Dementia Flashcards
what is the leading cause of dementia?
alzheimer’s disease
what is the main risk factor for AD?
age
the prevalence of AD increase after the age of ?
60 years
mutations in what genes cause AD?
APP or PSEN or apolipoprotein E4 allele variants
ApoE2 ————- risk
decreases
ApoE4———— risk
increases
patients with which genetic condition have an increased risk of developing AD?
Down syndrome
injuries to which part of the body can increase risk of developing AD?
head
what is the histological presentation of dementia?
excess accumulation of extracellular B-amyloid plaques and intracellular neurofibrillary tangles (aggregates of Tau protein)
there is widespread —————– atrophy
cortical
there is —————- of gyri and —————– of sulci
narrowin and widening
what are the areas of the brain which can be first affect in AD? (3)
nucleus basalis of meynert
entrohinal cortex and hippocampus
there is ——— and ———– onset of worsening memory in AD
insidious and progresssive
early symptoms of AD reflect impairment of which type of memory?
episodic memory
AD is not associated with?
behavioural or personality changes
with AD there are often early subtle impairments of? (4)
planning, decision making, working out complex sequences and learning new tasks
as the AD progresses there are difficulties with?
languae, bheavioural problems (such as aggression), depression and disorientation becomes more pronounced
what tools are used for diagnosis?
MMSE, MRI and SPECT scan
what are the CSF biomarkers in AD?
increase in phosphorylated tau protein and decrease in B-amyloid
what do you use to treat patients with AD (mild to moderate)
acetylcholinesterase inhibitors (donepezil,galantamine or rivastigimine)
what is used for patients who are intolerant of or have a contraindication to EChE inhibitors or have severe AD?
memantine
what type of drug is menantine?
voltage dependent non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist
what are thee complications of AD?
haemorrhagic stroke due to B-amyloid deposits in cerebral blood vessels that can weaken them
haemorrhagic stroke due to B-amyloid deposits in cerebral blood vessels that can weaken them
cerebral amyloid angiopathy
what is frontotemporal dementia?
group of neurodegenerative disorders characterised by relatively focal frontal and temporal cerebral atrophy
what are teh three broad syndromic variants of frontotemporal dementia?
behavioural variant
semantic dementia
progressive non-fluent aphasia
what is the most common type of fTD?
behaviouraal variant
what are the symptoms of FTD?
loss of inhibition , apathy, repetitive behaviours and diffulty planning
what is characteristic of FTd behvaaioural variant/
memory is preserved in early disease and behavioural symptoms are more pronounced
what are the two forms of primary progressive aphasia?
semantic dementia
and progressive non-fluent aphasia
what is semanitc dementia?
impaired word comprehension and object naming
loss of recognition of familiar faces or objects
impaired word comprehension and object naming
loss of recognition of familiar faces or objects
semantic dementia
what is progressive non-fluent aphasia?
slow/hesitant speech, word finding deficits and agrammatism. may be associated orofacial apraxia
slow/hesitant speech, word finding deficits and agrammatism. may be associated orofacial apraxia
progressive non-fluent aphasia
how can orofacial apraxia be tested?
coughing or swallowing
what investigation can be used to diagnose FTD?
MRI and lumbar puncture
what is the second most common form of dementia?
vascular dementia
what caauses vascular dementia?
vascular changes secondary to cerebrovascular disease
what are the symptoms of vascular dementia?
executive and attentional impairments, behavioural changes (disinhibition), cognitive slowing, focal neurological problems and difficulty walking/falls
what is the most appropriate imaging modality used to diagnose vascular dementia?
MRI
what does MRI show in vaascular dementia?
the presence and location of infarcts and commonly shows white matter changes and patchy reduced attenuation in the cortex
what is creugzfeldt-Jakob disease?
it is a transmissible prion neurodegenrative disease
what does the prion cause in CJD?
cell death (spongiform changes in the cortex) and astrocytosis
what doees CJD present with?
rapidly progressing dementia, ataxia and myoclonic jerks
what is the best initial test for CJD/
EEG
what is the charateristic feature of EEG in CJD/
pseudoperiodic sharp wave activity
what does CSF analysis show in CJD?
elevated 14-3-3 protein
