Dementia Flashcards
Symptoms of Dementia
Difficulty with everyday tasks
Confusion in familiar environments
Memory Loss
Changes in mood and behaviour
Prevalence of Dementia
850,000 people in the UK
2% at 65-69
20% at 85-89
What % of dementia is caused by Alzheimer’s disease?
60%
What % of dementia is caused by vascular dementia?
20%
What % of dementia is caused by dementia with lewy bodies?
15%
What causes 5% of dementia?
Frontal temporal dementia
What is Alzheimer’s?
Most common form of progressive dementia
What causes dementia?
Specific neuronal loss due to beta amyloid plaque and tow tangles which leads to cell loss and brain shrinkage
What is the average life expectancy after Alzheimer’s diagnosis?
7-10 years
What are risk factors for Alzheimer’s disease?
Advanced age
Cerebral perfusion
Head trauma
Genetics
Slightly more prevalent in females
What does the hippocampus do?
Essential for memory storage
What is the role of the basal forebrain?
Memory and learning
What is lost in the hippocampus and forebrain in Alzheimer’s disease?
Cholinergic neurons
Why does β amyloid cause issues in Alzheimer’s disease?
β amyloid is more sticky and so aggregation occurs and plaque builds up
What do plaques and tangles in the brain lead to?
Neurodegeneration and cognitive symptoms
What does apolipoprotein E4 mutation increase cause?
Aggregation of β amyloid
What is the Mini-mental state examination?
Test out of 30
21-24 for mild dementia
10-20 for moderate dementia
What is SPECT?
A scan that is used to diagnose Lewy Body dementia
What are the current drug targets for dementia?
Neuroprotection
Improve cognition
What can be used to manage dementia symptoms?
Pharmacological Intervention - reduce symptoms
Management of non-cognitive function - psychosis and anxiety
Interventions to maintain quality of life
How do AChE inhibitors work in treating dementia symptoms?
Prevents breakdown of ACh and increases ACh levels in the CNS and increases cholinergic transmission
What are the limits to AChE inhibitors in dementia?
Drugs only enhance the neurons that are still present and hopefully improve memory and cognition
Only 2-6 month improvement
Side effects include fatigue and bradycardia
When is Memantine used in dementia?
For those with moderate dementia who are intolerant or have contraindications to AChE inhibitors
How does Memantine work?
Inhibits glutamate transmission so decreases harmful effects of glutamate in the brain to improve cognitive impairment
Can cause constipation and hypertension
