Cognitive Decline Flashcards
Describe episodic memory
A category of long-term memory that involves the recollection of specific events, situations, and experiences.
Examples - memory of first day of school, first kiss
Describe semantic memory
Long term memory that is not drawn from personal experience - includes general knowledge and word meanings
Describe procedural memory
Long-term memory which is responsible for knowing how to do things e.g. how to walk, how to ride a bike
What is antegrade amnesia?
Difficulty in acquiring new material and remembering events since the onset of the illness or injury
What is retrograde amnesia?
Difficulty in remembering information prior to the onset of illness or injury
What are the macroscopic changes seen in AD?
Widespread cerebral atrophy, particularly in the cortex and hippocampus
What are the microscopic changes seen in AD?
Cortical plaques due to the deposition of Amyloid-Beta protein and intraneuronal neurofibrillary tangles caused by the abnormal aggregation of tau protein
Hyperphosphorylation of which protein is linked to AD?
Tau
What is the first line pharmacological treatment of AD?
Acetylcholinesterase Inhibitors
- Donepezil
- Galantamine
- Rivastigmine
What is the second line pharmacological treatment for AD?
Memantine
When is memantine prescribed in AD?
- moderate AD where intolerant or have a contraindication to acetylcholinesterase inhibitors
- as an add-on to acetylcholinesterase inhibitors in moderate to severe AD
- as a monotherapy in severe AD
True or False?
Donepezil is contraindicated in Bradycardia
True
How does vascular dementia usually present?
A history of several months/years of sudden or stepwise deterioration of cognitive function
What are some signs and symptoms of vascular dementia?
Focal neurological abnormalities - visual disturbance, sensory or motor symptoms
Difficulty with attention and concentration
Seizures
Memory disturbance
Gait disturbance
Speech disturbance
Emotional disturbance
What might an MRI of someone with vascular dementia show?
Infarcts and extensive white matter changes
What is the characteristic pathological feature of Lewy-Body Dementia?
Lewy bodies (alpha-synuclein cytoplasmic inclusions) in the substantia nigra, paralimbic and neocortical areas
What are the features of Lewy-Body Dementia?
Progressive cognitive impairment (can be fluctuating)
Parkinsonism
Visual hallucinations
What imagining can be used to determine a diagnosis of Lewy-Body dementia?
SPECT scan
What is the pharmacological management of lewy body dementia?
1st line = acetylcholinesterase inhibitors (e.g. Donepezil)
2nd line = memantine
What are the 3 recognised types of frontotemporal lobar degeneration?
Frontotemporal dementia (Pick’s Disease)
Progressive non-fluent aphasia (chronic progressive aphasia CPA)
Semantic dementia
What is characteristic of Pick’s Disease?
Personality change and impaired social conduct
Other features - hyperorality, disinhibition, increased appetite
What is the characteristic macroscopic appearance of a brain with Pick’s disease?
Frontal gyral atrophy with a knife blade appearance
What are the microscopic changes associated with Pick’s Disease?
Pick bodies - spherical aggregations of tau proteins
Gliosis
Neurofibrillary tangles
Senile plaques
What are the features of CJD?
Dementia (rapid onset)
Myoclonus
