Chapter 15 Part 3: Causes of Neurocognitive Disorders

Question 1

relationship between alzheimers and smoking

Answer 1

alzheimer’s disease may manifest through a malfunction in the ability for cells to inherently repair themselves. This factor may interact wiht cigarette smoking to shorten the lives of smokers who are at risk for alzheimer’s, before alzheimer’s can actually develop. Therefore, smoking may exacerbate the degernerative process of alzheimer’s disease, causing people with the disease who also smoke to die much earlier than nonsmokers.

Question 2

aluminum hypothesis

Answer 2

the theory that aluminum fumes may contribute to alzheimer’s. Most scientist now conclude that if aluminum exposure plays any role in alzheimer disease, the role is small.

Question 3

what two anomalies are seen in the brain in individuals with alzheimers?

Answer 3

1) neurofibrillary tangles
2) beta amyloid plaques.

theses two things accumulate over the years and are believed to produce the characteristic cognitive disorders we have been describing. Additionally, people with alzheimer’s have BRAIN SHRINKAGE.

Question 4

why can’t we just scan the brain for tangles or plaques before someone dies to give a definite diagnosis of alzheimers?

Answer 4

the tangles and plaques are too small to see in a living brain.

Question 5

which chromosome is defected to produce early onset alzheimers? late onset alzheimrs?

Answer 5

defects in chromosome 14 results in early onset

defets in chromosome 19 seems to be related to late onset.

Question 6

which syndrome is associated with increased risk of alzheimers?

Answer 6

down syndrome. The defects in chromosome 21 is linked to alzheimers as well, and the fact that people with DS have 3 chromosomes result in a heightened risk for alzheimers

Question 7

what is a deterministic gene

Answer 7

a gene that is 100% indicative of developing a disease. there are some genes that are deterministic of alzherimesr, meaning that if you have one of these genes you have a nearly 100% chance of developing alzheimers.

Question 8

deterministic genes of alzheimers

Answer 8

1) amyloid beta peptides
2) presenilin 1
3) presenili 2

Question 9

susceptibility genes of alzheimers

Answer 9

1) apolipoprotein E4

- these genes only slightly increase the risk of developing Alzheimer’s disease.

Question 10

2 mechanisms that may account for amyloid protein buildup

Answer 10

1) APP gene expression for amyloid precursor protein, a large protein that is eventually broken down into the amyloid protein found in amyloid plaques
2) buildup of apolippoprotein E, which normally helps transport cholesterols, including amyloid protein. There are lots of Isoforms such as E1, E2, E3, and E4. Having E4 copy is associated with alzheimers. Having two genes for apoE4 increases the risk for Alzheimer’s Disease.

Question 11

in the core of the plaques is a solid waxy suvstance made of ___ ___

Answer 11

amyloid beta

Question 12

APP is a large protein that is enevtyally broken down into amyloifd protein. Which chromosome houses APP gene?

Answer 12

chromosome 21.
This may be why people with down syndrome may have higher incidence of the disease; because they have a third copy of APP, this may result in secretion of a lot of APP protein, resulting in more plaques.

Question 13

ApoE gene is located on chromosome ____. What is its usual function? What isoform is implicated in alzheimers?

Answer 13

ApoE gene is located on chromosome 19. usually is meant to help with cholesterol transport, including amyloid protein, through the blood stream. The isoform that is implicated on LATE ONSET ALZHEIMERS is E4 on chromosome 19.

Question 14

ApoE4 gene doesn’t cause alzheimer’s alone- what must it be paired with?

Answer 14

life stress, hypertension, or poor cardiac health such as high cholesterol levels. Also, CTE due to traumatic injury could be paired with ApoE4 to create intense neurocognitive disfunction.

Question 15

general social influences on the development of neurocognitive disorder

Answer 15

lifestyle that puts you at increased risk for stroke could lead to the development of vascular ND ex/ smoking, drug use, diabetes, etc.

Question 16

cultural influence on the development of neurocognitive disorder

Answer 16

in extreme cultural practices like papua new guinean cultures of cannibalism, this could put members at increased risk for developming a prion-based neurocognitive disorder.

Question 17

why may chinese people have an apparent lower level of neurocognitive disorders?

Answer 17

early stages of condusion and memory loss may be better tolerated in cultures with lowered expectations of older adults. Therefore, they may just be reporting it less than western cultures.

Question 18

it’s been hard to harness plastic abilities of the brain to remedy extensive brain damage seen in individuals with alzheimers. What are the three goals of current treatment?

Answer 18

1) trying to prevent certain conditions
2) trying to delay the onset of symptoms
3) attempting to help these individuals and their caregivers cope with the advancing deterioration

Question 19

Explain caregievr burnout of inidividuals who are helping take care of people with neurocognitive disorders

Answer 19

caregivers of people with neurocognitive disorder eventually become clinically depressed and report stress symptoms at three times the normal rate. Clinicians are becoming increasingly sensitive to the needs of caregivers.

Question 20

promising factor that may help preserve and perhaps restore neurons

Answer 20

glial cell derived neurotrophic factor.

Question 21

possible biological treatments for treating vascular ND

Answer 21

drugs that help prevent much of the damage inflicted by the blood clots characteristic of stroke.

Question 22

which neurotransmitter is being researched for its affects in preventing alzheimer’s progression?

Answer 22

cholinesterase inhibitors. Drugs that prevent the breakdown of acetylcholine are promisng in slowly the progression of alzheimers. Some studies have shown that cognitive abilities improve to the point where they were six months earlier.

Question 23

Cons of using cholinesterase inhibitors to prevent progression of alzheimer’s

Answer 23

• short lasting.
• liver problems
• if you stop using them, which almost 3/4 due because of the negative side effects such as liver damage and nausea, they lose the six month gain.

Question 24

newer drugs other than cholinesterase inhibitors are now focusing on targeting:

Answer 24

the beta amyloid plaques in the brain.

Question 25

possible vaccine for alzheimers?

Answer 25

could be used as a preventative treatment by getting the immune system to attack the process that ove produces the beta amyloid proteins that lead to cell death

• this was stopped being reserached because it caused serious brain inflammation.

Question 26

psychosocial treatments:

people with neurocognitive disorders can be taught skills to compensate for their lost abilities. Discuss the use of memory wallets

Answer 26

placing plastic cards in the wallets of people with NDs, with printed DECLARATIVE STATEMENTS (ex/ my name is john and I have a wife and three kids). This allows them ti improve their conversations with others and “grounds” them in fact.

Question 27

psychosocial treatments

Cognitive stimulation

Answer 27

encouraging people with NDs to practice learning and memory skills. May be an effective method for delaying the onset of the more severe cognitive effects of this disorder.

Question 28

examples of cognitive stimulation

Answer 28

these activites include word games, tests of memory of famous and familiar faces, and practice with numbers. These can maintain cognitive activity and improve the quality of life.

Question 29

T/F psychosocial treatments and interventions can prevent mental decline completely in people with diagnosed alzheimers

Answer 29

false. People with interventions are able to live more fully for a longer period, but they still ultimately experience impairment and death.

Question 30

psychosocial treatments for counteracting the aggression seen in advanced ND

Answer 30

teaching communication skills in a manner similar to programs for persons with ASD.
- carefivers are often given assertiveness training to help them deal with hostile behaviours. Otherwise, caregivers may either passivley accept all the criticism inflicted by the person with neurocognitive disorder, which increases stress, or become angry in return. (elder abuse)

Question 31

It is important to teach carefivers how to handle stressful circumstances so they do not esscalate abusive situations. clinicians must first recgonize that the ability to adapt to stressors differs among people though. what are some cultural differences in the coping styles of caregivers

Answer 31

for example, in alabama, white caregivers tend to use acceptance and humor to cope, whereas black caregivers use religion and denial to cope.

Question 32

three major conclusions for preventing NDs

Answer 32

1) control your blood pressure
2) do not smoke
3) lead a socially and physically active life.