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SK298 - Brain, the mind & mental health > Dementia > Flashcards

Dementia Flashcards

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1
Q

What is meant by the term dementia?

A

A set of symptoms associated with decline in brain functioning

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2
Q

What is the most common cause of dementia?

A

Alzheimer disease

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3
Q

What is meant by the term prevalence?

A

The total number of cases of a condition in the population

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4
Q

What is meant by the term incidence?

A

The number of newly diagnosed cases of a condition

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5
Q

In the UK, what is the estimated prevalence of dementia?

A

1.3% or 1 in 79 people

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6
Q

What is the prevalence of dementia in people over the age of 65?

A

7.1% or 1 in 14

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7
Q

What is the estimated global prevalence of dementia in people 60 and over?

A

Between 5% - 8%

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8
Q

How many people, globally, are predicted to have dementia by 2050?

A

131.5 million

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9
Q

How many people, globally, were thought to have dementia in 2015?

A

46.8 million

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10
Q

What year was Alzheimer’s disease first reported?

A

1906

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11
Q

What physical changes to the brain were noted when Alzheimer’s was first reported?

A
  • smaller than expected
  • cortex covered in localised deposits
  • abnormal bundles of fibres (fibrils)
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12
Q

What is meant by the term non-modifiable risk factors?

A

Those that cannot be altered or changed

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13
Q

What is the strongest risk factor for developing AD?

A

Age

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14
Q

To what extent does someone over the age of 65’s risk of developing AD increase?

A

Roughly doubles every five years

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15
Q

Roughly how many people over the age of 80 are affected by AD?

A

1 in 6

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16
Q

Is there a difference in prevalence of AD between genders?

A

Yes - higher in women than in men

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17
Q

What is an allele?

A

Any of several variants of the same theme formed through mutation

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18
Q

Approximately what percentage of cases of AD develop due to genetic mutations?

A

1-5% of cases

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19
Q

What are the names of the three proteins which, if mutated, can cause AD?

A
  • Amyloid precursor protein (APP)
  • Presenilin 1 (PS1)
  • Presenilin 2 (PS2)
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20
Q

What is beta amyloid peptide?

A

A peptide which is the main component of the amyloid plaques seen in the brains of people with AD

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21
Q

What does autosomal dominant mean?

A

That only one copy of the mutation needs to be inherited for the condition to occur

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22
Q

Dementia onset lower than what age is considered to be early-onset?

A

65

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23
Q

What is meant by the term sporadic AD?

A

The type of AD where the cause is not known

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24
Q

What is the name of the allele which is found in approximately 50% of people with AD?

A

APOE4

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25
Q

What does the protein produced by the APOE4 gene do?

A

It is involved in the transport of cholesterol and other lipids around the body

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26
Q

Of the three major alleles of the APOE gene, which is themost common in the general population?

A

APOE3

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27
Q

Of the three major alleles of the APOE gene, which seems to provide a ‘protective’ effect against AD?

A

APOE2

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28
Q

What are epigentic mechanisms?

A

Those which control the silencing and activation of genes

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29
Q

Acetylation involves the addition of acetyl groups to what?

A

Histones

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30
Q

In general, increased methylation does what?

A

Reduces gene transcription

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31
Q

In general increased acetylation does what?

A

Increases gene transcription

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32
Q

What effect would a decrease in DNA methylation have on gene transcription?

A

It would result in an increase in gene transcription - genes that would normally be silenced become more active

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33
Q

Broadly speaking, what are the three main modifiable risk factors for AD?

A
  • Metabolic and vascular factors
  • Diet and nutrition
  • Lifestyle
34
Q

What are two examples of metabolic and vascular factors which increase the risk of AD?

A
  • Diabetes
  • Hypertension (high blood pressure)
35
Q

What are the four non-modifiable risk factors for AD?

A
  • Age
  • Biological sex
  • Genetic factors
  • Race and ethnicity
36
Q

What dietary factors can increase the risk of developing AD?

A
  • High levels of saturated fats
  • Low folic acid
  • Low vitamins B6 and B12
37
Q

What is the connection of folic acid to the potential of developing AD?

A

It plays an important role in the catabolism of the amino acids methionine and homocysteine

38
Q

What social factors can increase the risk of developing AD?

A
  • Increased isolation
  • Low socioeconomic status
  • Low level of education
  • Non-engaging job
39
Q

Women and ethnic minorities are at a higher or lower risk of developing AD than men and Caucasian populations?

A

Higher

40
Q

How might hearing loss be a risk factor for developing AD?

A
  • It may result in atrophy of some brain areas
  • Struggling to hear could prevent other cognitive functions from taking place
  • Loss of hearing could result in social isolation and withdrawal from mentally stimulating activities
41
Q

Will all people with mild NCD (neurocognitive disorders) progress to major NCD?

A

No, the conversation rate is approximately 10% per year

42
Q

What does validity mean in reference to scientific tests?

A

Whether a test is well-designed and measures what it is intended to measure

43
Q

What does reliability mean with regards to scientific tests?

A

The extent to which an evalution is accurate and yields the same results when used by different clinicians or researchers

44
Q

Does a diagnosis of major NCD mean that an individual has AD?

A

No, it is made if the person has major NCD and there is additional evidence for AD

45
Q

At what point is it possible to definitively diagnose AD?

A

Post-mortem

46
Q

What are the physical characteristics of AD within the brain?

A
  • Brain atrophy
  • Accumulation of neurofibrillary tangles inside neurons
  • Deposition of amyloid plaques outside cells
47
Q

In general, AD is characterised by overall atrophy and thinning of the cortex in which areas of the brain?

A
  • Parietal
  • Frontal and temporal lobes
  • Corpus callosum
48
Q

What happens to the size of the ventricles in patients with AD?

A

They shrink

49
Q

What is the corpus callosum?

A

A large bundle of neurons that connects the two hemispheres of the brain, allowing them to communicate with each other

50
Q

Which two regions of the brain are involved in memory?

A
  • Hippocampus
  • Temporal lobe
51
Q

Which region of the brain is involved with speech and language?

A

Temporal lobe

52
Q

Which region of the brain is associated with reasoning and problem solving?

A

Frontal lobe

53
Q

AD causes disorientation and motor impairment due to affecting which regions of the brain?

A
  • Hippocampus
  • Parietal lobe
  • Frontal lobe
54
Q

Where in the brain is the hippocampus located, in relation to the cortex?

A

The hippocampus is a medial part of the temporal lobe, so it is located towards the centre of the brain relative to the cortex

55
Q

What is the role of CSF?

A
  • Cushioning and buoyancy of the brain
  • Physical protection of the brain
  • Regulation of brain pressure
  • Clearance of waste products from the brain
56
Q

In which mental health condition is reduced ventricle size also observed?

A

Schizophrenia

57
Q

Death of what in the brain is the cause of atrophy due to AD?

A

Neuronal cell bodies and fibres

58
Q

What actually are neurofibrillary tangles?

A

Defects in the microtubules within a neuron

59
Q

Which type of neurotransmitter pathway dies early on in AD?

A

Acetylcholine

60
Q

Dopaminergic neurons are lost at which stage of AD?

A

Later stages

61
Q

Neuronal loss in the cholinergic pathways would cause which symptoms seen in AD?

A
  • Memory loss, including spatial memory
  • Cognitive impairments
62
Q

What is thought to be a key contributor to why neurons die due to AD?

A

Amyloid plaques

63
Q

From what parent protein is the amyloid peptide cleaved?

A

Amyloid precurser protein

64
Q

In the non-amyloidogenic pathway, APP is cut by which enzymes?

A

Alpha-secretase near the membrane, gamma-secretase in the remaining portion

65
Q

Where does the enzyme beta-secretase cut APP?

A

Outside the neuronal membrane

66
Q

How many amino acids are in the form of beta-amyloid that is most increased in AD?

A

42

67
Q

What are the mechanisms of removal of amyloid beta from the brain?

A
  • Proteolytic breakdown
  • Phagocytosis
  • Removal into lymphatic system
  • Clearance across blood-brain barrier
68
Q

What causes atherosclerosis?

A

The build-up for fat, cholesterol and other substances

69
Q

What cardiovascular risk factors increase the risk of developing AD?

A
  • Hypercholestoremia
  • Hypertension
  • Smoking
  • Diabetes
70
Q

What is the name for the accumulation of amyloid beta in the walls of the blood vessels of the brain?

A

Cerebral amyloid angiopathy

71
Q

What damage to blood vessels does aggregated amyloid beta cause?

A
  • Damage to endothelial cells
  • Death of smooth muscle cells in the blood vessel walls
  • Loss of tight junction proteins between cells
  • Structural changes to the astrocytes that exist around blood vessels
72
Q

What are microtubules?

A

Structures that provide support to cells and also move molecules and cell components from one part of the cell to another

73
Q

How are microtubules formed?

A

By the assembly of a protein called tubulin into protofilaments that associate to form hollow tubes

74
Q

What is Tau?

A

A protein associated with microtubules that is the main component of the neurofibrillary tangles seen in the brains of people with AD

75
Q

What is phosphorylatio?

A

The process by which a phosphate group is added to an amino acid

76
Q

Which enzyme mediates addition of phosphate to amino acids?

A

Kinase

77
Q

Which enzyme mediates removal of phosphate from amino acids?

A

Phosphatase

78
Q

What qualities can phosphorylation of a protein change?

A

Its solubility, localisation within the cell, function and interaction with other proteins

79
Q

Under normal conditions, what does phosphorylation of tau in the microtubule-binding region contribute to?

A
  • Regulation of neuronal growth
  • Axonal transport
  • Stabilisation of microtubules
80
Q
A

SK298 - Brain, the mind & mental health (19 decks)

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