dementia Flashcards
definition
an acquired, progressive impairment of cognition without clouding of consciousness that has been present for at least 6 months.
must have had symptoms for?
6 months
primary degenerative conditions?
alzheimers, lewey body and picks disease
picks disease - what do you find in brain?
picks bodies
what kind of demntia is picks?
frontotemperal
secondary causes of dementia ?
vascualr dementia depression HIV syphillis encephalitis alcohol and head trauma
polymorphisms in which gene are known to contribute to alzheiers
ApoE gene
apoE4 predispose
apoE2 assocaited with longevity in the disease
brain changes in alzheimers?
cortical atrophy with thinning of sulci and gyri
which lobe is spared in alzheimers
occipital
what happens to the ventricles in alzheimers?
enlargement
histologically, you get deposition of B amyloid plaques, what can stain these?
stain green with congo red stain
what kind of tangles do you get in AD?
neurofibrillary tangles of phosphorylated tau proteins
vascular dementia - who is it more common in ?
men with CVD risk
what is the pathology?
multiple small vessel infarcts in the brain
presentation of vascular dementia?
sudden onset with stepwise progression of symptoms.
symptoms get worse, plateau, get worse, plateau
what do you get first in vascular dementia? functional or memory?
functional first then memory
gait disturbance and urinary incontinence
what is very prominent in vD?
mood disturbance and mood disorders
what scan shows reduced attenuation throughout the brain in vascular dementia?
spect scan
what score can be used to differentiate a potential vascular dementia from alzheimers
Hackinski score
Lewey body dementia. where do you get degeneration?
substantia nigra and cortex
where do you get lewey body deposition?
substantia nigra and cortex
LBD characterised by ?
fluctuating cognition with lucid periods and recurrent visual hallucinations
what is the main issue in LBD?
executive function, issues seen with multi tasking and performing complex tasks
why would symptoms be worsened by taking anti psychotics?
anti psychotics block D2. LBD affects same area as parkinson
memory in LBD?
spared until later in disease
can get parkinsonsism with early and repeated falls
y
what sort of sleep disorders can you get with LBD?
REM
LBD lies on a spectrum with ?
parkinsons as it affects same area as brain
how do you differentiate PD and LBD?
o Lewy body: cognitive decline before or at the same time as onset of parkinsonism.
o Parkinson’s: onset of cognitive decline at least a year after the onset of parkinsonism.
how do you diagnose LBD?
SPECT scan shows low dopamine uptake n basal ganglia
age of onset of Picks?
usually younger (less than 70)
what are picks bodies?
intra cytoplasmic filamentous inclusions
what are picks cells ?
swollen neurones
how does picks present?
insight is lost quickly but memory is impaired
caused by prion disease, can cause rapid progression in dementia in under 50?
mad cow disease
