Dementia/MCI Flashcards
Approximately ___% of people over age 65 have symptoms consistent with AD.
10%, the rates double every 4-5 years
Percentage of people double every ____ years.
4-5 years
Average age of diagnosis is ____.
75
By age 85, about ___% of individuals have AD.
50%
African Americans are ____ as likely to develop AD compared to whites.
twice; moderated by increased prevalence of related medical conditions, access to/utilization of health care, and quality of education
Latin/x are ____ as likely to develop AD compared to whites
1.5x; moderated by increased prevalence of related medical conditions, access to/utilization of health care, and quality of education
About ___% of sporadic AD and ___% have familial AD.
95%; 5% (between ages 40-60)
APOE e4 on chromosome 19 is involved in what?
breaking down the amyloid precursor protein (APP); less effective than other alleles, which is why individuals with the APOE e4 allele may be at higher risk for AD given higher risk for beta-amyloid plaques.
Normal breakdown of the APP involves __- and __-secretase.
alpha and gamma
Abnormal breakdown of APP can involve what?
beta
PSEN-1 and PSEN-2 are associated with which secretase enzyme?
gamma; abnormal breaking down of the APP (different location) causing clumping, even sticker than when broken down with beta secretase
Trisomy 21 is associated with increased risk of AD, why?
the extra chromosome 21 is associated with greater expression of APP, which may explain why there may be higher accumulation of beta amyloid.
Clinical diagnosis of AD is ___% accurate
85-90%
Clinical diagnosis of AD includes (neuroimaging, etc.):
MRI, biomarker/blood chemistry studies, neurodiagnostic workup, neurologic exam, and neuropsychological evaluation (with good clinical history)
PET amyloid scans have been shown to be effective as well, but can yield false positive, as this can be found in normal brains.
The progression of AD:
- length of illness (in years)
range 2-20 years; average 7-10 years
What are the 4 domains of MCI?
amnestic, single domain
amnestic, multiple domains
non-amnestic, single domain
non-amnestic, multiple domains
Symptoms of AD in stage 1 (1-3 years)
worsening of recent memory, learning problems, decline in initiation/apathy, social isolation, dysnomia, anosognosia
Symptoms of AD in stage 2 (2-10 years)
Amnesia, aphasia, visuospatial difficulties (commonly topographical disorientation), personality/emotional changes (guardedness/suspiciousness)
Neuroimaging may show significant ventricular dilation and enlarged sulci.
Symptoms of AD in stage 3 (8-12 years)
Severe dementia, global aphasia, and mutism; sleep disturbance and behavioral disturbance (hallucinations and nighttime wandering)
Leads to severe dementia and complete dependence
End stage of AD:
may be nonambulatory, noncommunicative, increased difficulty chewing and swallowing; increased vulnerability to pneumonia (most AD patients die from pneumonia).
The largest known risk factor of AD
age
___% of those with MCI go on to develop a dementia, most of them AD
10%
Pure VaD occurs in ___% of cases.
3% Most are mixed/comorbid
Mixed pathology was found in ___% of VaD cases
77%; majority are VaD + AD
The most common domains if cognitive impairment associated with VaD
executive dysfunction, slowed processing speed, and impaired attention
Approximately ___% of individuals with VCI go on to develop VaD.
12%
A patient presents with slowed gait, frequent falls, swallowing problems, and blurry vision. Differential diagnosis?
Parkinson’s disease; progressive nuclear palsy (FTD motor variant)
blurry vision can be a sign of vertical gaze palsy
A patient presents with problems coordinating movement to pour a glass of water in their right hand, but not left. Differential diagnosis?
Corticobasal syndrome
A patient has a raw score of 6 on the Boston Naming Test. Differential?
Semantic dementia (naming and visuospatial component) less: logopenic, Alzheimer
What is most associated with ALS?
FTD-MND
