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PMCOL 412 > Dementia I > Flashcards

Dementia I Flashcards

1
Q

2 major categories of memory

A

declarative (explicit) and non-declarative (implicit)

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2
Q

Declarative memory is

A

recall of facts or event

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3
Q

Non-declarative memory is

A

stands for non-verbal motor learning such as

playing a musical instrument or riding a bicycle

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4
Q

Declarative memory areas

A

Medial temporal lobe and associated structures

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5
Q

non-declarative memory areas

A

Striatum, Amygdala, Neocortex and Cerebellum

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6
Q

Learning vs. memory

A

Learning involves acquisition of new facts and knowledge, whereas memory refers to the storage and retrieval of learned information

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7
Q

2 memory types (temporally differentiated)

A

STM and LTM

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8
Q

Short term memory

A

STM/working memory

ability to hold information for seconds to minutes

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9
Q

Long-term memory

A

retention of information in a more permanent form

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10
Q

Memory impairment diagnosis is based on…

A

studies of medical history, neuropsychological testing, neurological/psychiatry examinations and brain imaging

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11
Q

Dementia Definition

A
  • A clinical syndrome characterized by acquired losses of cognitive and emotional abilities severe enough to interfere with daily functioning
  • Strictly a clinical diagnosis
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12
Q

Dementia has a fixed level of decline TRUE OR FALSE

A

FALSE
Rate of cognitive decline varies with
individuals and specific disease

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13
Q

Dementia is caused by dysfunctions in these areas

A

dysfunction of the cerebral hemisphere, especially cortex, hippocampus and their subcortical nuclei such as caudate nuclei and thalamus

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14
Q

Dementia may be associated with the following domains of consciousness

A

Dementia may be associated with ANY major domains of cognition
INCLUDES declarative memory, executive function, visuospatial function or language

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15
Q

Co-morbid symptoms in dementia

A

Psychiatric symptoms are common in dementia: apathy and loss of initiative are always present.
Depression, anxiety and hallucinations are also frequent

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16
Q

Advanced dementia shows issues in

A

basic daily living activities (bathing, dressing, feeding)

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17
Q

Is dementia fatal?

A

No, it decreases life expectancy BUT death in dementia is mainly due to sepsis, pneumonia, pulmonary embolism or heart disease

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18
Q

When do dementia patients die (at what stage)

A

usually die at mild-to-moderate stages

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19
Q

Primary Dementia has 2 categories

A

non-degenerative diseases and neurodegenerative diseases

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20
Q

Primary dementia

A

dementia caused by neurodegenerative and non-neurodegenerative diseases
when dementia is the main cause (not secondary to another pathology)
makes up 98% of dementias

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21
Q

Neurodegenerative diseases

A

AD, Frontotemporal dementia (FTLD), Lewy Body

dementia (LBD), Huntington disease, Prion disease

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22
Q

Non-neurodegenerative diseases

A

Vascular dementia, Normal Pressure Hydrocephalus etc.

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23
Q

___% of dementias are secondary and triggered by ____ and ____ (can/can’t) be resolved if treated

A

About <2% of dementia may be triggered by infections, metabolic disorders and drug intoxication which if treated early can be resolved completely

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24
Q

Most common causes of dementia

A

Alzheimer’s (AD–55%), vascular dementia (VaD–20.6%), frontotemporal dementia (FTLD–8.4%), Dementia with Lewy Bodies (LBD-4.5%)

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25
Q

Most dementia patients exhibit…

A

similar symptoms/pathologies including behavioural/psychological symptoms including delusions, depression, anxiety etc.

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26
Q

Evidence suggests that some people with
pathology similar to AD don’t develop
cognitive deficits–believed to be due to

A

which is believed to be due to higher cognitive reserve related to brain anatomical modification or
adaptability to overcome cognitive deficit

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27
Q

Most dementia occurs after age ___ and are _____, those before are caused by ____

A

Most cases of dementia are sporadic and occur after 65yrs of age,
whereas only a small percentage of cases which
appear before 65yrs are caused by genetic abnormalities

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28
Q

Hereditary AD is due to mutations of (3)

A

amyloid precursor protein (APP), presenilin 1 (PS1) and PS2

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29
Q

Hereditary VaD is due to mutations of (2)

A

Neurogenic locus notch homolog protein 3 (NOTCH-3)

and APP

30
Q

Heritable FTLD is due to mutations (3)

A

mutations of microtubule-associated protein tau (MAPT), granulin (GRN) and chromosome 9 open reading frame 72 (C90RF72)

31
Q

Dementia affects ___% of people over 65

A

5-7%

32
Q

Dementia prevalence ____ with age

A

Increases (after 65)

33
Q

Dementia affects ___% if people between the ages of 85-89 years

A

20-25%

34
Q

Incidence of dementia (new cases per year)

A

1 per 100 per year at 70 years, increases

to ~2-3 new cases per 100 per year by 80 years

35
Q

Cost of dementia in 2018

A

$1 trillion USD and increasing

36
Q

Dementia rates are ____

A

Increasing; especially in low-middle income countries

declining in some wealthy countries (US, UK, sweden, Netherlands)

37
Q

Sex difference in dementia

A

More women than men have dementia

38
Q

Racial and ethnic differences in dementia

A

None

39
Q

Risk factors for dementia–unmodifiable

A

include age and inheritance of Apolipoprotein E4 (APOE4) allele

40
Q

Risk factors for dementia–modifiable

A

depending on stages of life include less education, hypertension, obesity, hearing loss, physical inactivity, diabetes, smoking, social isolation and depression, elevated cholesterol and poor diet

41
Q

Around ___% of dementia can be attributed to modifiable risk factors

A

30%
determined by calculating population-attributable risks for 7 established risk factors (i.e., diabetes,
hypertension, obesity, physical inactivity,
depression, smoking and low educational)

42
Q

recently added risk factors

A

excessive alcohol, traumatic brain injury (TBI), air pollution

43
Q

Diagnosing dementia–based on

A

cognitive history and the mental status examination (Mini Mental State Examination, Montreal Cognitive Assessment)

44
Q

There is not laboratory test for diagnosing dementia (true or false)

A

TRUE
At present there is no laboratory test for dementia diagnosis.
Laboratory test may help in determining the cause of dementia

45
Q

Techniques to help identify dementia types

A

Structural imaging (compound tomography, CT or magnetic resonance imaging, MRI) is recommended to identify potentially treatable cause dementia such as tumor

46
Q

10 warning signs of dementias

A
  • memory loss
  • difficulty performing daily tasks
  • problems with language
  • disorientation to time and places
  • poor or decreased judgement
  • problems keeping track of things
  • misplacing things
  • changes in mood and behaviour
  • trouble with images and spatial relationships
  • withdrawal from work or social activities
47
Q

MRI in dementia–uses

A

for diagnosis of different subtypes of dementia.

MRI usually shows atrophy of the temporal lobes, frontal cortex and hippocampi regardless of the dementia subtype

48
Q

PET in dementia

A
  • PET shows a region-specific reduction in fluorodeoxyglucose (FDG) uptake depending on the type of dementia
  • Additionally, amyloid or tau PET scan can identify amyloid and tau aggregates which occur in AD and some other type of dementia
49
Q

Dementia treatments–failed clinical trials

A

Clinical trials of non-steroidal anti-inflammatory drugs, hypoglycemic drug (rosiglitazone), estrogen replacement therapy, statins, vitamins and ginkgo biloba have all been negative.

50
Q

indapamide as a dementia therapy

A

There is some evidence that antihypertensive

indapamide may have some beneficial effects on dementia

51
Q

T/F: there is currently disease-modifying treatments for dementia

A

FALSE

No disease-modifying treatment for dementia is currently available

52
Q

Current drugs for dementia

A

Only symptomatic with modest effects on cognitive function.

These treatments which include acetylcholinesterase inhibitors, memantine, ADs and cholesterol lowering drugs

53
Q

acetylcholinesterase inhibitors for dementia

A

counteract the low levels of acetylcholine that contribute to memory impairment or prevent the cognitive deficit by blocking glutamatergic NMDA receptor functioning.

54
Q

Current therapies for AD

A 
ONLY TREATS SYMPTOMS
Acetylcholinesterase inhibitors (galantamine, donepezil and rivastigmine)
and memantine (NMDA receptor antagonist)
55
Q

Current therapies for VaD

A

ONLY TREATS SYMPTOMS

Acetylcholinesterase inhibitors, memantine and cholesterol-lowering drugs

56
Q

Current therapies for LBD

A

ONLY Treats SYMPTOMS

Acetylcholinesterase inhibitors, memantine and antidepressants

57
Q

Non-drug dementia prevention–WHY

A

Since genetics account for only part of the risk for dementia, influencing modifiable risk factors may able to reduce the development of dementia.
Indeed, some of the following non-pharmacological strategies have been shown to lower the risk of developing dementia in older population.

58
Q

Non-drug dementia prevention strategies

A 
Physical exercise
Mental stimulation 
Diet/supplements 
Social Engagement 
Stress reduction
59
Q

Physical exercise in dementia

A

Animal and human studies indicate regular physical exercise can improve memory.
Aerobic conditioning increases Brain-derived neurotrophic factor (BDNF) which lowers the risk of AD-related dementia.

60
Q

Mental stimulation in dementia

A

Reading, learning, doing puzzles and board games have been suggested to lower the risk of developing dementia.
While physical activity increases production
of hippocampal neurons, mental stimulation increases the neuronal survival rate, functioning and plasticity of neuronal circuits.

61
Q

Social engagement in dementia

A

High social engagements have been suggested to increase cognitive ability and decreased the risk of dementia

62
Q

Stress reduction in dementia

A

Meditation, tai chi chih, yoga or other relaxation can improve memory abilities.
Adequate sleep also reduces stress, whereas poor sleep is associated with cognitive deficits and greater Aβ burden in the brain

63
Q

Nutrition in dementia

A

Brain healthy diets emphasize anti-inflammatory omega-3 fats from fish and antioxidant fruits and vegetables.
Mediterranean diets are recommended for healthy aging.
Some gastrointestinal bacteria that increase fat metabolism may also help in cognitive ability

64
Q

MCI (mild cognitive impairment) definition

A

represents the transition between the normal cognition and dementia

65
Q

Abnormalities in MCI interface with daily function: True or False

A

FALSE
Patients with MCI have abnormalities in
a specific aspect of cognition but does
not interfere with daily functioning

66
Q

Most common MCI

A

The amnesic form of MCI, in which declarative episodic memory is impaired

67
Q

Potential alterations in the neuropathology with MCI

A

The neuropathology of MCI is mixed, but amyloid plaques and tangles may be detected

68
Q

Common symptoms in MCI

A

Most MCI patients exhibit psychiatric symptoms such as depression, anxiety, apathy and irritability

69
Q

Progression of MCI

A

Most individuals with MCI though progressed to dementia, smaller groups of individuals remain either stable or reverted back to normal

70
Q

What can alter MCI progression

A

Evidence indicates that diabetes, metabolic syndrome, lower serum folate level increase the risk of progression
from MCI to dementia
A Mediterranean diet decreases the risk of conversion from amnestic MCI to AD compared with other diets

PMCOL 412 (35 decks)

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