Dementia 6

Question 1

ApoE gene, depending on the allele you have, can confer increased risk of Alzheimers (ApoE4) or decreased risk of Alzheimers (ApoE2)..What is the role of ApoE in your body?

Answer 1

Apolipoprotien E clears cholesteral and Amyoid Beta from brain.

Question 2

ApoE gene, depending on the allele you have, can confer increased risk of Alzheimers (ApoE4) or decreased risk of Alzheimers (ApoE2).

What % of people have the ApoE 4 gene?

Answer 2

25 %

Question 3

What are the 3 main categories for treatment of Alzheimers Disease?

Answer 3

1. Cholinesterase inhibitors (indicated in mild-mod illness MMSE 10-26)
2. Glutamatergic NMDA antagonist (Indicated in moderate to severe)
3. Ketone food

Question 4

What are the three main Cholinesterase inhibitors and

the one Glutamatergic NMDA antagonist medication for Alzheimers?

Answer 4

1. Cholinesterase inhibitors
   - Donepezil
   - Rivastigmine
   - Galantamine
2. Glutamatergic NMDA antagonist
   - Memantine

Question 5

Of the three cholinesterase inhibitors that treat Alzheimers - Donepezil, Galantamine and Rivastigmine…which one is also FDA approved to trx dementia related to Parkinson Disease?

Answer 5

Rivastigmine.

Question 6

Caprylidine is a NOVEL medication for Alzheimers. What is the mechanism of action?

Answer 6

Increases Ketones for neurons to use as energy source, bc in Alzheimers, neuronal ability to utilize glucose as energy source is impaired.

Question 7

What is the histological finding in Lewy Body dementia and Parkinson Disease and what is it made of?

Answer 7

Lewy Bodies = Alpha-Synuclein aggregates with ubiquitin and neurofilaments.

Question 8

What are the 3 core and 2 suggestive diagnostic features of Lewy Body Dementia?

Answer 8

Core symptoms:

1. fluctuating cognition
2. Detailed visual hallucinations
3. Parkinsonsims starts AFTER cognitive decline

Suggestive symptoms:

1. REM behavioral disorder
2. Severe Neuroleptic sensitivity

Question 9

What is the average time from diagnosis of Parkinson Disease to the onset of Major NCD?

Answer 9

10 years.

Question 10

In Lewy Body and Parkinsons treatment of psychosis is tricky bc it can worsen moment disorder…what are the three medication types used?

Answer 10

1. Cholinesterase inhibitors
2. Pimavanserin (Serotonin 2A Inverse Agonist) FDA approved for PD psychosis only.
3. Clozapine (Zyprexa and Seroquel no benefit)