Alzheimer's

Question 0

Symptoms of Alzheimer’s

Answer 0

Slow onset
Amnesia (memory)
Aphasia (speech)
Agnosia (recognising)
Apraxia (coordination)
Neuropsychiatric & behavioural complication

Question 1

Causes of dementia

Answer 1

Alzheimer's (50%)
Vascular dementia (25%)
Mixed (25%)
Lewy Body D (15%)
Others (5%):
Frontotemporal
Subcortical
Secondary causes (intracranial lesions)

Question 2

Risk factors for Alzheimer’s

Answer 2

Age
Family history
Apoliprotein (Apo) E4 status
Head injury
Depression
Hypertension
Diabetes
High cholesterol
AF
Presence of cerebral emboli

Question 3

Pathology of Alzheimer’s

Answer 3

Naked eye: unremarkable to grossly abnormal
⬇️ brain weight
Diffuse atrophy- more marked in frontoparietal & temporal lobes
Neuritic plaques- deposition of Amyloid
Neurofibrillary tangles- P tau

Question 4

What could be seen in Alzheimer’s brain in CT scan?

Answer 4

Atrophy

Enlarged ventricles

Question 5

What NTs are affected in Alzheimer’s?

Answer 5

ACh!
Glutamate!
5HT
NA

Question 6

From what cholinergic nucleus are neurones lost from in Alzheimer’s?

Answer 6

Nucleus of Meynert

Question 7

What causes the loss of neocortical cholinergic immervation in Alzheimer’s?

Answer 7

Amyloid plaques

Question 8

What drugs treat Alzheimer’s?

Answer 8

AChEIs

NMDA rec antagonists

Question 9

Side effects of AChEIs

Answer 9

GI side effects, usually short lived

Rarer complications: Stomach ulcers, SA & AV block, seizures

Question 10

3 Clinical features of Lewy Body Dementia

Answer 10

Fluctuating cognitive impairment
Parkinsonism (& falls)
Visual hallucinations

Question 11

Lewy body pathology

Answer 11

Mild cortical atrophy
Enlarged ventricles
Lewy bodies

Question 12

What NTs are affected in Lewy body D?

Answer 12

ACh

Dopamine

Question 13

3 BPSD syndromes

Answer 13

Agitation
Psychosis
Mood disorders