Neurodegenerative Flashcards
What is dementia?
A significant loss of intellectual abilities, such as memory capacity, severe enough to interfere with social or occupational functioning.
Dementia is an umbrella term for a set of symptoms that cause different diseases in the brain
What are the criteria for the diagnosis of dementia?
● Impairment of attention, orientation, memory, judgment, language, motor and spatial skills, and function.
● By definition, dementia is not due to major depression or schizophrenia
What are some important things to remember about dementia?
● It is progressive, meaning symptoms will continue to worsen as more brain cells lose connection with each other and eventually die.
● It is NOT a normal part of aging.
● There are several causes of dementia.
● Someone can have brain changes that resemble more than one type of dementia.
● Dementia-like symptoms can be observed without progressive brain changes.
- Half of people who have Alzheimer’s disease have some other form of dementia (mixed dementia)
- Alzheimer’s is the leading cause of dementia
What is Alzheimer’s Disease?
A neurodegenerative disease characterized by amyloid plaques and tau tangle build-up in the brain
What are some key features of Alzheimer’s Disease?
● It is difficult to predict symptoms, the order they will appear, or the rate of progression.
● Symptoms may be minimal in the beginning and progress slowly.
● Alzheimer’s is individualized
What are some areas affected by Alzheimer’s Disease?
● Cognition: Ability to think, understand, communicate, make decisions.
● Emotions and mood: Loss of interest in hobbies.
● Behavior: Acting out of character, hiding things, repeating words or actions.
● Physical abilities: Coordination and mobility.
What are the symptoms of early-stage Alzheimer’s Disease?
● Marked memory loss
● Disorientation to time and space
● Poor judgment
● Personality changes
When do the symptoms of early-stage Alzheimer’s Disease begin?
20 years before diagnosis.
What are the symptoms of middle-stage Alzheimer’s Disease?
● Increased memory problems
● Difficulties with speech
● Restlessness
● Irritability and loss of impulse control
*Occipital lobe, frontal regions, Broca’s and Wernicke’s area affected
How long does middle-stage Alzheimer’s Disease typically last?
2-10 years.
What are the symptoms of late-stage Alzheimer’s Disease?
● Incontinence of urine and feces.
● Loss of motor skills.
● Decreased appetite.
● Great difficulty with speech and language.
● May not recognize family or even oneself in a mirror.
● Loss of most (or all) self-care abilities.
● Decreased ability to fight off infection.
*Parietal region and almost everything in the brain is affected
How long does late-stage Alzheimer’s Disease typically last?
1-5 years.
What are senile plaques?
Buildup of beta-amyloid that may interfere with neuronal communication
What are neurofibrillary tangles?
Twisted threads of tau protein
What are the structural brain changes that characterize Alzheimer’s disease?
Amyloid build-up, tau build-up, neurodegeneration/atrophy.
What is the role of cerebrovascular disease in Alzheimer’s Disease?
Observed in over 70% of people with Alzheimer’s disease, often measured using white matter hyperintensities (WMHs). Similar to AD-specific pathology, cerebrovascular pathology is known to occur before declines in cognition.
*High blood pressure, smoking, diabetes increases white matter hyperintensities
What are some risk factors for Alzheimer’s Disease?
● Age
● Heredity
● Mild cognitive impairment: Objective memory impairment but no dementia
● Health status: High blood pressure, high cholesterol, poorly controlled diabetes
What is a protective factor against Alzheimer’s Disease?
Education
What is Vascular Dementia (VaD)?
A common type of dementia caused by reduced blood flow to the brain. It involves cognitive deficits that are severe enough to impact everyday function.
What are the causes of Vascular Dementia?
● Narrowing of the small blood vessels deep inside the brain (subcortical vascular dementia or small vessel disease).
● A stroke (post-stroke dementia or single-infarct dementia).
● Many “mini strokes” (transient ischemic attacks) that cause tiny but widespread damage to the brain (multi-infarct dementia).
**Dementia develops in 15-30% of people after they have a stroke
What are some risk factors for Vascular Dementia?
Age, history of stroke, atherosclerosis, high blood pressure, diabetes, smoking, high cholesterol.
What are some symptoms of Vascular Dementia?
● Confusion and agitation
● Problems with memory, attention, and concentration
● Unsteady gait
● Urinary frequency, urgency, or incontinence
● Night wandering
● Depression
● Decline in the ability to organize thoughts or actions
● Difficulty planning ahead and communicating
What are some vascular imaging changes observed in Vascular Dementia?
● Extensive (>25%) white matter lesions.
● Large cortical infarction.
● Microbleed.
● Multiple lacunar infarcts
What are the two types of stroke?
● Hemorrhagic stroke: Bleeding in the brain.
● Ischemic stroke: Blockage of blood flow to the brain.
What are some symptoms of a right hemisphere stroke?
● Left hemiparesis (weakness) or hemiplegia (paralysis).
● Anosognosia (inability to acknowledge physical reality of stroke).
● Apraxia (difficulty planning and executing complex motor sequences)
What are some symptoms of a left hemisphere stroke
● Right hemiparesis or hemiplegia.
● Aphasia (language difficulties)
○ Non-fluent (Broca’s aphasia).
○ Fluent (Wernicke’s aphasia).
○ Global aphasia.
What are the characteristics of Broca’s aphasia?
Impaired language production, especially syntax (grammar), with more or less intact language comprehension. Individuals with Broca’s aphasia are aware of their deficit and often suffer from depression.
What are the characteristics of Wernicke’s aphasia?
Intact language production, although output often does not make sense and includes neologisms (made-up words). Language comprehension is impaired, and individuals are often unaware of their deficit.
