Alzheimer's disease Flashcards
What are the risk factors of Alzheimer’s disease?
- most cases are sporadic
- downs syndrome
What is the general pathophysiology of Alzheimer’s?
widespread cerebral atrophy (degeneration)- particularly involving the cortex and hippocampus (both memory functions)
What parts of the brain stay intact in Alzheimer’s
- thalamus
- brainstem
- basal ganglia
What causes cerebral atrophy in Alzheimer’s?
caused by cortical plaques forming in the brain due to the deposition of type A beta amyloid protein and intramural neurofibrillary tangles
What causes intramural neurofibrillary tangles in Alzheimer’s?
increased phosphorylation of the tau protein
What does the tau protein do?
it stabilises the internal skeleton of nerve cells and promotes tubular assembly into microtubules
What is the biochemical cause of Alzheimer’s?
there is a deficit of acetylcholine (BP, memory, peristalsis, excretions) from damage to an ascending forebrain projection
Symptoms of Alzheimer’s
- memory loss- esp recent events
- problems with reasoning and communication
- nominal dysphasia- cant recall names of people or object
- difficulty with ADL’s
What are the behavioural and psychological symptoms of Alzheimer’s?
- depression
- agitation
- psychosis
- apathy (lack of interest/ enthusiasm)
- disinhibition
How do you diagnose Alzheimer’s
- cognitive screen
- FBC (to rule out other causes)
- CT/ MRI- dilation of ventricle horns and atrophy of parietal and temporal areas
What is the non-pharmacological treatment of Alzheimers
- promote patient wellbeing
- group cognitive stimulation therapy
What is the pharmacological management for mild- moderate Alzheimer’s
acetylcholinesterase inhibitors
- donezepil (CI in bradycardia, SE= insomnia)
- galantamine
- rivastigmine
Second line management of Alzheimers
memantine- NMDA (glutamate receptor) receptor antagonist
used when alzheimers gets worse
What treatment is not recommended in Alzheimer’s
- antidepressants not recommended
antipsychotics only prescribed when risk of harming themselves/ others
How do you know if it is vascular dementia
stepwise symptoms
