Alzheimers: a clinical approach

Question 1

NMSE

Answer 1

Screening for cognitive decline
Maximum score is 30
Anything below 25 may indicate dementia
Easy and can be done by any doctor. Can be used as extra evidence

Question 2

10 word task

Answer 2

Healthy young adults
+- 7 good answers
Learning curve
Primary effect, recency effect

Patients
-Less good answers
-Flat learning curve
-Intrusions
-Perseverations

Question 3

MRI characteristics

Answer 3

Medial temporal lobe atrophy

Easily applicable
Not very sensitive
subjective component
Time consuming and labour intensive
Not easy in clinical practice
Variability post-processing techniques and outcomes

Question 4

CSF biomarkers

Answer 4

Lumbar puncture for retrieval - cerebrospinal fluid
-Proteins: amyloid beta 1-42
Tau
Hyperphosphorylated tau

Question 5

PET: pathology visualized

Answer 5

Positron emission tomography
New tracers bind to amyloid

-Expensive
Invasive
11C
Amyloid positive controls

Question 6

18F amyloid tracers

Answer 6

Plutemetamol-PET: good correlation with PIB-PET

Large studies
effect of amyloid PET on diagnosis and patient management
18F tracers increase availability and amyloid imaging