NP: Chapter 19 Alzheimers disease

Question 1

diagnosis of alzhheimers is made when … or more cognitive domains are affected

Answer 1

2

Question 2

hoeveel jaar te leven na onset of the disease AD

Answer 2

7-8 jaar maar…

Question 3

prevalence AD

Answer 3

46 million

Question 4

double aging

Answer 4

1. the number of elderly people will increase over the next decade
2. the average life expectancy has increased and continues to do so

Question 5

4 risk factors for AD

Answer 5

1. age
2. woman
3. genetic predisposition, 5% van de cases are caused by familial type of the disease. + APOE E4 allele
4. vascular risk factors: hypertension, diabetes, smoking

Question 6

diagnosis bij dementia

Answer 6

1. severity of the symptoms is determined
2. type of dementia = ethiological diagnosis

Question 7

op basis waarvan wordt de etiological diagnosis gesteld

Answer 7

national institiute of aging and alzheimer association NIA-AA, met low/medium/high probability of underlying AD pathology

= probable AD

Question 8

definite diagnosis voor AD

Answer 8

kan alleen bij post-mortem AD

Question 9

probable AD 4 factors

Answer 9

1. evidence of ad genetic mutation
2. clear decline in memory + in one other cogn. domain
3. steadily progressive, gradual decline in cognition without extended plateaus
4. no evidence of mixed ethiology

Question 10

in what patients with MCI is risk of developing AD the highest

Answer 10

patients with amnestic type of MCI, impairment in episodic memory

Question 11

hoe meet je episodic memory in deze patienten

Answer 11

met delayed recall on memory learning task

Question 12

mild neurocognitive disorder dsm 5

Answer 12

evidence of modest cog. decline in one or more domains
do not interfere with independence in daily living
not due to delirium
not due to other mental disorder

Question 13

major neurocognitive disorder dsm 5

Answer 13

evidence of substantial cogn. decline in one or more domains
interference with independence in daily life
not due to delirium
not due to other mental disorder

Question 14

cognitive domains

Answer 14

learning and memory
attention
language
perception
praxis
executive functioning
social cognition

Question 15

senile plaques

Answer 15

accumulations of amyloid beta protein BETWEEN the cells

Question 16

neurofribrillary tangles

Answer 16

phosphorylated tau protein WITHIN the cells

Question 17

the presence of senile plaques and neurofibrillary tangles causes…

Answer 17

necrosis and atrophy

Question 18

dus welke is extraneuronal

Answer 18

the senile plaques

Question 19

dus welke is extraneuronal

Answer 19

the senile plaques

Question 20

amyloid cascade hypothesis

Answer 20

normally there is a balance between the amount of amyloid beta is produced from APP.
maar bij AD: abnormal cleavage of APP, daardoor imbalance between production and breakdown of amyloid beta protein -> aggregation and form plaques.
later: tau protein added.

Question 21

limitation van amyloid cascade

Answer 21

why do some ppl develop ad and others do not even though they have app

Question 22

the vascular hypothesis

Answer 22

cerebrovascular damage plays an important role in ad.

vascular risk factors -> reduction in blood circulation -> deficiency of oxygen -> hardening and decreased flexibility of blood vessels -> vessels become fragile and damage

Question 23

what is the main symptom of ad during the first stage

Answer 23

anterograde loss of episodic memory. later ook decreased sense of orientation en later ook soms language impairments

Question 24

wat zijn nog meer problemen

Answer 24

executive functions, attention, apraxia, deficits in visual perception

Question 25

wat kan je voor ad doen met neuroimaging

Answer 25

uitsluiten van andere diagnosen
of evidence voor ad: atrophy in medial temporal lobe (vooral ook hippocampus)

Question 26

wat voor drugs voor ad

Answer 26

niks wat het oplost

cholinesterase inhibitors: positive effect on cog. functioning and daily functioning in patients with mild to moderate ad

Question 27

waarom zouden cholinesterase inhibitors werken

Answer 27

cholinergic hypothesis: the loss of cholinergic neurons leidt tot presynaptic cholinergic deficiency (zorgen er voor dat acetylcholine is broken down less quickly)