(PM3B) Dementia & Alzheimer's Flashcards
What are the types of dementia?
(1) Alzheimer’s disease – 62%
(2) Mixed dementia – 10%
(3) Vascular dementia – 17%
(4) Rarer causes of dementia – 5%
(5) Dementia with Lewy bodies – 4%
(6) Frontotemporal dementia – 2%
What is dementia?
Chronic progressive mental disorder that adversely affects higher cortical functions
Including:
- memory
- thinking
- orientation
- comprehension
- calculation
- learning capacity
- language
- judgment
What is Alzheimer’s disease?
Most common form of dementia
Degenerative cerebral disease with characteristic neuropathological and neurochemical features
Onset and development is slowly but steadily over several years
Progressive deterioration in cognition, function and behaviour
What are some cognitive symptoms of Alzheimer’s disease?
(1) Memory loss
(2) Disorientation/ confusion
(3) Poor concentration
(4) Failing intellect
(5) Language impairment
What are some non-cognitive symptoms of Alzheimer’s disease?
(1) Depression
(2) Anxiety
(3) Delusion
(4) Aggression
(5) Sleep disturbances
(6) Dis-inhibition – inability to suppress inappropriate behaviour
What are some disabling symptoms of Alzheimer’s disease?
(1) Difficulties with daily living
(2) Self-neglect
(3) Incontinence
What may the symptoms of Alzheimer’s disease be confused with?
(1) Diabetes
(2) Thyroid problems
(3) Vitamin deficiency
(4) Infection
(5) Anxiety
(6) Brain tumour
(7) Depression
How does the brain tissue of a patient with Alzheimer’s disease compare to the brain tissue of a healthy patient?
(1) Enlargement of the ventricles – loss of tissue
(2) Hippocampus is degenerated
(3) Grooves of cerebral cortex are much more defined
What is the significance of the weight of an orange with regard to dementia?
Approximately the mass of the brain lost in a patient with dementia
What are the significant toxic peptides in dementia or Alzheimer’s disease?
(1) Tau
(2) Amyloid beta – Aß
How is Alzheimer’s disease diagnosed?
(1) Symptom + memory assessment
(2) MRI + PET scans for biomarkers
Why are memory tests used to diagnose Alzheimer’s disease?
Show problems in particular areas
Why are CT and MRI scans used to diagnose Alzheimer’s disease?
Can show brain shrinkage (atrophy)
What questionnaire is often used for diagnosis of Alzheimer’s disease?
Mini Mental State Exam (score /30)
What is the clock drawing test?
A test for Alzheimer’s disease diagnosis
Points are lost for incorrect drawing of a clock
Describe the common level of amyloid beta (Aß) levels in a patient first diagnosed with dementia.
Almost at its maximum
What is the purpose of using an MRI in dementia or Alzheimer’s disease diagnosis?
(1) Highlights atrophy in hippocampus
(2) Can detect pre-symptomatic changes
(3) Non-invasive
(4) Reproducible
What is the purpose of using an FDG scan in dementia or Alzheimer’s disease diagnosis?
(1) Highlights deficits in parietal lobe
(2) Links metabolic state to synaptic activity
(3) Useful in differentiating between types of dementia
What is the predominant risk factor for dementia?
(1) Age
What are some of the risk factors for dementia?
(1) Age – >65yrs old
(2) History of stroke
(3) Head injury
(4) Vascular diseases
(5) Diabetes
(6) Smoking
(7) Drinking
(8) ApoE4 genotype
(9) ApoJ genotype
(10) TREM2 status
What is dementia pugilistica?
Punch drunk
Head injuries in sport
Subsequent development of dementia
What are some of the biomarkers that increase following a traumatic head injury?
(1) Hyperphosphorylated Tau
(2) Amyloid plaque deposition
Name 3 early onset genes for Alzheimer’s disease.
(1) APP
(2) PSI
(3) PSII
What is the amyloid cascade hypothesis?
(1) Amyloid beta accumulation
(2) Amyloid beta oligomerisation (clump) + deposition
(3) Inflammatory response – from glial cells?
(4) Synapse loss
(5) Oxidative stress
(6) Ca2+ overload
(7) Neuronal death
