Ch 3 lecture review Flashcards
What are the three stages of Alzheimer’s Disease?
- Preclinical
- Mild Cognitive Impairment (MCI)
- Dementia
What are the properties of the pre-clinical phase of Alzheimer’s Disease?
Development of amyloid plaques
Development of neurofibrillary tangles
no symptoms yet
lasts 10-20 years
What are the properties of the MCI stage of Alzheimer’s Disease?
for 80%, first symptom is memory loss one area of cognition is impaired symptom happens consistently (all the time) last 5-10 years Multi-subtypes
What are the four subtypes of MCI in Alzheimer’s Disease?
amnestic subtype
nonamnestic subtype
amnestic multi-domain subtype
nonamnestic multi-domain subtype
What are the properties of the Dementia stage of Alzheimer’s Disease?
2 or more areas of impairment no longer independent varies in years can have trouble with bills someone must help you because you cant remember
What are the 5 diagnostic criteria for MCI?
Impairment in only one cognitive function
Cognitive impairment doesn’t impact ADL’s or work
Patient doesn’t have all cause dementia
(req. 2 areas and significant interference w ADL’s and work)
The impairment is 1.5 standard deviations below the mean for their age
General Rule: earlier the onset, more rapid the progression. Later, slower progression
What are the three stages of Alzheimer’s dementia?
forgetfulness
confusional
terminal
Describe disorientation during the forgetfulness stage of Alzheimer’s dementia.
this is typically temporal disorientation, so the patient may not remember the time or the date. (retirees don’t often track the week and date precisely, so must differentiate) ongoing confusion
Though rare, Geographical disorientation can occur.
Describe the 5 memory impairments found during the forgetfulness stage of Alzheimer’s dementia.
forgetting details of conversations
repeating themselves with unusual frequency
word finding difficult/language difficulty (this is not forgetting! it’s a problem with retrieving specific words from their lexicon.)
mild problem with language comprehension
problems with executive function (bills, budget planning, etc.)
In addition to cognitive function deficits, what two mental disorders are experienced frequently by patients in the forgetfulness stage?
depression and anxiety, with an elevated risk for suicide in the first year following diagnosis.
Describe the 8 changes experienced as a patient transitions from the forgetfulness stage to the confusional stage of Alzheimer’s dementia.
more severe temporal disorientation
(forgetting the season or year)
disorientation to place
spatial disorientation
disorientation to person (ex: can recall their telephone number)
more severe memory impairment (from details to whole events)
no ambiguity at this stage
Often stop watching movies and TV, reading, because it’s a frustrating experience and they can’t follow the events.
geographic orientation is more severe (should not be driving)
anomia so severe that its difficult to understand what they’re saying
comprehension declines (they cannot understand you)
develop acalculia
apraxia develops (failure of skilled, learned movement)
During the confusional stage, what 5 disorders tend to occur?
anomia dyscalculia apraxia increase in anxiety decrease in depression (can't remember why they're depressed)
What is anomia?
inability to retrieve the appropriate word from the person’s lexicon.
what is dyscalculia?
loss of ability to do simple arithmetic problems.
what is apraxia?
impairment or incompletion to perform skilled, learned sequences (ex: making breakfast or coffee)
What two types of apraxia were mentioned that correspond to the confusional stage of Alzheimer’s dementia?
audio-motor apraxia
ideational apraxia
what is audio-motor apraxia?
the loss of ability to orientate an object to an action (ex: can’t orient a match to a matchbox to light it)
What is ideational apraxia?
performing steps of skilled, learned sequences out of order
True or False. You can diagnose Alzheimer’s disease in a living individual by tests measuring the presence of neurofibrillary tangles and amyloid plaques in their brain.
False. Alzheimer’s is diagnosed by behavior and is exclusionary. Although some technology is being created, there are currently no tests for amyloid plaques or neurofibrillary tangles. These are only evident in a cadaver.
