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PSYC 351B > Dementias > Flashcards

Dementias Flashcards

1
Q

What is dementia?

A
  • non acute cognitive decline that interferes with everyday functioning
  • multidimensional disorder: multiple areas affected
  • progressive: constantly changing/getting worse
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2
Q

What cognitive problems occur in dementia?

A
  • memory
  • language (lose words)
  • visuospatial (disoriented in space)
  • executive (overwhelmed by novel things)
  • affective/personality (change in mood, aggression)
  • absence of delirium
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3
Q

What are the cortical dementias?

A
  • alzheimer’s disease
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4
Q

What are the subcortical dementias?

A
  • Parkinson’s disease

- Huntington’s disease

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5
Q

What is explored for a differential diagnosis?

A
  • aging
  • MCI
  • focal lesions
  • delirium
  • depression
  • visual and auditory deficits
  • psychosis
  • static encephalopathy
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6
Q

What are the neuropsychological syndromic patterns within dementia?

A
  • anterograde amnesic disorder
  • frontotemporal dementia
  • semantic dementia (receptive lang.)
  • primary progressive aphasia (expressive lang.)
  • posterior cerebral cortical atrophy
  • dementia with psychomotor slowing
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7
Q

What are the neuronal tau protein abnormalities?

A
  • neurofibrillary tangles (intracellular)
  • neuritic (senile) plaques (extracellular)
  • granulovacuolar bodies (intracellular)
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8
Q

Where do neuronal tau protein abnormalities occur?

A
  • in associative cortex and hippocampal area
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9
Q

What are the neurotransmitter disturbances?

A
  • acetylcholine
  • serotonin
  • catecholamines (DA and NE)
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10
Q

What are the details of the tau protein abnormalities?

A
  • all correlate with severity of disease

- all are seen in non-demented elders but less and not outside of the hippocampal regions

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11
Q

What areas are associated with impaired episodic memory?

A
  • bilateral medial temporal
  • hippocampus (CA1)
  • entorhinal cortex (subiculum)
  • amygdala
  • parahippocampal gyrus
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12
Q

What areas are associated with impaired semantic and implicit memory?

A
  • association cortex
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13
Q

What areas are associated with impaired organization, encoding, and source memory?

A
  • frontal lobes
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14
Q

What areas are associated with the intact procedural memory?

A
  • relatively intact basal ganglia
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15
Q

What is the most common dementia?

A
  • alzheimer’s disease (50-80%)
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16
Q

What are the risk factors for alzheimer’s?

A
  • family history
  • APOE genotype
  • very low education level
  • brain reserve
  • early head injury
  • cardiovascular disease
17
Q

What kind of morphological changes happen with alzheimer’s?

A
  • atrophy

- especially in memory and language areas

18
Q

What is implicated in memory and learning for alzheimer’s disease?

A
  • semantic memory
  • new learning
  • vulnerability to interference
  • spared recognition during early stages
  • tangle formation in cholinergic projection neurons
  • possible implicit learning
19
Q

What is implicated in language for alzheimer’s disease?

A
  • word finding difficulties
  • lexical access and semantic processing problems
  • language may progressively deteriorate
  • writing is compromised early but reading is spared
20
Q

What is implicated in visuospatial function for alzheimer’s disease?

A
  • agnosia (later)
  • impaired performance on Judgment of Line Orientation test
  • impaired visuoconstructional ability
21
Q

What is implicated in executive functions for alzheimer’s disease?

A
  • high sensitivity
  • judgement, abstract reasoning, problem solving, and complex decision making processes
  • working memory
  • divided attention, shifting and other attentional control problems
  • multitasking is impaired
22
Q

What are some general features of an alzheimer’s neuropsychological profile?

A
  • disorientation
  • apraxia
  • motor and psychomotor dysfunction
  • anosognosia
  • behavioural and affective changes (apathy, agitation, anxiety, irritability, depression, disinhibition)
23
Q

What groups are affected by dementia with lewy bodies?

A
  • over 50 year old
  • slightly more males
  • people with ApoE4 allele subgroup
  • more common than previously thought
24
Q

How are the symptoms of dementia with lewy bodies?

A
  • multiple cognitive deficits, often fluctuating
  • extrapyramidal designs (Parkinsonism)
  • hallucinations/delusions
25
Q

What are lewy bodies?

A
  • intracytoplasmic inclusions

- made of synuclein protein

26
Q

How does dementia with lewy bodies compare to alzheimer’s?

A
  • DLB: more rapid decline

- slightly better memory performance but worse executive functions

27
Q

What is the overall profile of dementia with lewy bodies?

A
  • lack of initiative and apathy
  • visuospatial and visuoconstructional impairments
  • psychomotor and motor slowing
  • delusional thinking
  • outrageous hallucinations
28
Q

What are the symptoms of frontotemporal dementia?

A
  • executive functions severely affected
  • personality changes
  • loss of insight, disinhibition
  • may have motor problems or apraxia
29
Q

What is the etiology of frontotemporal dementia?

A
  • generally unknown

- genetic component in many: tau pathology, mutated tau gene (chromosome 17), TBI

30
Q

What groups are affected by frontotemporal dementia?

A
  • younger age of onset (40-65)

- 20% of all progressive dementias cases

31
Q

What is the frontaltemporal dementia neurophysiology?

A
  • mirovascular defects (ischemic)
  • astrocytic gliosis
  • often with “Pick’s bodies”: enlarged, balloon-shaped cells, intracytoplasmic, fill entire cell, tau based
32
Q

What is anterograde amnesic disorder?

A
  • difficulty in accessing information from the present (ex. who visited yesterday)
33
Q

What is semantic dementia?

A
  • degradation of areas that process language

PSYC 351B (14 decks)

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