Dementia Flashcards
Which type of dementia presents with behaviour and language changes?
Frontotemporal
Which type of dementia presents with hallucinations?
Lewy-body
Which type of dementia is associated with prev stroke?
Vascular
Outline the pathology in Alzheimer’s
Wide spread degeneration of cortical neurones
Presence of protein plaques (abnormally folded amyloid)
Neurofibrillary tangles
What are the risk factors associated with Alzheimer’s disease?
Mid-life diabetes
Vascular risk factors
Systemic or CNS inflammation
Which genes are implicated in Alzheimer’s?
Amyloid precursor protein
Beta-amyloid
Presenillin 1 and 2
Apolipoprotein
How does Alzheimer’s present?
Progressive memory decline
Visulo-spatial problems
Hallucinations and delusions come in at late stage
What does Alzheimer’s show on MRI?
Brain atrophy in temporal lobe and hippocampus
How is Alzheimer’s managed?
ACh inhibitors
NMDA inhibitors
Give examples of ACh inhibitors
Donepezil
Rivastigmine
Galantamine
Give examples of NMDA inhibitors?
Memantine
What is the approx. survival from onset of Alzheimer’s disease?
8 years
Outline the pathology present in vascular dementia
Ischaemic necrosis
Fibrous and hyaline degeneration in small arteries causing white matter ischaemia
What are the 3 main patterns in vascular dementia?
Stepwise
Sudden - after multiple silent strokes
Stepwise subcortical
What does CT show in vascular dementia?
Areas of infarction
How is vascular dementia managed?
Secondary prevention of further stroke
Outline the pathology present in Lewy-Body dementia
Depositions of Lewy-bodies - aggregations of proteins within nerve cells
How does Lewy-Body dementia present?
Symmetrical extra-pyramidal features
Persistent, detailed hallucinations
Dysphagia, dyspraxia
What does MRI show in Lewy-body dementia?
Generalised cerebral atrophy
How is Lewy-Body dementia treated?
Rivastigmine
Levodopa at start
Where are mutations found in familial frontotemporal dementia?
Microtubule associated protein tau
Progranulin
How does protein tau normally work?
Facilitates axonal transport through microtubular protein interactions
Outline the pathology present in familial frontotemporal dementia
Phosphorylated protein tau and ubiquitin protein inclusions affect functioning in frontal and temporal lobes
How does frontotemporal dementia present?
Language disturbance, personality or behaviour changes
What is the average survival from symptom onset in frontotemporal dementia?
6-11 years
Which condition is associated with an abnormal, transmissible prion protein isoform?
CJD dementia
