Final

Question 1

What is the number one risk factor for AD

Answer 1

Number one risk factor is age

Question 2

Risk factors for AD

Answer 2

• Gender - men are two times more likely because of occupation and exposure to toxins
• toxin exposure
• having a primary relative diagnosed with AD
• rural living - drinking well water

Question 3

What is the prevalence of AD?

Answer 3

• Most common cause of dementia
• 50 million affected world-wide
• 6th leading cause of death
• in US, 5.7 million people affected

Question 4

DSM-5 criteria for AD

Answer 4

• insidious onset with progressive course
• mild neurocognitive disorder due to AD
  
  • probable - causative genetic mutation from family history/genetic testing
  • possible - if no genetic mutations
    AND
• decline in learning/memory
• steadily progressive
• no evidence of mixed etiology
• Major neurocognitive disorder due to AD
  
  • probable (possible if these criteria are not met)
    
    • causative genetic mutation from family history or genetic testing
      OR all 3 of:
  • evidence of decline in learning/memory and 1 more additional domain
  • no evidence of mixed etiology

Question 5

What is one symptom of language expression and language comprehension in AD

Answer 5

Expression
- anomia
- less content, more irrelevant and tangential speech, formulaic language
Comprehension
- working memory deficits impact auditory comprehension at discourse level
- often able to understand simple two to three step directions

Question 6

What is the most common irreversible type of dementia?

Answer 6

Alzheimer’s dementia
- 50 - 70% of cases

Question 7

What is the earliest appearing hallmark in AD?

Answer 7

Beta amyloid plaques and neurofibrillary tangles

Question 8

Which neurotransmitters are affected in AD?

Answer 8

Acetylcholine and glutamate

Question 9

What are some risk factors and protective factors of AD?

Answer 9

Risk factors
- Male
- Hearing
- Age of mother at time of birth
- Level of education
- Diagnosis of MCI
- Insufficient sleep
Protective factors
- higher level of educations
- socially and cognitively active lifestyle
-regular physical exercise

Question 10

Predictors of disease progression for AD

Answer 10

Average of 8 years, but some suffer for 12 years or more
- rapid decline of AD is linked to early age of onset, presence of extrapyramidal signs, presence of delusions or hallucinations

Question 11

Early stages of AD: Effects of AD on cognition and communication

Answer 11

• disoriented to time
• no difficulties with ADLs, but they do have difficulties with IADLs
• episodic memory deficits
• longer hesitations and slower rate of speech in spontaneous speech

Question 12

Middle stages of AD: Effects of AD on cognitive and communication

Answer 12

• scoring 16 or below on the MMSE
• disoriented to time and place
• motor function is good, but restlessness is common
• worsening episodic memory, decrease in memory span
• difficulty focusing attention
• fluent and halted in speech, more silent pauses
• basic ADLs are okay, instrumental ADLs need assistance
• driving becomes an issue

Question 13

Late stages of AD: Effects of AD on cognitive and communication

Answer 13

• Disoriented to person, time and place
• MMSE scores 0-9
• incontinence of bladder and later on bowel
• speech slower with more halting
• some may be mute
• reading comprehension severely impaired

Question 14

What is a clinical presentation that appears in MCI that does not appear in typical aging?

Answer 14

episodic memory deficits

Question 15

Diagnosis of dementia

Answer 15

• must meet criteria for dementia
• must have gradual onset
• clear history of worsening cognition
• presentation of amnestic or nonamnestic cognitive deficits

Question 16

What are the 3 subtypes of MCI

Answer 16

• Amnestic - episodic memory impairment
• Single-domain (non memory domain) - deficits in language ability, EFs or visuospatial functions
• Multiple domain - may occur with or without memory impairments

Question 17

What is the 2 main differences between diagnosing a MCI vs a Major CI?

Answer 17

MCI - modest decline, does not affect IDLs
Major CI - severe decline, affects IDLs

Question 18

Prevalence of MCI

Answer 18

a. Estimated to be between 10-20% of individuals 65 and older
b. Estimated to be between 16-20% of individuals 70-89 years of age

Question 19

Is amnestic MCI more common than non-amnestic MCI?

Answer 19

No

Question 20

18. What are the differences between mild and major neurocognitive disorder?

Answer 20

a. Mild neurocognitive disorder
i. There’s a “modest” cognitive decline in one or more domains.
ii. But it does not interfere with independence in everyday activities (IADLs).
iii. It is not due to delirium.
iv. Not due to another mental disorder.
b. Major neurocognitive disorder
i. There’s a “significant” cognitive decline in one or more domains.
ii. It DOES interfere with everyday activities – they will need assistance with IADLs at least.
iii. It is not due to delirium.
iv. Not due to another mental disorder.
v. They will become more frustrated and more impacted by their disorder in the afternoon/evening.
vi. Diagnosis of dementia is used.

Question 21

19. What are the neuropsychological deficits associated with MCI?

Answer 21

a. Working and episodic memory deficits
b. Executive function deficits
c. Language deficits
i. Not much of a linguistic knowledge loss, but difficulty with performing.