • Aging occurs as a result of changes in DNA & RNA
  • Changes may occur due to mutations caused by external factors, accumulation of errors during transcription, and telomeres
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6
Q

Inheritance & Aging

A
  • Many inherited factors contribute to aging

- Can affect one system but usually affects multiple systems

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7
Q

Oxidative stress & aging

A
  • Free radicals form as oxygen changes to water
  • Free radicals accumulate causing mitochondrial damage
  • Implicated in Parkinson’s Disease (dopamine breakdown to free radical formation) + Familial ALS (super oxide mutase deficient so O2* builds up)
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8
Q

Aging of the brain - history of study of aging

A
  • Softening of brain
  • Vascular dementia (Hardening of arteries)
  • Alzheimer’s disease
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9
Q

What # cause of death is Alzheimer’s disease?

A

7th

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10
Q

What # cause of death is Alzheimer’s disease in >65 years old?

A

5th

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11
Q

Normal aging of the brain

A
  • Loss of tissue with aging

- Older people - smaller body size and smaller brain size

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12
Q

Ideal Aging

A
  • 1-2% brain volume loss/decade 40-80 years old
  • 6-10% total loss by old age (>80 years old)
  • Hippocampus loses at faster rate - 5%/decade; total of 25% by 80 years old
  • Decrease in cortical thickness
  • Ventricular enlargement
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13
Q

How do neurotransmitters change with aging and which ones change?

A
  • Decrease with decrease in number of receptors

- Dopamine, serotonin, GABA

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14
Q

Neuronal Changes with aging occur primarily where?

A

Basal ganglia & pre frontal cortex

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15
Q

Features of neuronal changes with aging

A
  • Cell body shrinks
  • Dendritic tree changes
  • Decrease in axon collaterals
  • Other mechanisms decline - Ca2+ buffering, enzymes, downregulation of GLU receptors, GABA receptors, LTP, calmodulin, synaptic vesicle
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16
Q

Aging of glial cells

A
  • Less well understood
  • Active in myelinization, transport of nutrients, maintaining homeostasis
  • More affected in neurotransmission than originally thought
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17
Q

Aging of vasculature

A
  • Small and microvessel disease important contributor to dementia
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18
Q

Postural control & aging

A
  • Decreases because of decline in sensory system, motor system, central processing, dual task abilities
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19
Q

“Aging Machinery” Hypothesis

A
  • Aging is inevitable and irreversible
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20
Q

“Negative Plasticity” Hypothesis

A
  • Aging comes from over-reliance and disuse

- 2 way street - can be partially reversed with training

21
Q

Healthy Aging

A
  • Exercise
  • Control BP
  • Healthy diet
  • Reduce caloric intake
  • Reduce stress
  • Stable marriage
  • Rest (8 hours sleep)
  • Life long learning
22
Q

Nature v. Nurture

A
  • Aging is inevitable but some people age better than others because of better genes, lifestyles, higher education, higher socioeconomic status, and cognitive reserve
23
Q

Cognitive reserve concept

A
  • If you start with higher level of intelligence, you have a little more reserve so you can decline in cognitive function a bit before you see a difference in day to day function
24
Q

Blue Zone Areas

A
  • Areas that live considerably longer than others (consider 7 day adventus)
  • Sardinia, Italy
  • Okinawa, Japan
  • Nicoya, Costa Rica
  • Icaria, Greece
  • Loma Linda, California
25
Q

Dementia causes

A
  • 60% Alzheimer’s
  • 30-40% vascular
  • 15% other (progressive disease, reversible condition, lewy body dementia, alcoholism, endocrine disorder, depression, AIDS, FTD)
26
Q

Alzheimer’s Disease

A
  • Most common form of dementia due to neuronal degeneration
  • Affects all areas of brain especially basal forebrain and cortex
  • Some studies show hippocampus and left parietal cortex are affected first
  • First sign - memory loss
27
Q

Characteristics of Alzheimer’s Disease

A
  • Large ventricles
  • Cortical atrophy
  • Shrunken gyri
  • Widen sulci
  • Shrunken hippocampus
28
Q

Alzheimer’s disease - microscopic changes

A
  • Neurofibrillary tangles (NT) - inclusions with neurons, tau proteins
  • Amyloid plaques (AP) - in extracellular space
29
Q

When is definite diagnosis of AD made?

A

Post mortum

30
Q

How is probable diagnosis of AD made?

A

Based on clinical presentation

31
Q

Neurotransmitter changes with AD

A
  • Decrease in Ach in basal forebrain

- Other systems affected: Noradrenalin, serotonin, dopamine, GABA

32
Q

Clinical Progression of Alzheimer’s Disease

A
  • Initial onset characterized by short term memory deficits often times noted by family
  • Gradual & steady decline in cognitive fxn over a period of years
  • Apraxia - later sign
  • All systems eventually affected
33
Q

AD Stage 1

A

No impairment/normal function

34
Q

AD Stage 2

A

Very mild cognitive decline

35
Q

AD Stage 3

A

Mild cognitive decline (early-stage Alzheimer’s)

36
Q

AD Stage 4

A

Moderate Cognitive Decline (mild or early-stage Alzheimer’s disease)
- Forgetfulness, difficulty performing hard mental arithmetic, complex tasks, personal history, moody/withdrawn

37
Q

AD Stage 5

A

Moderately severe cognitive decline (moderate/mid-stage Alzheimer’s)
- Problems with own address/number, confusion about location/day, mental arithmetic that are easier, proper clothing

38
Q

AD Stage 6

A

Severe cognitive decline (mod severe/mid-stage Alzheimer’s)
- Lose awareness, difficulty with personal hx, trouble remembering name, dressing confusion, apraxia, changes in sleep, need help with ADLs, personality and behavior changes

39
Q

Very severe cognitive decline

A
  • Severe/late stage Alzheimer’s

- Lose ability to respond to environment, to carry on conversation, and to control movement

40
Q

Risk factors of AD: Increased risk with

A
  • Advanced age
  • Women
  • Previous TBI with unconsciousness
41
Q

Genetics of AD

A
  • Exposes you to AD but does not predict certainty

- Main one is APP gene which everyone has on chromosome 21 so can relate to Down Syndrome

42
Q

Treatments of AD

A
  • Acetylcholinesterase inhibitors
43
Q

Vascular cerebral infarcts

A
  • Other cause of dementia
  • 30-40% of dementias
  • Seen with AD
  • BP and lipid management important
44
Q

Binswanger’s Disease

A
  • Other cause of dementia
  • Affects subcortical white matter
  • Disease of microcirculation
  • Associated with HTN and other vascular disease
  • Seen with shrunken gyri and enlarged ventricles
45
Q

Symptoms of Lewy Body Dementia

A
  • Pronounced fluctuations in awareness/alertness
  • Visual hallucinations
  • Parkinson-like motor sign (rigidity, tremor, bradykinesia)
46
Q

What is average life expectancy after diagnosis of Lewy Body dementia?

A

8 years

47
Q

How do you treat Lewy Body Dementia?

A

Treat cognitive, psychiatric, and motor symptoms of disorder

48
Q

AIDS related dementia

A
  • High incidence of dementia with AIDS
  • Cause unknown
  • Can cause other neuro complications of AIDS - infection of CNS, CNS lymphoma, Toxic encephalopathy

Neuroscience IV - Sara (7 decks)

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