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Cognitive Reserve and Dementia > Dementia > Flashcards

Dementia Flashcards

1
Q

what is dementia

A
  • a set of symptoms that include memory loss and mood changes
  • there are many types not just AD
  • any cause of dementia will affect the brain
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2
Q

origins of dementia

A
  • degenerative
  • vascular
  • infective
  • toxic
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3
Q

AD

A
  • physical disease - named after the doctor who first described it (Alois)
  • proteins build up to form structures called ‘plaques and tangles’
  • this leads to nerve cell death
  • a progressive disease, over time, more parts of the brain are damaged
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4
Q

symptoms of AD

A

early
- confustion
- problem finding right word
- loss of interest
- blame others
middle
- frequently confused/disoriented
- mood swings
- help with daily care
late
- require great deal of help
- extreme memory loss
- weight loss or overeating
- loss of speech

  • vast individual differences -
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5
Q

onset of AD

A
  • a neuropsychological elements consisting of amnesia and 1 or more of
  • aphasia
  • apraxia
  • agnosia
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6
Q

diagnosing AD

A
  • history
  • cognitive tests
  • physical exam
  • brain scan
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7
Q

cause of AD?

A
  • no single factor causing AD
  • likely a combination of factors
  • age
  • genetics
    -environmental
    -lifestyle
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8
Q

amyloid cascade hypothesis

A
  • two hallmark pathologies identified in AD
  • b amyloid peptide
    neurofibillary tangles
  • an excess AB triggers disease
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9
Q

neurotransmission
chonlinergic hypothesis

A
  • AD treatment target ACh receptors
    ACh neurotransmitter release
  • GABA - attention
  • Glutamate - memory consolidation
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10
Q

risk factors of AD

A

age
- greatest risk for dementia
- risk due to other are realated factors
- high blood pressure
changes in nerve cells

genetics
- APOE gene - influence AD

environmental
- pollution - 11% of dementia cases
- health/medical history
- social activity and mental activity - reduce risk

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11
Q

MCI and stats

A
  • mild cognitive impairment
  • the presence of cognitive abnormality greater than expected in relation to age and education
  • according to Alzheimer’s society - between 5-20% of 65+ have MCI
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12
Q

MCI, Permanent?

A
  • it can be transitory with normal functional integrity resuming
  • some can have permanent MCI
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13
Q

types of MCI

A
  • amnesic mild cognitive impairment
  • amnesic multi-domain mild cognitive impairment
  • non-amnesic mild cognitive impairment
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14
Q

diagnostic criteria for MCI

A
  • decrease in short or long term memory
  • preserved daily living
  • difficult to diagnose

characterized with subtle changes in
- day to day memory
-perception
- language
- planning

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15
Q

methods used to diagnose MCI

A

memory clinic
- lab tests
- history
- medical exam
- MRI scan

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16
Q

Issues with diagnosing MCI

A

sensory impairment
vision
- poor sight - poor neuropsychological test performance

hearing
- old might miss hear questions

individuals differences not taken into account

17
Q

why is accurate diagnosis of MCI important

A
  • identify people at risk of dementia
  • ensure available treatment
  • plan ahead
  • understand characteristics
18
Q

MCI - early signs of dementia

A
  • for some, MCI is a prodromal stage of dementia - lifestyle choices can affect development of AD
  • but not everyone with MCI develop dementia
19
Q

risk factors/ influences of MCI

A
  • several bio-psycho-social factors that influence
  • age
  • biological - blood pressure
  • psychological - depression
  • social - life events
20
Q

MCI - linking brain and behaviour

A
  • the fornix - implicated in episodic memory
  • in MCI tissue volume was reduced in the fornix
  • shift in memory load
  • we could potentially use fornix volume as a biomarker of MCI
21
Q

the earlier the better - pre MCI

A
  • memory complaints may be associated with later development of MCI or AD
22
Q

Fjell 2014

A

“it will be difficult to understand AD without understanding why it affects older brains”
- we can not understand AD until we understand ageing better

23
Q

typical progression of AD symptoms

A
  • changes in behavior in cogntive takes 20 years to develop
  • not necessarily true, not all older adults have dementia
24
Q

AD biomarkers

A

show us a window into the brain changes
- CSF
show us AD pathology
invasive
- PET
pick up metabolism and glucose function
expensive - limited
-FDG-PET
indicator of synaptic activity
can not directly detect core pathological features
-MRI
see fine details of grey and white matter
a late event
can not detect core pathological features

25
Q

treatment of AD

A

in absence of cure, attempts are made to delay progression

  • lifestyle interventions
  • restoring plasticity
  • reducing pathology with drug treatments
26
Q

drug treatments for AD

A
  • donepezil
  • rivastigmine
  • galantamine
    treat symptoms of mild and moderate AD
  • lacanemab
    slower the decline in humans
27
Q

are interventions to minimize AD worthwhile

A

implementing can reduce the prevalence of dementia

28
Q

prevalence dementia - UK

A
  • going up
  • roughly doubles every 5 years
29
Q

dementia prevalence - china

A
  • as it becomes more ‘westernized’ dementia is increasing
  • going up in terms of obesity and smoking - a link to lifestyle factors
  • almost tripled between 1990 and 2010

Cognitive Reserve and Dementia (2 decks)

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