Dementia and Aging Flashcards
What is maximum life for a human?
120 years.
What is current life expectancy for a M and F?
77.4 (72.1) and 82.2 (78.2)
Who lives longer - white or hispanic females?
Hispanic females!
What are the four theories of aging?
- Cellular Theories
- DNA mutation theories
- Inherited factors
- Stress related theories
Cellular aging theory describes lifespan as genetically predetermined. How does it rationalize this conclusion?
Postulates that fibroblasts only have a certain # of mitotic cycles before they die. Shorter lifespan = faster divisions.
In the DNA mutation theory, what 2 things happen that result in breakdown?
- DNA ends protected by telomeres which break down over time, leading to destruction of code.
- Errors accumulate that have occurred in RNA transcription over time.
What system is most often implicated in the inheritance theory of aging?
Cardiovascular system.
The oxidative stress theory is caused by a increased number of free radical as oxygen is converted to water. What cell do these free radicals typically damage?
Mitochondrial cells, specifically their membrane leading to dysfunction.
Free radical accumulate over time
Name 2 diseases that are implicated in the oxidative stress theory of aging.
- PD
- breakdown of dopamine to free radicals - Familial ALS
- super oxide mutase deficient, many O2 radicals
Alzheimer’s is the ___ leading cause of death. For people > 65, it’s the ___ leading cause of death.
7th, 5th
What is the main problem with determining what normal aging of the brain looks like?
Generational changes in body side - older people were smaller
-also undiagnosed disease related to brain atrophy
What is ideal brain volume loss from 40-80?
1-2% per decade
Which loses brain volume faster, the cortex or hippocampus?
Hippocampus, around 5% per decade
With neurons and aging, is it a loss in the number of neurons or loss in function of neurons that is most impactful?
Neuronal function.
All of the following neurotransmitters decline except:
- Dopamine
- Serotonin
- GABA
- Norepinephrine
- Norepinephrine
Decline accelerated in basal ganglia.
What happens to axonal cell bodies and dendrites with age?
Cell body shrinks, fewer dendritic branches and spines.
Less collaterals, too.
T/F: Glial cells are active in myelinization and transport of nutients.
True.
What part of aging vasculature is important in dementia?
Small and microvessel disease.
Aging affects postural control across 4 systems. Name the system and give an example of the decline in function.
- Sensory
- peripheral and central integration - Motor
- muscle performance - Central processing
- reaction time - Dual task ability
What are some secondary mechanisms of aging that change be modified?
- Exercise
- Diet
- Stress
- Relationships
- Sleep
- Lifelong learning
In the nature vs nuture debate, what is cognitive reserve?
The idea that if you start with a higher intelligence, you have more to lose before you notice a change in daily function.
Where are 4 blue zones?
- Sardinia, Italy
- Nicoya, Costa Rica
- Okinawa, Japan
- Icaria, Greece
What are 6 common traits of blue zones?
- Family
- No smoking
- Plant-based diet
- Constant moderate physical activity
- Social engagement
- Legumes
What are indirect costs of dementia ($50b per year)?
Lost wages of family members who care for a relative.
___% of people with dementia have AD.
60
ADaffects all areas of the brain, but two in particular. Name them.
- basal forebrain
2. cortex
Name the 2 microscopic changes that are diagnostic of AD, despite a post-mortem autopsy being the only definitive measure.
- Neurofibullary tangles
- Tau protein within neurons - Amyloid plaques
- extracellular space
What neurotransmitter decreases in concentration in the basal forebrain with AD?
Acetylcholine
List an early and late stage sign of AD.
EARLY
-short term memory deficits
LATE
-apraxia
Name 3 risk factors for AD.
- Really old
- Female
- Previous TBI with unconsciouness
T/F: The ApoE gene is linked with AD.
True.
Do people with trisomy 21 have an increased risk for AD? Why?
Yes, because of the association with APP (amyloid precursor protein) dysfunction.
What is a common treatment for AD?
Acheytlcholinesterase (inhibits breakdown of acetylcholine.
-effects peak after weeks to months
What pathology accounts for 30-40% of all dimentias?
Vascular cerebral infarcts
- BP and lipid mgmt important
- damage to association fibers in corpus callosum
Binswanger’s Disease affects ___ due to disease of ___ from ____. It is associated with ___. ___ imaging shows shrunken giri and enlarged ventricles.
Subcortical white matter, microcirculation, amyloid plaques. CT/MRI
Name a few clinical characteristics of Lewy Body dementia.
- Large changes in awareness/alterness
- Visual hallucinations
- PD like motor symptoms (rigity, tremor, bradykin)
What other diseases do Lewy Bodies feature in?
AD, PD,
Lewy Body dementia is progressive. What is the average life expectancy after diagnosis?
8 years.
What are lewy Body Dimentia treatments aimed at?
Controlling:
- cognitive
- psychiatric
- motor symptoms (anti-psychotics can worsen)
Other than dementia, what are 3 common neurological complications of AIDS?
- Infection of CNS
- CNS lymphoma
- Toxic encephalopathy
At what stage is AD diagnosed?
SOmetimes 3, usually 4 when symptoms like forgetfulness take hold.
