Dementias Flashcards
What is Pick’s disease?
Frontotemporal dementia - a rare form of progressive dementia, typically in late middle age and often familial, involving localized atrophy of the brain
What are the characteristic features of normal pressure hydrocephalus?
Urinary incontinence Dementia Gait abnormalities
Which gender is more commonly affected by alzheimers?
Females
What is the most common dementia in the UK?
Alzheimers disease
What is the pathophysiology of Alzheimers disease?
Build up of amyloid plaques and neurofibrillary tangles on the brain
The accumulation of these leads reduction in transmission of information, and eventually to death of brain cells, with abnormal depositions remaining post-mortem
What are amyloid plaques?
Clumps of beta amyloid and degenerating bits of neurons and other cells which lurk in between nerve cells
What are neurofibrillary tangles?
Bundles of twisty filaments within neurons, mostly made from tau protein
What are the symptoms of Alzheimers disease?
Gradual progression of memory loss, with evidence of varying changes in planning, reasoning, speech and orientation
What is the second most common type of dementia?
Vascular dementia
What areas of the brain are most commonly affected by vascular dementia?
The white matter of both cerebral hemispheres, grey nuclei, thalamus and the striatum
What are the risk factors for vascular dementia?
Hypertension (main risk factor)
Smoking
Diabetes
Hyperlipidaemia
Obesity
Hypercholesterolaemia
What is the pathophysiology of vascular dementia?
Multiple (commonly small) cerebrovascular infarcts, small vessel disease and a single cerebrovascular accident
Which area of the brain is affected first in Alzheimer’s disease?
Nucleus basalis of Meynert
What is the nucleus basalis of Meynert?
The main source of the cholinergic projections to the rest of the brain
What is galantamine?
A cholinesterase inhibitor
What percentage of cases of early onset Alzheimers have a genetic implication?
5-10% due to autosomal dominant trait
What is the association with Down’s syndrome and dementia?
Alzheimers disease onset in 3rd or 4th decade of life
What genes are implicated in early onset Alzheimer’s?
APP mutations (chromosome 21)
Presenilin 1 (chromosome 14)
Presenilin 2 (chromosome 1)
What is the association between Apolipoprotein E and Alzheimer’s disease?
e4 allele predisposes to Alzheimers
Which gender is more commonly affected by Lewy Body dementia?
Males
At what age are people affected by Lewy Body dementia?
Over 50
What is the diagnosis if physical decline occurs faster than cognitive in Lewy body dementia?
Parkinson’s disease with superimposed dementia
What are the symptoms of Lewy Body dementia?
Visual hallucinations
Parkinson’s symptoms
Problems multitasking or complex cognitive tasks
Sleep disturbance
What is the life expectancy post-diagnosis of Lewy Body dementia?
7 years
