Dementia - Alzheimer's

Question 1

Define dementia

Answer 1

Neurodegenerative disorder where there’s a decrease in cognition (memory, judgement, language) over time

Question 2

What are risk factors of Alzheimer’s?

Answer 2

• Increasing age
• family history of Alzheimer’s disease
• Mutations in the amyloid precursor protein
• Apoprotein E allele E4 - encodes a cholesterol transport protein
• Caucasian ethnicity
• Down’s syndrome

Question 3

Describe the pathophysiology of Alzheimer’s

Answer 3

Beta amyloid plaques (breakdown product of amyloid precursor protein APP) and neurofibrillary tangles accumulate causing neuronal death

Question 4

When does Alzheimer’s usually present?

Answer 4

Usually develops after the age of 60

Question 5

What are the symptoms of Alzheimer’s?

Answer 5

4A’s:
* Amnesia (recent memories lost first)
* Aphasia (word-finding problems, speech muddled and disjointed)
* Agnosia (can’t recognise things)
* Apraxia (inability to carry out skilled tasks despite normal motor function)

Question 6

What investigations do you do for Alzheimer’s?

Answer 6

MRI

Question 7

What is seen on MRI for Alzheimer’s?

Answer 7

diffuse cortical and subcortical atrophy due to neuronal death

Question 8

How do you treat Alzheimer’s?

Answer 8

Acetylcholinesterase inhibitor (donepezil, Memantine)