Dementia & Alzheimer's

Question 1

What are the symptoms prior to developing dementia and Alzheimer’s?

Answer 1

-forgetting words
-change in behaviour
-processing speed
-low attention

Question 2

How are people diagnosed?

Answer 2

-Patient history taken by GP
-Mental ability tests and cognitive assessments
-Blood tests for other conditions
-Dementia brain scan

Question 3

What diseases can cause the development of dementia?

Answer 3

diabetes and cardiovascular disease

Question 4

What are the advantages of the mini mental state examination to diagnose dementia?

Answer 4

-relatively quick and easy to perform
-requires no additional equipment
-can provide a method of monitoring deterioration over time

Question 5

What are the disadvantages of the mini mental state examination to diagnose dementia?

Answer 5

-biased against people with poor education due to elements of language and mathematical testing
-bias against visually impaired
-limited examination of visuospatial cognitive ability
-poor sensitivity to detect mild/early dementia
-not particularly sensitive but is good (at a population level) at distinguishing where onset of dementia has occurred

Question 6

What score on the mini mental state examination shows mild dementia? and severe dementia?

Answer 6

-18-23
-0-17

Question 7

What are biomarkers?

Answer 7

biological markers that allow us to measure what is happening in the living body

Question 8

What are the different scan types for the biomarkers for the diagnosis of Alzheimer’s disease?

Answer 8

-Positron emission tomography
-Cerebrospinal fluid
-High sensitivity blood tests
-Genetic screening

Question 9

How is positron emission tomography used?

Answer 9

radioactive tracers to measure glucose, amyloid-beta and Tau accumulation

Question 10

What is amyloid-beta?

Answer 10

a protein created in the brain being constantly produced

Question 11

What occurs with the accumulation of amyloid-beta?

Answer 11

-sticky protein
-forms a clump
-gets in the way of other processes, meaning neurons can’t fire and send signals across the brain

Question 12

What occurs when Tau becomes phosphorylated?

Answer 12

-can’t remove phosphate group (switch it off)
-Tau won’t function
-gets in the way of normal cell function

Question 13

What alleles show AD?

Answer 13

APOE

Question 14

What are the pathological hallmarks for Alzheimer’s disease?

Answer 14

-Amyloid-b accumulation
-neurofibrillary triangles
-neurodegeneration
-synapse degeneration

Question 15

What are the non-modifiable protective factors of Alzheimer’s?

Answer 15

Genetics

Question 16

What are the modifiable protective factors of Alzheimer’s disease?

Answer 16

-education attainment
-Mediterranean diet
-intellectual/social activities
-PA
-Moderate alcohol intake (one glass of red wine a day)

Question 17

What are the non-modifiable risk factors of Alzheimer’s disease?

Answer 17

-Ageing
-genetics

Question 18

What are the modifiable risk factors of Alzheimer’s disease?

Answer 18

-hypertension
-diabetes mellitus
-obesity
-smoking
-hypercholesterolemia

Question 19

How does PA effect the onset of AD?

Answer 19

low PA is a major risk factor for AD
(Reference - Tan et al, 2017)

Question 20

What % does the risk of AD increase in an individual with a sedentary lifestyle?

Answer 20

30%, irrespective of age, sex, education level or ethnicity
(Reference- Yan et al, 2020)

Question 21

Why should exercise be introduced during early signs of AD?

Answer 21

intervene the development of AD and increase the hippocampus size

Question 22

What is a problem with using drugs?

Answer 22

They treat after the diagnosis of AD rather than the prevention

Question 23

What is the standard PA guidance?

Answer 23

> 150min per week

Question 24

What is exercise associated with (Livingston, 2020)?

Answer 24

-slight memory increase and executive function scores
-changes in hippocampus size

Question 25

What can exercise cause that is beneficial to AD patients?

Answer 25

-delay in symptom onset
-reductions in symptoms

Question 26

What are the behavioural problems for individuals with dementia? (Lin et al, 2020)

Answer 26

• learning and memory
  -mental function/illnesses
  -motor function

Question 27

What are the functional problems for individuals with dementia? (Lin et al, 2020)

Answer 27

-Neurotrophic factors
-growth factors

Question 28

What are the cellular problems for individuals with dementia? (Lin et al, 2020)

Answer 28

-Neurons
-Glial cells

Question 29

What does exercise reducing oxidative stress cause?

Answer 29

decrease in synapse loss and AD

Question 30

What does exercise improving amyloid-beta improve?

Answer 30

increase alpha-secretase activity
decrease beta-decrease
-if you exercise pre-AD
prevents AD

Question 31

Why can’t you use drugs to block amyloid-beta production?

Answer 31

useful in other areas of the body