Alzheimers Flashcards
Most common cause of dementia
Alzheimers disease
Development of forgetfulness
Gradual
Remote memories are preserved
Recent memories are lost
Ribot’s law of memory
Forgetting words, esp proper name then gradually impaired speech fluency
Dysnomia
Repeats question before answering
Gradually repeating words
Echolalia
Impaired calculations
Acalulianor dyscalculi
Getting lost in familiar places
Visuospatial disorientation
Forgets to use common object
Ideational and locomotor apraxia
Test for alzheimers disease
NINCDS- ADRDA
Protein related to alzheimers disease
Amyloid precursor protein
Amyloid precursor protein gives rise to:
Beta secretase
Alpha secretase
Toxic to brain from cleavage of B secretase by cleavage of y-secretase
AB 42
Excess production leads to deposition in brain
Plaques
Excess production leads to hyperphosphorylation of neural microtubule or tau proteins
Neurofibrillary tangles
Earliest and most severe degeneration
Medial temporal lobe ( entorhinal/perirhinal cortex & hippocampus)
Symmetrical 3rd and lateral ventricle enlargement
Hydrocephalus ex vacuo
Widespread loss of nerve cells
Extreme atrophy of hippocampus
In alzheimers disease, ACH is increased or decreased?
Decreased ACH in alzheimers disease
Diffuse brain atrophy
Frontal, temporal, parietal lobe
Protein amyloid core surrounded y degenerating nerve terminal
Neuritic plaques
Soluble amyloid species
Early toxic molecule
Oligomers
Most evident in pyramidal layer
Granulovacular degeneration
Decreased cholineacetyltransferase
Loss of nucleus basalis of Meynert
Acetylcholine
Mutation in APP gene (in chromosome 21)
Familial Alzheimers disease
Alzheimers disease gene related to down syndrome
Presenelin 1 & 2
PS-1 & PS-2
Most important genetic risk factor
Apolipoprotein E4 ( in chromosome 9)
MRI & CT SCAN
Useful but not definitive
Triad of normal pressure hydrocephalus
Gait disturbances
Cognitive impairment
Impaired bladder control
3 Anticholinesterase drugs
Donezil
Rivastigmine
Galantine
NMDA Antagonist
Memantine
