Dementia & Alzheimer's Flashcards

1
Q

dementia

A
  • a general term
  • decline in cognitive function so extensive it interferes with daily life
  • SYNDROME that accompanies a disease/condition, not a disease itself
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2
Q

Sx of dementia

A
  • memory loss
  • inability to learn/remember new info
  • difficulty organizing or planning
  • difficulty with communication
  • inability to reason
  • inappropriate behavior
  • personality changes
  • paranoia
  • agitation
  • hallucinations
  • difficulty with coordination and motor function
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3
Q

top two causes of dementia

A

1) Alzheimer’s disease
2) Lewy body dementia

other: vascular dementia

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4
Q

cause/symptoms of multi-infarct dementia

A
  • cause: series of small strokes

- Sx progress in stepwise manner (sudden changes in ability)

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5
Q

cause of Dementia with Lewy Bodies (DLB)

A
  • build up of Lewy Bodies (alpha-synuclein protein in cytoplasm of neuron)
  • areas of brain that control memory/motor
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6
Q

additional symptoms with DBL

A
  • visual hallucination
  • Parkinsonian sx
  • severity fluctuates on a daily basis
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7
Q

symptoms of frontotemporal dementia (FTD)

A
  • behavioral changes
  • problems with language
  • ages 40-65
  • progresses steadily and rapidly
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8
Q

risk factors for FTD

A
  • genetics

- mutations in Tau protein, GRN

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9
Q

“dementia” that could be reversed

A
  • infections
  • subdural hematoma
  • metabolic problems
  • poisoning
  • nutrition deficiency
  • brain tumor
  • drug reaction
  • anoxia

once treated, return to normal

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10
Q

Alzheimer’s is the #__ leading cause of death in the US

A

Alzheimer’s is the #6 leading cause of death in the US

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11
Q

histologic characteristics of Alzheimer’s

A
  • beta amyloid accumulations

- neurofibrillary tangles

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12
Q

formation of beta amyloid

A
  • APP: amyloid precursor protein (transmembrane)
  • BACE and gamma secretase cleave APP
  • beta amyloid is released, accumulates in brain
  • forms AB oligomers, plaques
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13
Q

cleavage of APP (good/bad)

A
  • alpha secretase cleaves APP within the beta region so does not form beta amyloid; good cleave, nontoxic
  • BACE forms beta amyloid; bad cleave, toxic
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14
Q

genetic causes of Alzheimer’s

A
  • trisomy 21 (<1%)
  • late onset familial (AD)
  • early onset familial (AD)
  • unknown
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15
Q

Alzheimer’s risk factors

A
  • age
  • family Hx
  • gender (more common in females)
  • life exposure factors (head trauma, stroke, systemic vascular disorders, high cholesterol)
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16
Q

early onset familial Alzheimer’s disease

A
  • mutation in APP
  • mutation in secretase
  • high penetrance
  • low prevalence
17
Q

late onset familial Alzheimer’s disease

A

APOE-e4

  • low penetrance
  • high prevalence
18
Q

dementia treatments

A
  • cholinesterase inhibitors
  • NMDA receptor antagonists

treat symptoms, not underlying disease

19
Q

cholinesterase inhibitors in the Tx of dementia

A
  • prevents breakdown of ACh

- ACh plays an important role in thinking and memory skills

20
Q

NMDA receptor antagonists in the Tx of dementia

A
  • regulate activity of glutamate

- Glu helps brain process/store memories

21
Q

Beta secretase inhibitors in the tx of dementia

A
  • inhibit BACE from cleaving APP and producing beta amyloid
  • concerns: inhibiting BACE may cause abnormality in other pathways
  • studies show lack of efficacy
22
Q

gamma secretase inhibitors in tx of dementia

A
  • inhibit gamma secretase from cleaving APP and producing beta amyloid
  • concerns: gamma secretase has other substrates
  • studies show dangerous side fx (skin cancer, infections) and lack of efficacy
23
Q

methods tried/failed to cure dementia

A
  • tau anti aggregate agents
  • passive immunotherapy
  • gamma secretase inhibitors
  • beta secretase inhibitors
24
Q

diagnostic method for AD

A
  • medical history
  • cognitive fxn test
  • brain scan
25
Q

memory loss is associated with _______

A

memory loss is associated with brain atrophy

26
Q

biomarkers for AD diagnosis

A

CSF AB42 (decreased)
CSF total tau (elevated)
CSF phosphorylated tau (elevated)