Cortical Dementias

Question 1

AD Risk factors (12)

Answer 1

Age, genetics/family history, gender, education, DS, head trauma, depression, vascular risk, sedentary lifestyle, high fat diet, low vitamin intake

Question 2

Pathological changes in AD

Answer 2

Shrinkage of cortex due to beta-amyloid plaques and neurofibrillary tangles caused by clumped tau protiens, ventricular enlargement

Question 3

Diagnosis for AD

Answer 3

No single test; physical, psychiatric, and neurologic exams required

Question 4

AD stages (language related)

Answer 4

Early: mild word retrieval and comprehension deficits
Middle: Frequent word retrieval deficits and ungrammatic language output
Late: Non-functional reading and writing, limited comprehension, speech limited to single words, speech may be bizzare and devoid of meaning

Question 5

AD Verbal parallels to other disorders

Answer 5

1. Reduced verbal fluency
2. Anomic aphasia
3. Transcoritcal sensory aphasia
4. Semantic aphasia
5. Wernicke’s aphasia
6. Unrecognizable output/mutism

Question 6

Lewy Body Dementia–unique features

Answer 6

Fluctuating attention/cognition, visual hallucinations, PD-like motor symptoms, less medial-temporal involvement than AD

Question 7

Three presentations of Lewy Body

Answer 7

1. Begins with memory/cognitive impairment then acquires more unique LBD symptoms
2. Begins with movement disorder, then dementia symptoms of LBD appear
3. Begins with neuropsychiatric symptoms, then LBD develops

Question 8

LBD Course

Answer 8

Mean duration is 5-6 years, but development is variable based on the patient

Question 9

Frontotemporal Dementia–clinical characteristics

Answer 9

Develops between 35-75; Patients live 2-10 years post-diagnosis

Lack of inhibition; inappropriate social behaviors; loss of concern regarding changes in behavior; increased appetite; deficits in speech/language; oral fixation; memory loss (semantic impairment rather than episodic)

Question 10

Frontotemporal Dementia Cause

Answer 10

Accumulation of tau proteins–neurofibrillary tangles like in AD, Picks bodies, glosis (scarring)

Question 11

Vascular Dementia

Answer 11

Caused by multiple strokes/TIAs; step-wise progression

Memory decline and deficits in two of the following: orientation, attention, language, visuospatial functions, executive functions, motor control

Question 12

Primary Progressive Aphasia

Answer 12

Can have early onst; begins with language deficits and over the course of years can move to global deterioration