Lecture 14

Question 1

What are the Symptoms of Dementia?

Answer 1

1. Loss of Intellectual Ability
2. Memory Impairments
3. Other higher cortical disturbances
4. Not Delirium
5. Specific or Presumed Organic factor

Question 2

How are IQ norms established?

Answer 2

By age group

Question 3

How is memory impaired with Dementia?

Answer 3

Recent events impaired more than historical events

Question 4

What other disturbances of higher cortical functioning would someone with Dementia experience? Besides memory impairments

Answer 4

1. Impaired Abstract thinking
2. Impaired judgement
3. Aphasia, Apraxia, Agnosia, Construction Difficulty

Question 5

What is difficulty finding words called?

Answer 5

Aphasia

Question 6

What is the inability to recognize things called?

Answer 6

Agnosia

Question 7

What is disordered motor planning called?

Answer 7

Apraxia

Question 8

What is the inability to reproduce things, for example copy a drawing called?

Answer 8

Construction Difficulty

Question 9

How is Dementia measured?

What is a normal score?

Answer 9

Using the Mini Mental Status examination

Above 25

Question 10

What is the most common form of Dementia? What % of dementia does it account for?

Answer 10

Alzheimer’s

64%

Question 11

What are the two types of Alzheimer’s? Which is most common?

Answer 11

Early Onset

Late Onset

Question 12

What explanation did Prof. Pihl give for the higher number of women with Alzheimer’s?

Answer 12

Alzheimer’s is related to level of cognitive functioning and the current population of women being diagnosed were not as educated as men

Question 13

What are the 4 categories of the MMSE?

Answer 13

1. Orientation (time and place)
2. Registration (identify objects, Attention/calculation)
3. Recall
4. Language (follow command, write sentence etc…)

Question 14

Approximately how long does it take for Alzheimer’s to progress from very mild to very severe?

Answer 14

8-10 years

Question 15

What is the Diagnostic criteria for Alzheimer’s?

Answer 15

More or less the same as for Dementia

Question 16

How heritable is Alzheimer’s?

Answer 16

Much more heritable for early (autosomal) than late onset

Question 17

What is another name for early onset Alzheimer’s? What % of cases?

Answer 17

Autosomal Alzheimer’s

5% of cases

Question 18

What does Alzheimer’s do to the brain?

Answer 18

Plaques and Tangles develop in the entorhinal cortex, then the hippocampus and finally the neocortex

Question 19

What causes tangles?

Answer 19

Excess Phosphorous

Question 20

What causes plaques?

Answer 20

build up of beta amyloid

Question 21

What happens when there is an abnormality in the Tau protein?

Answer 21

tangles

Question 22

What is the most important gene that has been identified in early onset Alzheimer’s?

Answer 22

Amyloid precursur gene

Question 23

What are tangles?

Answer 23

twisted tubules in the neuron that provide nutrition

Question 24

What is the Debate about Alzheimer’s?

Answer 24

Is it different from the norm? or is it a part of normal aging? (normal curve that shifts over as age increases)

Question 25

What is present in 50% of people with late onset Alzheimer's vs. 10% in normal population?

Answer 25

APOE 4 allele: involved in the transportation of phosphorous and lipids to the brain

Question 26

Why do some people point to the IGF pathway to explain Alzheimer's?

Answer 26

IGF pathway is an insulin pathway lack of insulin in the brain has been shown in labs to affect the buildup of plaques and tangles

Question 27

What other gene has been looked at recently to explain Alzheimer's? (related to calcium) What is your risk if you have no copies of this gene? one copy? two copies?

Answer 27

CALHM1 gene Controls calcium concentrations in nerve cells Also leads to more amyloid plaques no copies: 1 in 20 one copy: 1 in 14 two copies 1 in 10

Question 28

What is the criteria for Mild Neurocognitive Disorder? What is the problem with this?

Answer 28

1. Evidence of modest cognitive decline: that is producing concern in the individual or their loved ones 2. Modest Impairment: Does not interfere with the person's life (remain independent) 3. Not delirium 4. not another mental disorder Problem: This describes everyone

Question 29

Is there a Gold Standard for Alzheimer's? What study shows this?

Answer 29

No Brains of nuns and priests donated their brains which were examined after their death for signs of Alzheimer's. they all were normal yet had a significant amount of plaques and tangles

Question 30

What 3 conclusions does Prof Pihl come to about Alzheimer's?

Answer 30

1. Cognitive Decline and Alzheimer's result from the same physiological mechanisms and are characterized by the same physical signs (plaques and tangles) 2. As life expectancy increases Alzheimer's may become the norm 3. Alzheimer's is simply a normal consequence of living long

Question 31

Until when does Myelination of the prefrontal and associated areas continue?

Answer 31

continues into late 50's

Question 32

What % of ALZ patients are cared for at home? | What is the risk for depression if caring for someone with mild dementia? moderate dementia?

Answer 32

50% cared for at home caregiver risk for depression mild dementia: 16% moderate dementia: 40%

Question 33

How did they predict which nuns would develop Alzheimer's?

Answer 33

Their original letter of intent written when they were young Complexity of sentences more concrete thoughts = more likely more abstract thoughts = less likely

Question 34

What personality trait predicts Alzheimer's?

Answer 34

Conscientiousness: Low = more likely to develop alzheimer's High = less likely

Question 35

What is someone who has excess fluid around the brain called?

Answer 35

Hydrocephalic