Neuroscience (Approach to Dementia)

Question 1

State the 2 forms of long-term memory. State any processes involved.

Answer 1

1. implicit memory
2. explicit memory - medial temporal lobe (encoding + retrieval)

Question 2

State the 6 cognitive domains

Answer 2

1. complex attention
2. executive function
3. learning and memory
4. language
5. perceptual-motor
6. social cognition

Question 3

State some important points of history taking that can help in diagnsois of dementia

Answer 3

1. cardiovascular risk factors –> vascular dementia (fast onset with stepwise progression)
2. family history of dementia –> genetic Alzhiemer’s disease
3. HIV or iatrogenic immunosuppression –> CNS infection
4. chronic alcohol use

Question 4

State the 10 red flags for potentially reversible causes of dementia

Answer 4

1. < 2 years since symptom onset
2. rapidly progressive
3. young onset (< 65 year old)
4. features of autoimmune encephalitis (psychosis, prominent mood/anxiety symptoms, sleep disturbances)
5. constitutional symptoms - LOW, LOA, fever
6. focal neurological deficit - hemiparesis
7. prominent fluctuations in sympotms
8. high risk exposure - drugs and alcohol
9. high-risk behaviour
10. history of immunocompomisation

Question 5

Dementia is the group of symptoms affecting ____, ____ and ____ ____ severely though to inferfere with daily life

Answer 5

Dementia is the group of symptoms affecting MEMORY, THINKING and SOCIAL ABILITIES severely though to inferfere with daily life

Question 6

State the causes of dementia (4)

Which is the most common?

Answer 6

1. Alzheimer’s disease (most common)
2. Vascular dementia (reduced blood flow to brain)
3. Lewy body dementia (associated with abnormal protein deposits in brain)
4. Frontotemporal dementia (damage to frontal and temporal lobes)

Question 7

State the non-modifiable and modifiable risk factors of dementia

Answer 7

NON-MODIFIABLE = age
MODIFIABLE
- cardiovascular and metabolic risk factors
- cardiovascular comorbidities
- traumatic brain surgery
- sleep distubrances
- depression
- diet
- levels of physical activity and social activity
- lifelong cogntiive acitvity

Question 8

State the pathophysiology of Alzheimer’s disease

Answer 8

COGNITIVE DECLINE + NEURODEGENERATION

1. amyloid plaques (diffuse plaques less correlated with cognitive impairment)
2. neurofibrillary tangles

Question 9

State the investigations used for Alzheimer’s disease

Answer 9

• MRI of brain
• thyroid function tests
• serum folate and vitamin B12 test