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dementia > chapter 4 > Flashcards

chapter 4 Flashcards

1
Q

annual incidence of AD

A

-6-8%
-slightly higher prevalence rate is found in women
-duration ranges from 2-20 years
-accounts for more than half of all patients with dementia

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2
Q

brain changes

A

-hippocampal atrophy
-atrophy in both hemispheres
-presence of: neuritic plaques, neurofibrillary tangles, granulovacular degeneration

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3
Q

neuritic plaques

A

complex spherical structures consisting of extracellular depostits of B-amyloid peptide AB42)

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4
Q

neurofibrillary tangles (NFT)

A

insoluble intracellular aggregates of abnormal hyperphosphorylated microtubule-associated or tau proteins

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5
Q

granulovacular degeneration

A

fuild-filled spaces which contain granular debris and these interrupt interceullar communication and information processing

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6
Q

diagnostic markers of AD

A

presence of both neuritic plaques and neurofibillary tangles in large concentrations in different areas of the brain

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7
Q

AD begins ______

A

in the lower part of the brain and works it way up
-stage 1: transentorhinal region
-stage 2: entorhinal region
-stage 3: limbic regions -stage 4: neocortical sensroy assoc. and prefrontal region

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8
Q

gender risk factors

A

elderly woman have a higher risk for AD dementia

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9
Q

among all the dementia, mean are at a higher risk for

A

vascular dementia

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10
Q

associated risk factors with gender

A

-greater cardiovascular disease
-lower educational or physical activity levels

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11
Q

2 times higher incidence o dementia and AD in

A

African-American and Hispanic populations

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12
Q

Asian countries have

A

lower prevalence of dementia

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13
Q

older adults with ______ education are less likely to develop dementia

A

higher

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14
Q

cardiovascular factors

A

risk factors for cardiovascular disease (diabetes mellitus, hypertension) are also associated with increased risk of dementia

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15
Q

diabetes mellitus

A

-older adults with diabetes had approx. a 2-fold increase in dementia
-diabetes more strongly associated with VaD than AD

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16
Q

hypertension if not treated in midlife is associated with

A

poor congitive function and higher risk for dementia and AD in late life
=both high systolic blood pressure and low diastolic blood pressure have been assoc. with increased risk of dementia and AD

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17
Q

high blood pressure leads to dementia by creating

A

increased risk for developing ischaemia and stroke
-low blood pressure during late adult life leads to dementia by increasing the risk of cerebral hypoperfusion and hypoxia

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18
Q

behavioral/lifestyle factors

A

protective factors aganist AD are: mental activity, physical activity, smoking

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19
Q

psychosocial factors

A

-depression increases risk of dementia

20
Q

genetics in AD

A

-majority of individuals with DS tend to develop AD if they survive 40 years

21
Q

early stages of AD

A

-anterograde episodic memory impairment
-lang. deficits
-visuospatial deficits
-primary or secondary visual deficits
-executive dysfunction

22
Q

middle stages of AD

A

-deficits in orientation
-deficits in foucused attn and easily distracted
-obvious deficits in visuopereception and visuospatial skills
-bladder incontinence
*needs supervison and assistance with basic ADLs

23
Q

late stages AD

A

-deficits in all areas of orientation
-global deficits in carrying out basic ADLs

24
Q

a diagnosis of possible AD requires

A

moderate neuritic plaques and hipppocampal NFTs

25
Q

clinical diagnosis

A

-has an insidious onset
-associated most commonly with episodic memory impairment
-memory deficits correlate with basal forebrain and medial temporal regions

26
Q

lang deficits AD

A

-reduced spontaneous speech
-word finding probs
-tendency to use less complex grammar and syntac
-global aphasia or mutism in advanved stages

27
Q

visuospatial deficits AD

A

-orientation in their own enviornment
-deficits in self-navigation

28
Q

other deficits AD

A

-executive dysfunction
-agnosia
-apraxia

29
Q

assessment of cognitive functions

A

-neuropsychological exam
-Mini Metal State Exam
-MOCA, Mattis Dementia Rating Scale, Mini Cog, 7-Min Screen, Clock Drawing Test

30
Q

early AD

A

deficits mainly in orientation and memory tasks

31
Q

early FTD

A

deficits in speech

32
Q

early DLB

A

deficits in visuospatial components

33
Q

neuropsychiatric inventory 9NPI)

A

characterizing profiles along 10 behavorial domains and 2 neurovegetative domains
-has a nursing home version

34
Q

behavorial pathology in alzheimers disease rating scale (BEHAVE-AD)

A

examines 25 symptoms arranged in 7 behavioral domains

35
Q

behavorial rating scale for dementia (BRSD)

A

assessment of 46 behaviors arranged into 6 subscales

36
Q

MMSE scores

A

-normal 28-30
-MCI 25-27
mild dementia 20-24
-moderate 13-20
severe less than 12

37
Q

moca scores

A

-normal functioning 27+
-mild 21-26
-moderate 11-20
-severe 10 or less

38
Q

memory tests

A

-rey auditory verbal learning test (RAVLT) can differentiate between indviduals with AD and those without dementia or between other forms of dementia
-delayed recall subtest has high sensitivty for AD

39
Q

FTLD and VaD

A

predominance of deficits in EF compared to AD

40
Q

primary prevention

A

prevention of subsequnt dementia in cognitive normal indviduals
-several risk factors have been identified but no clear reccomendations

41
Q

secondary prevention

A

prevention of development of AD in non-demented individuals with some evidence of cognitive impairment

42
Q

symptomatic treatment

A

2 classes medication have been approved for treatment of cognitive symptoms:
-cholinesterase inhibitors and memantine

43
Q

cholinesterase inhibitors (ChEIs)

A

-ChEIs have been reported to show benefits in mild, moderate and severe AD

44
Q

memantine

A

found to have an effect on delusions, agitation/aggression and irritability

45
Q

neuropsychiatric profiles of AD

A

-mild stages: apathy, depression, irritability and anxiety; fewer behavioral abnormalities reported overall
-moderate to severe stages: agitation, anxiety, motor hyperactivity

46
Q

neuropsychiatric profiles of VaD

A

-specific profile is dependent on the persons brain changes
-commonly observed deficits include depression, apathy, and irritability

47
Q

neuropsychiatric profiles of FTD

A

-a spectrum of cognitive and behavioral disorders resulting from specific deteration in frontal and temporal regions
-personality, emotional, and behavioral changes
-apathy, motor hyperactivity, disinhibition and hyperphagia

dementia (7 decks)

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