alzhimers 1

Question 1

define dementia

Answer 1

• Dementia is a typically progressive clinical syndrome
of deteriorating mental function significant enough
to interfere with activities of daily living (ADLs).

Question 2

what does dementia affect?

Answer 2

• cognitive domains (such as memory, thinking,
language, orientation and judgement)
• social behaviour (such as emotional control and
motivation)

Question 3

for a diagnosis of dementia to be made, the person must have:

Answer 3

• Impairment in at least two cognitive
domains {memory, language, behaviour,
and visuospatial or executive function}
leading to significant functional decline
{enough to affect activities of daily living
(ADLs)} that cannot be explained by
another disorder or adverse effects of
medication

Question 4

what is early-onset dementia?

Answer 4

is
generally defined as dementia that develops
before 65 years of age.

Question 5

what is mild cognitive impairment?

Answer 5

is cognitive
impairment that does not fulfil
the diagnostic criteria for dementia, for
example, because only one cognitive domain
is affected, or deficits do not significantly
affect ADLs.

Question 6

what causes alzhimer’s disease?

Answer 6

 atrophy of the cerebral cortex
 formation of amyloid plaques and
neurofibrillary tangles.
 Acetylcholine production in affected
neurones is reduced.
• Post-mortem studies show that AD and
vascular dementia often co-exist.

Question 7

how does vascular dementia occur?

Answer 7

Vascular dementia occurs as a result of reduced

blood supply to the brain.

Question 8

what causes vascular dementia?

Answer 8

caused by a wide variety of cerebrovascular
disorders, including large or multiple small
infarcts, cerebral amyloid angiopathy, and
cerebral autosomal dominant arteriopathy with
subcortical infarcts and leukoencephalopathy
(CADASIL).

Question 9

what is the main pathological feature of dementia with lewy bodies?

Answer 9

Main pathological features of DLB are cortical
and subcortical Lewy bodies (abnormal
deposits of protein inside nerve cells).

Question 10

how may DLB have similar features to parkinsons disease dementia?

Answer 10

People who develop cognitive symptoms and motor
features of Parkinson’s disease within 1 year are
classed as having dementia with Lewy bodies.
• People with Parkinson’s disease who develop
dementia after more than 12 months are classed as
having Parkinson’s disease dementia.

Question 11

what is frontotemporal dementia?

Answer 11

FTD is characterized by progressive
degeneration of the frontal and/or temporal
lobes.
• FTD tends to have an insidious onset and
gradual progression, typically presenting in
middle age.

Question 12

what is alzhimers disease?

Answer 12

Alzheimer’s disease is an irreversible, progressive brain
disease that slowly destroys memory and thinking
skills.

Question 13

what role do neurons play in AD?

Answer 13

• The brain has billions of
neurons, each with an
axon and many dendrites.
• To stay healthy, neurons
must communicate with
each other, carry out
metabolism, and repair
themselves.
• AD disrupts all three of
these essential jobs

Question 14

what are the 4 genes that influence disease development of AD?

Answer 14

– Amyloid precursor protein (APP) gene
• Fault on chromosome 21
– Two presenilin genes (PSEN-1 and PSEN-2)
• Fault on chromosome 14(PSEN-1)
• Fault on chromosome 1 (PSEN-2)
– Develop the disease in their 30s or 40s
• One affects older people (over the age of 65)
• One gene is known to influence disease
development: apolipoprotein E (APOE)

Question 15

what is the different forms of the APOE gene?

Answer 15

– APOE2
– APOE3
– APOE4

Question 16

what are the cardinal clinical features of AD?

Answer 16

• Memory loss
• Decline in language
• Apraxia
• Agnosia
• Progressive loss of executive functions -
organizing , planning and sequencing
• Behavioural changes – agitation, aggression,
wandering delusions
• Loss of sight relative or complete
• Depression – through severe depression is
unusual , perhaps due to loss of insight

Question 17

what happens when AD progresses?

Answer 17

AD spreads through the brain. The cerebral
cortex begins to shrink as more and more
neurons stop working and die.

Question 18

what are the mild AD signs?

Answer 18

Mild AD signs can include memory loss, confusion,
trouble handling money, poor judgment, mood
changes, and increased anxiety.

Question 19

what are the moderate AD signs?

Answer 19

can include increased memory
loss and confusion, problems recognizing people,
difficulty with language and thoughts, restlessness,
agitation, wandering, and repetitive statements.

Question 20

what would happen in severe AD?

Answer 20

extreme shrinkage occurs in the
brain. Patients are completely dependent on others
for care.
•Symptoms can include weight loss, seizures, skin
infections, groaning, moaning, or grunting,
increased sleeping, loss of bladder and bowel
control.

Question 21

how does death usually occur in AD?

Answer 21

death usually occurs from aspiration pneumonia or
other infections. Caregivers can turn to a hospice
for help and palliative care.