Neurological Disorders - Alzheimer's Disease

Question 1

What is dementia and where is it present?

Answer 1

Altered neural fx and loss of ordered neural fx
Loss of cognition
And it is present in several unrelated disorders

Question 2

What is Alzheimer’s disease always associated with?

Answer 2

Dementia

Question 3

What is Alzheimer’s disease?

Answer 3

Progressive and irreversible degenerative disorder

Question 4

When does Alzheimer’s disease manifest?

Answer 4

65 and increases prevalence as age increases

Question 5

What is the etiology of Alzheimer’s disease?

Answer 5

90% is idiopathic (known as the sporadic form and occurs after age 65 - apoE gene is implicated)
10% is familial

Question 6

In 10% of cases of Alzheimer’s which has a familial etiology, what chromosomes and genes are involved and when does it set in?

Answer 6

Before 65
Chromosome 1 12 14 21
APP, PS1, PS2 genes

Question 7

People with which syndrome are at an increased risk of Alzheimer’s disease and why?

Answer 7

Down syndrome because a mutation on the same chromosome (21) is involved in AD too

Question 8

What does the APP gene code for and what happens if it is mutated in AD?

Answer 8

codes for precursor of amyloid protein, accumulation of amyloid proteins occur if gene is mutated

Question 9

Which chromosome is the ps1 gene on?

Answer 9

14

Question 10

Which chromosome is the ps2 gene on?

Answer 10

1

Question 11

What is the patho of AD?

Answer 11

The cerebral cortex atrophy - prominent sulci (dips) and slender gyri (neural tissue)

Question 12

What causes the lesions in AD? Do they lesions impact anything?

Answer 12

Accumulation of proteins

They impact neural fx

Question 13

What parts of the brain are affected in AD?

Answer 13

Amygdala and hippocampus

Question 14

What form the neuritic plaques in AD? Are they permanent? Where are they located?

Answer 14

Accumulation of amyloid protein
Permanent
At terminal end of neurons

Question 15

What causes neurofibrillary tangles in AD? Are they permanent?

Answer 15

Accumulation of fibrous protein in cytoplasm of cells

They are resistant to breakdown and persist after necrosis

Question 16

What neurotransmitter is decreased in AD?

Answer 16

Acetylcholine

Question 17

What are the manifestations of mild AD (2-4 yr)

Answer 17

Memory problems, careless work habits, familiar routine is manageable

Question 18

What are the manifestations of moderate AD (2-10 years)

Answer 18

Decline in cognition 
Profound confusion 
Language problems (interpreting/reception)
Motor disturbances 
Indifference 
Problems with ADLs 
Repetitive speech 
Paraphasias (using words in wrong context)

Question 19

What are the manifestations of severe AD (approx 2 year)

Answer 19

Severe mental impairment 
Minimal volume movement 
No self care
Bladder and bowel in continent 
Rigid flexor posturing

Question 20

What is the primary feature of AD?

Answer 20

Dementia

Question 21

How is AD diagnosed?

Answer 21

No definitive test
Clinical presentation
Determine other diagnosis with and exclude dementia from other causes
EEG, CT, MRI, labs (to exclude other dementia)

Question 22

Is dementia a disease?

Answer 22

No. It is a manifestation of a disease.