Dementias

Question 1

State some forms of Dementia

Answer 1

• Alzheimer’s Disease
• Mixed (Vascular and Alzheimer’s)
• Vascular Dementia
• Lewy Body Dementia

Question 2

Outline the pathophysiology of Alzheimer’s disease

Answer 2

1. Abnormal processing of APP to produce beta-amyloid. This may disrupt neurotransmission between neurones, or lead to Amyloid Angiopathy
2. Abnormal neurofibillary tangles from Phosphorylated tau protein
3. Both beta-amyloid plaques and neurofibillary tangles lead to an inflammatory response and neuronal death

Question 3

What does the pathology of Alzheimer’s disease look like?

Answer 3

• Wider sulci and narrower gyri

- Larger ventricles of the brain

Question 4

Why might Alzheimer’s Disease be associated with Down’s syndrome?

Answer 4

Amyloid Precursor Protein (APP) gene is located on Chromosome 21, which Down’s syndrome patients have an extra copy of

Question 5

Outline the drug treatments for Alzheimer’s disease with examples

Answer 5

Acetylcholinesterase Inhibitors, i.e. Donepezil, Galantamine, Rivistagmine

NMDA Receptor Antagonists i.e. Memantine

Question 6

Outline the pathophysiology of Lewy Body Dementia

Answer 6

Lewy bodies are formed by misfolded alpha-synuclein

Question 7

On histopathology, what might Lewy Body dementia look like?

Answer 7

Dark eosinophillic inclusions

Question 8

Outline the pathophysiology of Vascular dementia

Answer 8

Caused by ischaemic / haemorrhagic infarcts

Question 9

What are risk factors of Vascular Dementia?

Answer 9

• Hypertension
• Hypercholesterolaemia
• Diabetes
• Smoking
• Ischaemic heart disease