Dementia: neurobiology and clinical aspects

Question 1

What is dementia?

Answer 1

A syndrome, not a disease
Cognitive impairment
Progressive
Multi Domain

Question 2

What is meant by cognitive impairment?

Answer 2

Deficits within:

Memory
Language
Visuospatial sketchpad
Social
Executive

Question 3

What is meant by executive?

Answer 3

Working memory
Structural tasks
Set shifting
Attention

Question 4

Is dementia important?

Answer 4

Disabling, upsetting condition

Very common

Question 5

What causes dementia like symptoms?

Answer 5

Brain dysfunction - thyroid, depression, sodium, poor sleep, drugs, pain
Brain damage - vascular disease, alcohol, HIV, multiple sclerosis, B12, tumour
Neurodegeneration - alzheimer’s, lewy body disease

Question 6

What causes dementia?

Answer 6

Many causes

Many other conditions can give signs which may be thought to be dementia

Question 7

What is the most common cause of dementia?

Answer 7

Alzheimer’s disease

Question 8

What is alzheimer’s disease?

Answer 8

Misfolding
Increased accumulation of amyloid beta proteins - aggregation
Intracellular protein aggregation
Episodic memory disturbance

Question 9

How does alzheimer’s affect memory?

Answer 9

Affects the consolidation component of memory formation

Question 10

Describe wernicke’s syndrome

Answer 10

Delirium
Ataxia
Eye movements

Question 11

Describe Korsakoff’s psychosis

Answer 11

Amnesia

Confabulation - affects consolidation

Question 12

Which vitamin is involved in wernicke-korsakoff’s psychosis

Answer 12

Thiamine

Question 13

What is the long term effect of wernickes and korsakoffs

Answer 13

Attention
Speed
Ataxia
but also seizures, head injuries, malnutrition. liver disease, other drugs

Question 14

Describe memory loss in terms of headinjury

Answer 14

Anterograde amnesia
Retrograde amnesia
Affects consolidation process

Question 15

What other things does alzheimer’s affect?

Answer 15

Memory
Visuospatial 
Language
Depression
Disorientation
Hallucination 
Aggression 
Paranoia
Apathy
Weight loss
Aggression
Immobility

Question 16

Is there any treatment for Alzheimer’s disease?

Answer 16

dementia is inexorably progressive, incurable and eventually fatal’
Treatment for aggravating factors, symptom disability, complications

Question 17

Is there any treatment for dementia?

Answer 17

Depends on the cause
Sometimes the cause can be treated for example in cerebrovascular accident or thyroid etc. Can not treat the cause of alzheimer’s

Question 18

Which drugs should be avoided in dementia?

Answer 18

antimuscarinics, antipsychotics, sedatives.