Non-Alzheimer's Disease Dementias: Dementia with Lewy Bodies, Frontotemporal and Vascular Dementia Flashcards
What you see with AD, VD, LB, and FTD
AD - attack mediotemporal lobe
VD - looks like ischemic event
LB - Will see eosinophilic inclusions
FTB - kinfe edge
Patho of AD, VD, LBD, FTB
AD - beta amyloid plaque formed
VD - stroke
LBD - alpha synuclein
FTD - could be tau related
Diagnosis of AD
AD - Dementia two or more areas of cognition Progressive worsening of memory and cog Age 40-90 Absence of other systemic
Diagnosis of VD
Dementia
Cerebrovascular dz present:
Focal neurologic signs OR CT/MRI evidence
Onset 3 months of stroke, or abrupt deterioration, or stepwise couse
DLB diagnosis
Dementia
Deficits in ocgnition usually attnetion/spatial
Parkinsonism
Hallucinations
Fluctuations
Depression or REM sleep dz may be present
FTD diagnosis
Prominant behavioral - loss of IP skills, emotional blunting, impersistence
OR
Language involved in comprehension/fluency
Cognition typically preserved
Associated with MND/ALS
Most/least Cognition Language Psychiatric Behavior Motor
AD/FTD FTD/DLB DLB/VaD FTD/VaD DLB/AD
VaD Cog Language Psych Behavior Motor Safety
Attnetion/exec Aphasia from stroke? Depression common Social withdrawl Maybe forcal motor or bradykinesia Depends on focailtiy of Sx
Diagnosing VaD
Cog testing
MRI flair
Hachinski ischemic scale
VaD vs. AD Mortality and memory
VaD better for memory worse for mortality
Choinergic hypothesis of VaD
White matter changes in cholinergic projection areas
DLB diagnosis
Dementia (typically deficit in spatial)
2/3 - parkinsonism, hallucinations, fluctuations
Could also have depression or REM
DLB Cog Language Psych Behavior Motor Safety
Attnetion/visuospatial Rearely impaired Depression almost always...hallucinations Social withdrawl Parkinsonism Driving is big here
Diagnosiing DLB
No hel from imaging
MALES major risk***
DLB vs. Alz cog decline
DLB is slower decline than AD
DLB pathology
Will still keep cells but decreased activity of ChAT
FTD Cog Lan Psych Behav Motor Safety
Executive function Can be primary feature OCD-like behavior Prminent loss of social skills, poor hygeine, apathy Rare Across the board secondary to judgement
Diagnosing FTD
Can use imaging to see focal atrophy patterns
Presents at a younger age
Orbitofrontal
Dorsolateral
Parasagittal
Disinhibition
Dysexecutive
Contributes to the apathy
Personality changes in AD vs. FTD
FTD more prominent
Common behaviors for FTD
Hyperorality and feeding behavior
FAB
Tell patients to tap after you do…then tell them not to…won’t be able to resist
Language vairants of FTD
As you move from anteiror to posterior
PPA - non-fluent
PPA - fluent
Semantic dementia
PPA and semantic dementia
Types of FTD
PPA - attacks the frontal lobe mostly
Semantic is more temporal lobe
Main early symptoms of each
Alz - cognition
VD - Motor/cog/language
LB - Psychiatric/motor/cog
FTD - behabior/language
