Dementia and Alzheimers Disease Flashcards
What is Dementia?
significant loss of intellectual abilities that INTERFERE with social/occupational function/daily life
What intellectual abilities are lost due to dementia?
- attention
- orientation (person/time/place)
- memory (NOT ALWAYS)
- judgement
- language
- motor
-spatial skills
-function
What is the #1 cause for dementia?
Alzheimer’s disease
What is the second common cause of dementia?
vascular disease
What are 3 names of the standardized tests used to diagnose and stage dementia?
- Mini Mental State Examination (MMSE)
- MoCA
- Clinical Dementia Reading (CDR)
What is the MMSE?
used to screen for dementia
- scored out of 30
- if score is less than 24 = IMPAIRED
- asks questions about:
a. orientation
b. registration
c. attention and calculation
d. recall
e. language
f. visuospatial abilities
What is the MoCA?
designed to detect mild cognitive impairment
scored out of 30
less than 26 = IMPAIRED
What kind of questions are on the MoCA?
name pictures of animals
remember 5 words
repeat grammatically complex sentences
What is the CDR?
-semi structured interview of patient and informant (spouse, guardian, etc..)
- assesses 6 domains:
1. memory
2. orientation
3. judgment/problem solving
4. community affairs
5. home/hobbies
6. personal care
What is the scoring like for the CDR?
0 to 3
0 = none
0.5= very mild
1= mild
2= moderate
3 = severe
Is dementia more prevelant among men or women?
women
What do we see as key features in people’s brains when they are diagnosed with Alzheimer’s Disease?
- atrophy
- senile plaques
- neurofibrillary tangles
What are senile plaques for AD?
build up of beta-amyloid protein
- interfere with neuronal communication
What are neurofibrillary tangles?
threads of TAU protein that become tangled
What is atrophy in AD?
- decrease in size of brain or certain areas/structures in the brain
What 4 things must be present in order to diagnose AD?
- memory impairment (amnestic presentation)
- impairment in at least one other cognitive domain/ “nonamnestic presentation” (language, visiospatial, executive)
- insidious onset –> gradual onset NOT rapif
- clear-cut history of worsening condition
Can AD cause personality changes?
YES
What are the 4 risk factors of AD?
- age (#1 RISK FACTOR)
- heredity
- mild cognitive impairment
- health status (high BP, cholesterol, diabetes)
What is one protective factor of AD??
EDUCATION!!! —> increases your baseline
What 5 things are important to diagnosis of dementia?
- interfere with the ability to function in everyday life
- decline from previous levels
- not explained by other psych disorders
- detected by combo of history taking and objective cognitive assessment
- impairment in minimum TWO of following domains
- ability to acquire and remember new info
- reasoning and handling complex tasks
- visuospatial abilities
- language function
- personality
What 3 genetic mutations are possibly linked to early onset-AD?
- APP
- PSEN1
3.PSEN 2
How can we treat mild to moderate AD?
cholinesterase inhibitors (“Aricept”)
- prevent breakdown of acetylcholine (helps with memory!)
How do we treat moderate to severe AD?
drug called “Namenda” or “memantine”
- NMDA anatagonist
- regulates glutamate
Are the side effects of most AD meds intense?
YES! (diarrhea, vomiting, fatigue, muscle cramps)
“walls…the walls” - Profs friend’s quotes
