Alzhiemer's Flashcards
What are the two main causes of alzheimers?
- Genetics
- Sporadic
What genetic factors may increase the risk of alzheimers?
Chromosomal
- PSEN 1/2 defects
Apolipoprotein E4 allele
- ApoE4
- Responsible for cleaving amyloid precursor protein
What is the pathology of alzheimers?
Accumulation of Beta amyloid plaques extracellularly
- These can get in between synapses and result in progressive neuronal damage
Neurofibrillary Tangles
- Inside cells
- Eventually can cause apoptosis of neurones
What are the main symptoms of alzhiemers?
Dementia
- Reduced memory and cognition
- Behavioural change
- Hallucinations and delusions
- Depression, irratibility
What is the DDx of alzheimers?
Other types of dimentia
- Frontotemporal
- Lewy body
- Vascular
What sets the other types of dementia apart from alzheimers?
Frontotemporal
- Loss of the frontal and temporal lobes WITHOUT alzheimers histology
Lewy Body
- Presence of lewy bodies in neuronal cell bodies
- Parkinsonism
Vascular
- Result of many TIA’s
- Stepwise progression
Investigations of alzheimers?
Detailed history from friends and family, inquire about changes in behaviour and memory.
CT/MRI
- Rule out anything else and other types of dimentia
- Normal pressure hydrocephalus (look for brain shrinkage from lots of CSF
Bloods
What blood tests should be done?
FBC U&Es ESR Glucose TSH & B12
What pharma treatment should be followed for dementia?
Cholinesterase inhibitors
- Denepezil
- Rivastigmine
Antiglutametergics
- Memantine
Treat hypertension
What other management should be done
Cognitively stimulating hobbies and environments
Who should be contacted with the diagnosis?
Social services
Alzheimers society
Respite
What is the only way to get a definitive diagnosis of AD?
Post mortem showing Beta amyloid plaques and neurofibrillary tangles on histology
