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PHA333 > Alzheimer's 1 (PB) > Flashcards

Alzheimer's 1 (PB) Flashcards

1
Q

What is dementia?

A

progressive cliical syndrome of deteriorating mental function significant enough to interfere with activities of daily living

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2
Q

What does dementia afffect?

A

cognitive domains - memory, thinking, language, orientation, judgement

social behaviour - emotional control and motivation

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3
Q

How is a diagnosis of dementia made?

A

impairment in at least 2 cognitive domains* that lead to a significant functional decline* that cannot be exaplained by another disorder/adverse effect of medication

  • memory, language, behaviour, visuospatial function
  • *enough to affect activities of daily living
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4
Q

erly onset/young onset dementia

A

dementia that develops before the ge of 65yrs

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5
Q

What is mild cognitive impairment?

A

cognitive impairment that does not fulfil the criteria for dementia

  • only 1 cognitive domain is affected, deficits don’t significantly affect ADLs
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6
Q

ADL

A

activities of daily living

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7
Q

causes of dementia

A
  1. Alzheimer’s disease
  2. vascular dementia
  3. dementia with Lwey bodies (DLB)
  4. frontotemporal dementia (FTD)
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8
Q

pathological features of Alzheimer’s disease

A

atrophy of the cerebral cortex

formation of amyloid plaques and neurofibrillary tangles

acetylcholine production in affected neurons is reduced

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9
Q

What causes vascular dementia?

A

reduced blood supply to the brain

caused by cerebrovascular disorders - small infarcts (stroke), cerrbralamyloid angiopathy, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL)

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10
Q

features of dementiawith Lewy bodies (DLB)

A

cortical and subcortical Lewy bodies

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11
Q

What are Lewy bodies?

A

abnormal deposits of protein inside nerve cells

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12
Q

DLB and PD dementia classifications

A
  • cognitive symptoms and motor features of PD within 1yr classed as having dementia with Lewy bodies
  • PD who develop dementia >1yr classed as having PD demenita
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13
Q

What is frontotemporal dementia (FTD) characterised by?`

A

progressive degeneration of the frontal and/or temporal lobes

gradual progression

usually presents in middle age

can present in 30s or 90s

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14
Q

rarer causes of dementia

A
  • PD dementia
  • progressive supranuclear palsy
  • Huntington’s disease
  • prion disease
  • normal pressure hydrocephalus
  • benign tumours
  • chronic subdural haematoma
  • metabolic/endocrine disorders (chronic hypocalcaemia, recurrent hypoglycaemia)
  • vitamin deficiencies (B12, thiamine)
  • infections (HIV, syphilis)
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15
Q

What is Alzheimer’s disease?

A

irreversible progressive brain disease that slowly destroys memory and thinking skills

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16
Q

AD and neurons

A

AD disrupts

  • communication between neurons
  • metabolism of neurons
  • repair of neurons
17
Q

genes involved in AD

A

APP - amyloid precursor protein
PSEN-1 - presenilin gene)
PSEN-2
APOE2, 3, 4

18
Q

3 genes that influence AD in younger people

A

APP
PSEN-1
PSEN-2

19
Q

Gene defects and PSEN1 and 2

A

2 presenilin genes can be affected: PSEN-1 and PSEN-2

PSEN-1 is a fault on chromosone 14
PSEN-2 is a fault on chromosome 1

20
Q

What chromosome is affected in APP (amyloid precursor protein) gene defect of AD?

A

fault on chromosome 21

21
Q

gene defects that affects older people (>65yrs)

A

apolipoprotein E (APOE)

3 forms: APOE2, APOE3, APOE4

22
Q

APP and AD pathogenesis

A

APP (amyloid precursor protein) is broken down

  • first by alpha and betw secretase
  • then by gama secretase

forms differnent substitutents such as A beta 42, A beta 40 and P3

Abeta42 is toxic

it aggregates and forms amyloid plaques which lead to neuronal death

23
Q

Tau protein and AD pathogenesis

A

Tau forms insoluble filaments that accumulates as neurofibrillary tangles

24
Q

features of Alzheimer’s disease

A
  • memory loss
  • decline in language
  • apraxia (can’t preform movements on comand)
  • agnosia (can’t ID objects, people)
  • progressive loss of function
  • behavioural changes (agitation, aggression, wandering, delusions)
  • loss of sight
  • depression
25
Q

progression of AD

A

AD spreads through the brain

cerebral cortex begins to shrink as more neurons stop working and die

26
Q

mild AD signs

A 
memory loss
confusion
trouble handling money
poor judgement
mood changes
increased anxiety
27
Q

moderate AD signs

A 
inc memory loss
inc confusion
problems recognising prople
difficuty with language and thoughts
restlessness
agitation
wandering
repetitive statements
28
Q

severe AD

A

extremeshrinkage of the brain

patients completely dependent on others for care

symptoms: weight loss, seizures, skin infections, groaning, moaning, grunting, increased sleeping, loss of bladder/bowel control

29
Q

How does death usually occur from AD?

A

aspiration pneumonia

other infections

PHA333 (27 decks)

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