Alzheimer's Disease Related Dementia (ADRD) Flashcards
ability to think, learn, and remember
cognition
Cognitive health continuum:
“optimal functioning” to severe disability
- Difficulty with cognitive processes
- Not severe enough to interfere with daily life
mild cognitive impairment
- Difficulty with cognitive processes that affect everyday life
- Spans wide range of functioning
- Can occur as a result of Alzheimer’s, dementia, stroke, traumatic brain injury
cognitive impairment
- a general term for the impaired ability to remember, think, or make decisions that interferes with doing everyday activities.
- considered a syndrome (not a specific disease)
dementia
Many dementias are ()
progressive
4 major types of dementia
- Alzheimer’s
- Vascular Dementia
- Frontotemporal Dementia
- Lewy Body Dementia
- 2nd most common cause of dementia
- 10% - 20% of cases
- Caused by conditions that block or reduce blood flow to the brain
Vascular dementia (vascular cognitive impairment)
symptoms of VD may occur suddenly following () or slowly as a result of cumulative damage
stroke
main things to look out for when deciding whether patient probably has VD
- cognitive impairment + imaging evidence of cerebrovascular disease
- cognitive impairment has a temporal relationship with vascular event
- clear relationship between severity and pattern of cognitive impairment and cerebrovascular disease pathology
- no history of other neurodegenerative disorders
main things to consider that the patient only possibly has VD
- no clear relationship between cognitive impairment, imaging evidence, and vascular disease
- severity of aphasia prevents proper cognitive assessments (unless there is evidence that patient had normal cognition before event that caused aphasia)
- there is evidence of other NDs that may have caused the CI
3 potential mechanisms of blood vessel damage
- oxidative stress
- hypoxia
- inflammation
Front line treatment for VD is () to reduce stroke risk
anti-coagulants
A common difficulty in evaluating human studies is the clinical difficulties in ()
separating VaD from mixed dementia and AD
relationship between AD and VD
- many patients have mixed dementia (AD + VD)
- VD and AD share similar risk factors
- progression of AD can be accelerated by vascular patho or slowed by its prevention
() is a pathologically and clinically heterogenous disorder that involves degeneration of the frontal and/or temporal lobes
FTD
earliest manifestations of FTD
- personality and social behavior changes (behavior-variant FTD)
- language deficits
FTD can slowly progress to a more ()
global dementia
Pick’s disease is a type of FTD that is characterized by ()
Pick bodies
3 main proteins that are thought to be involved in FTD
- tau (MAPT gene)
- TDP43 (PGRN, C9ORF72, TDP43)
- FUS (FUS)
main pathogenic mechanisms that serve as targets for FTD-tau therapeutics
- stabilizing MAPT expression
- inhibit phosphorylation and acetylation of tau
- inhibit protein aggregation
- activation of tau clearance
examples of therapeutic interventions of FTD-TDP
- increase PGRN expression to promote endocytosis of protein aggregates
- mitigate environmental stress damage
- activation and modulation of clearing pathways (autophagy-lysosome, ubiquitin-proteosome)
Neurodegenerative disorders which are characterized by tau deposits in the brain, with symptoms of dementia and parkinsonism
tauopathy
tauopathies are mostly involved in ()
hereditary FTD