Dementia Flashcards
Dementia
progressive impairment in one of:
- learning and memory
- language
- social cognition
- problem solving
Mild cognitive impairment
Stage between cognitive decline of normal ageing and dementia
Struggle with memory, reasoning, attention etc
What is normal pressure hydrocephalus
Reversible cause of dementia, caused by reduced CSF absorption at arachnoid villi - following head injury, subarachnoid or meningitis
Sx normal pressure hydrocephalus
Urinary incontinence
Dementia
Gait abnormality - similar to Parkinson’s
Tx normal pressure hydrocephalus
Ventriculoperitoneal shunting
MRI AD
Hippocampal atrophy with sparing of motor and sensory cortex - bilateral and symmetrical
MRI FTD
Bilateral frontal and temporal atrophy
Left>right
MRI LBD
Medial temporal lobe atrophy
Sporadic vs genetic AD
- Sporadic is complex, mediated by APOE e4 homozygosity
- Genetic is autosomal dominant, mediated by PSEN 1 and 2 = increased AB42 production
Sub-types FTD
- Behavioural variant: behavioural and executive dysfunction → frontal and temporal lobe affected
- Non-fluent primary progressive aphasia - people cannot find words to speak
- Semantic variant primary progressive aphasia - knowledge and naming difficulties
Prion dementia
- Caused by propagation of misfolded prion proteins in CNS
- Protein-resistant amyloid containing prion protein (or scrapie prion protein) (PrPSc)
- PrPSc has high degree of B pleated sheet structure - this occurs spontaneously
- Cruedtzfelt-Jakob disease
- Normal prion proteins are in everyone - when unfolded it forms Prion SC form, which causes disease. This causes a chain reaction where all prion proteins are consequently misfolded. The resulting ‘sticky’ protein attaches to neurons and causes them to die
Vascular dementia
Infarcts and haemorrhages + progressive demyelination, axon injury, astrocytosis etc
Cause of Creutzfeldt-Jakob disease
Progressive neurological condition caused by prion proteins - cause amyloid folds in B-pleated sheets
Sx Creutzfeldt-Jakob disease
Dementia
Myoclonus
Cognitive deficits