Old age cognitive disorders

Question 1

Which memory is maintained in old age?

Answer 1

Semantic memory (world knowledge)

Question 2

What memory is lost with old age?

Answer 2

Episodic long term memory, working memory and processing speed

Question 3

What happens to brain usage as we age?

Answer 3

Hemispheric asymmetry reduction in older adults

Compensation - i.e. additional recruitment of neural activity to maintain performance

De-differentiation - loss of regional specificity

Question 4

Alzheimer’s pathology

Answer 4

Amyloid plaques, tau tangles

Question 5

Alzheimer’s site

Answer 5

MTL, parietal lobes to frontal lobes

Question 6

FTD pathology

Answer 6

Several, tau, FUS, TDP-43

Question 7

FTD site

Answer 7

Frontal (behavioural), temporal (semantic aphasia)

Question 8

Vascular dementia pathology

Answer 8

Vascular

Question 9

Dementia with LB pathology

Answer 9

Lewy bodies

Question 10

Dementia with LB features

Answer 10

Motor symptoms and sleep disturbances

Question 11

What is Delirium?

Answer 11

Delirium is an abrupt change in the brain that causes mental confusion, changed consciousness and emotional disruption

Question 12

Dementia diagnosis requires

Answer 12

Multiple cognitive deficits (including amnesia) 
Functional impairment 
Clear consciousness
Change from previous level 
Long duration (> 6 months)

Question 13

Which of the following best discriminates between dementia and delirium?

Answer 13

Fluctuation over time

Question 14

What neuropsychological disorder is associated with Ribot’s Law?

Answer 14

Retrograde amnesia

Question 15

AD primarily what type of memory deficit?

Answer 15

Episodic

Question 16

FDT primarily what type of memory deficit?

Answer 16

Semantic

Question 17

AD prevalence?

Answer 17

60-80%

Question 18

FTD prevalence?

Answer 18

5-20%

Question 19

VD prevalence?

Answer 19

5-15%

Question 20

DWLB prevalence?

Answer 20

2-8%

Question 21

Delirium contributing factors

Answer 21

Older age (> 65yo)
Male sex
Cognitive impairment / dementia
Physical comorbidity (biventricular failure, cancer, cerebrovascular disease)
Psychiatric comorbidity (e.g., depression)
Sensory impairment (vision, hearing)
Functional dependence (e.g., requiring assistance for self-care or mobility)
Dehydration/malnutrition
Drugs and drug-dependence
Alcohol dependence

Question 22

What can distinguish delirium?

Answer 22

Changes in consciousness not seen in dementia or psychosis

Question 23

Social treatments

Answer 23

Family, friends, and other caregivers can offer frequent reassurance, tactile and verbal orientation, cognitive stimulation (e.g. regular visits, familiar objects, clocks, calendars, etc.), and means to stay engaged (e.g. making hearing aids and eyeglasses readily available).

Question 24

What drugs can help and worsen delirium?

Answer 24

Haloperidol help

Benzodiazepines worsen

Question 25

Late Onset Alzheimer’s Disease (LOAD)

Answer 25

> 65 years

Vast majority of AD cases

Question 26

Early Onset Alzheimer’s Disease (EOAD)

Answer 26

<65 years
Mendelian single gene cause
More aggressive than LOAD

Question 27

EOAD accounts for

Answer 27

1% of all cases

Question 28

What a beta is more amyloidogenic?

Answer 28

Abeta 42

Question 29

What mutations are common in EOAD?

Answer 29

Presenilin I: chromosome 14 mutations are the most common cause of EOAD

Presenilin 2: chromosome 1

Question 30

Presenilin encodes

Answer 30

Gamma secretase component

Question 31

Presenilin mutations …

Answer 31

Increase ratio of Aβ42 : Aβ40 produced by γ-secretase

Question 32

Gene risk for LOAD?

Answer 32

APOE e4