Alzheimer’s Disease and Cognition Flashcards
What is the definition of cognition?
The mental action or process of acquiring knowledge and understanding through thought, experience, and the senses.
What are the consequences of cognitive impairment?
- increased risk for injury
- complicates disease management
- decreased functional ability
- increased need for assistive services
- financial hardship
- caregiver burden
What are the risk factors for cognitive impairment?
- Elderly people are at highest risk for cognitive impairment
- personal behaviors, substance abuse, participation in high-risk activities, accidental injuries
- environmental exposure
- congenital factors
- genetic conditions
- health-related conditions (acute/chronic treatments
What does th type and degree of cognitive impairment depend on?
The type of problem and its severity
What are the things that are helpful in recognizing cognitive impairment?
- memory
- language
- visuospatial
- calculation
- abstract reasoning
- thought process and content
What are some diagnostic tests for cognitive impairment?
- lab tests (to rule out medical problems)
- Neuropsychometric testing
- brain imaging techniques
What are some of the brain imaging techniques used to diagnose cognitive impairment?
- neuroimaging
- MRI or PET
What can the MRI or PET detect?
- intercranial tumors
- infarcts (vascular dementia)
- frontotemporal lobe atrophy
What is Alzheimer’s disease?
A common degenerative neurological disorder.
When does AD usually manifest?
After age 65
Half the population over ___ have AD.
85
When a patient has AD, what else may they die from?
Comorbidities
What are the two basic types of AD?
Familial and sporadic
What is an example of progressive degenerative changes in AD?
Gross atrophy of cerebral cortex.
What is AD caused by?
- neurofibrillary tangles
- Amyloid process
- loss of communication between neurons
- death of neurons results
Death of neurons follows a…
Specific pattern
What is the limbic system?
Center for emotion, memory
What is the hippocampus?
Center for recent memory
What type of memory is lost more slowly and why?
Remote memory, because it is spread over more areas of the brain
Death of neurons cause what?
Motor changes, loss of ability to think remember, and reason
Death of neurons causes changes in behavior that interfere with what?
Life.
What can exhibit from death of neurons?
Delusions or hallucinations
The summary of the pathophysiology and etiology of AD includes what?
- blood flow to affected areas decreases
- atrophy of cortical area of the brain
- structural, chemical changes
What are the risk factors of AD?
- Age over 65
- Family history
- Gender
- Head injury
Is there a way to prevent AD?
No
What are the actions that can limit risk of AD?
- weight control
- regular exercise
- consume protective foods
- use of drugs and alcohol
- being mentally and socially active
What things could be associations with AD?
- anoxia
- infectious disease (HIV)
- Depression
- poisoning
- substance abuse
- Down syndrome
- DM
- Atherosclerosis
- HTN
- smoking
- inflammation
In AD, what accompanies cognitive decline?
Physical decline
What do you do with the many manifestations of AD that are similar to those of other conditions?
Rule out other disease processes
What does the rate of progression of this disease depend on?
Overall health and type of care after diagnosis
Mnemonic: D:
Drug or alcohol
Mnemonic: E:
Emotional disorders
Mnemonic: M:
Metabolic or endocrine disorders
Mnemonic: E (2):
Eye and ear dysfunctions.
Mnemonics: N:
Nutritional deficiencies
Mnemonics: T
Tumors, trauma, or toxins
Mnemonics: I
Infections
Mnemonics: A
Atherosclerotic effects on heart, brain
How many stages of dementia are there?
Seven
How is stage 1 AD characterized?
No impairment
How is stage 2 AD characterized?
Normal aged forgetfulness
How is stage 3 AD characterized?
Mild cognitive impairment
How is stage 4 AD characterized?
Mild or early stage AD (symptoms are more obvious, trouble performing ADL’s)
How is stage 5 AD characterized?
Moderate AD (lose ability to live independently)
How is stage 6 AD characterized?
Moderately severe AD (can remember own name but not name of spouse)
How is stage 7 AD characterized?
Severe AD (complete loss of ability to respond to surroundings, requires total care)
For collaboration of a patient with AD, who is involved?
-MD, Nurse, Social Worker, Neurologist, Psychiatrist, PT, OT, Gerentology nurse specialist, MD, Case worker, pharmacists
Are there any diagnostic test for AD?
No, except for a brain autopsy
What are other diagnostics to discover AD?
H&P, (including psychiatric and neuro), Ongoing interviews, Brain scans, CT and MRI, PET imaging, Lab work ups
What is PET imaging?
It’s a type of nuclear medicine imaging.
What may slow down progression of of AD
Acetylocholinesterase inhibitors and MNDA receptor antagonists.
What if taken before the disease, may slow progression of AD?
NSAID’s
True or false.
Research suggests certain antihypertensives may be useful.
True.
What type of behaviors management drugs are given for AD?
- antidepressants
- antipsychotics
What is the prototype drug for mild to moderate AD?
Donepezil
What is Memantine?
A NMDA receptor antagonist
What is Memantine used for?
Moderate to Late AD
What is the action of Memantine?
It blocks the effects from high levels of glutamate thereby slowing the intracellular calcium accumulation and resultant nerve damage
What is contraindicated for Memantine?
Renal or hepatic impairment, seizure history.
What are the adverse affects of Memantine?
Heart failure, HTN, fatigue, dizziness, anxiety, confusion, insomnia, arthralgia, incontinence
What do you use is combination with Memantine?
Donepezil
