Dementia Flashcards
what is dementia?
an acquired and persistent generalised disturbance of higher mental functions
what the 4 most common types of dementia?
alzheimers
levy body
fronto-temporal
vascular
what is the first part of the brain that is affected in Alzheimer’s?
nucleus basalis Meynert
how does vascular dementia usually present as?
cumulative effects of many strokes
sudden onset of stepwise deterioration
what is well preserved in vascular dementia and what will this eventually cause?
insight and judgement
depression
how does lewy body dementia present as?
fluctuating cognitive impairment
visual hallucinations
parkinsonism
REM sleep behavioural sleep disturbance
how does frontal-temporal dementia present as?
characteristic changes to personality
social deterioration leading to impairment of intellect, memory and language
what is the main cause of death in those who have dementia?
broncho-pneumonia
what genetic cause Alzheimer’s?
amyloid precursor protein - APP
presenilin 1+2
apoliporotein E allele E4
what does apoloporoprotein E allele E4 code for?
cholestrol transport protein
in what condition is APP also increased?
downs syndrome
what is the gross pathology of alzhiemers?
accumulation of beta-amyloid peptide
degenerative product of APP = neural damage
neurofibrillary tangles
increased amyloid plaques
loss of AcH - caused by accumulation of Tau protein
how is dementia diagnosed?
mental state examination
CT/MRI - vascular demential
cognitive testing
what is seen on macroscopic pathology?
cortical atrophy
widening of sulk
narrowing of gyri
dilatation of ventricles q
what is spared in alzheimers?
occipital lobe
what seen on microscopic pathology?
entensive neural loss with associated astrocyte proliferation
what are lewy bodies?
alpha synuclein proteins
how is dementia treated?
supportive
acytelocholinerase inhibitors
what is an example of a acytelocholinerase inhibitor?
donepezil
when is donepezil not used?
fronto-temporal dementia
what is used in moderate/severe dementia?
memantine
what is the MOA of memantine?
NMDA antagonist
what is the most common complication of dementia?
depression
