Alzheimer's Disease Related Dementia (ADRD)

Question 1

ability to think, learn, and remember

Answer 1

cognition

Question 2

Cognitive health continuum:

Answer 2

“optimal functioning” to severe disability

Question 3

• Difficulty with cognitive processes
• Not severe enough to interfere with daily life

Answer 3

mild cognitive impairment

Question 4

• 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

Answer 4

cognitive impairment

Question 5

• 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)

Answer 5

dementia

Question 6

Many dementias are ()

Answer 6

progressive

Question 7

4 major types of dementia

Answer 7

1. Alzheimer’s
2. Vascular Dementia
3. Frontotemporal Dementia
4. Lewy Body Dementia

Question 8

• 2nd most common cause of dementia
• 10% - 20% of cases
• Caused by conditions that block or reduce blood flow to the brain

Answer 8

Vascular dementia (vascular cognitive impairment)

Question 9

symptoms of VD may occur suddenly following () or slowly as a result of cumulative damage

Answer 9

stroke

Question 10

main things to look out for when deciding whether patient probably has VD

Answer 10

1. cognitive impairment + imaging evidence of cerebrovascular disease
2. cognitive impairment has a temporal relationship with vascular event
3. clear relationship between severity and pattern of cognitive impairment and cerebrovascular disease pathology
4. no history of other neurodegenerative disorders

Question 11

main things to consider that the patient only possibly has VD

Answer 11

1. no clear relationship between cognitive impairment, imaging evidence, and vascular disease
2. severity of aphasia prevents proper cognitive assessments (unless there is evidence that patient had normal cognition before event that caused aphasia)
3. there is evidence of other NDs that may have caused the CI

Question 12

3 potential mechanisms of blood vessel damage

Answer 12

1. oxidative stress
2. hypoxia
3. inflammation

Question 13

Front line treatment for VD is () to reduce stroke risk

Answer 13

anti-coagulants

Question 14

A common difficulty in evaluating human studies is the clinical difficulties in ()

Answer 14

separating VaD from mixed dementia and AD

Question 15

relationship between AD and VD

Answer 15

• 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

Question 16

() is a pathologically and clinically heterogenous disorder that involves degeneration of the frontal and/or temporal lobes

Answer 16

FTD

Question 17

earliest manifestations of FTD

Answer 17

1. personality and social behavior changes (behavior-variant FTD)
2. language deficits

Question 18

FTD can slowly progress to a more ()

Answer 18

global dementia

Question 19

Pick’s disease is a type of FTD that is characterized by ()

Answer 19

Pick bodies

Question 20

3 main proteins that are thought to be involved in FTD

Answer 20

1. tau (MAPT gene)
2. TDP43 (PGRN, C9ORF72, TDP43)
3. FUS (FUS)

Question 21

main pathogenic mechanisms that serve as targets for FTD-tau therapeutics

Answer 21

1. stabilizing MAPT expression
2. inhibit phosphorylation and acetylation of tau
3. inhibit protein aggregation
4. activation of tau clearance

Question 22

examples of therapeutic interventions of FTD-TDP

Answer 22

1. increase PGRN expression to promote endocytosis of protein aggregates
2. mitigate environmental stress damage
3. activation and modulation of clearing pathways (autophagy-lysosome, ubiquitin-proteosome)

Question 23

Neurodegenerative disorders which are characterized by tau deposits in the brain, with symptoms of dementia and parkinsonism

Answer 23

tauopathy

Question 24

tauopathies are mostly involved in ()

Answer 24

hereditary FTD