SM_95b: Alzheimer's Disease Flashcards
Five neurocognitive networks include ____, ____, ____, ____, and ____
Five neurocognitive networks include spatial attention (right), face and object recognition (bilateral), working memory / executive comportment (bilateral), memory-emotion (bilateral), and language (left)
_____ affects the working memory / executive comportment network
Frontal type dementia affects the working memory / executive comportment network
____ affects the language neurocognitive network
Primary progressive aphasia affects the language neurocognitive network
____ affects the face / object recognition neurocognitive network
Semantic aphasia / dementia affects the face / object recognition neurocognitive network
____ affects the memory-emotion neurocognitive network
Amnestic (Alzheimer type) dementia affects the memory-emotion neurocognitive network
____ and ____ affect the spatial attention neurocogntive network
Lewy body dementia and posterior cortical atrophy affect the spatial attention neurocogntive network
Describe causes of cognitive impairment
Causes of cognitive impairment
- Metabolic / endocrine disease (hypothyroidism, B12 deficiency)
- Psychiatric disorders
- Autoimmune diseases
- Infections
- TBI
- Alzheimer’s disease
- Lewy body disease
- Cerebrovascular disease
- Frontotemporal lobar degeneration
Use ____ and ____ to determine the severity and type of cognitive decline after ruling out ____
Use MMSE and MoCA to determine the severity and type of cognitive decline after ruling out encephalopathy
Describe presentation of Alzheimer’s disease
Alzheimer’s disease clinical presentation
- Forgetfulness
- Repetitive in conversations
- Word finding difficulties
- Unable to take care of everyday activities
- Disoriented to time
- Can learn words but forgets
- Anomia and executive dysfunction
____ and ____ cause Alzheimer’s disease
Amyloid plaques and neurofibrillary tangles accumulate in Alzheimer’s disease
Mutations in ____, ____, and ____ may cause Alzheimer’s disease but single gene causes are RARE
Mutations in APP, Presenilin 1, and Presenilin 2 may cause Alzheimer’s disease but single gene causes are RARE
____ depletion has been implicated in Alzheimer’s disease
ACh depletion has been implicated in Alzheimer’s disease
Amnestic MCI is when the patient has ____
Amnestic MCI is when the patient has memory problems but other functions are normal
(brain compensates for changes)
(cognitive decline accelerates after Alzheimer’s diagnosis)
Benson’s syndorme is the ____ resulting from ____
Benson’s syndorme is the visual variant of Alzheimer’s disease resulting from posterior cortical atrophy
- Decline in visual processing skills
- Relatively intact memory and language in early stages
Standard treatment for Alzheimer’s disease involves ____ and ____ for cognitive enhancement
Standard treatment for Alzheimer’s disease involves NMDA receptor antagonists (memantine) and cholinesterase inhibitors (donezepil, rivastigmine, and galantamine) for cognitive enhancement
Alzheimer’s disease has ____ P-tau and ____ amyloid in CSF
Alzheimer’s disease has high P-tau and low amyloid in CSF
Describe presentation of dementia with Lewy bodies
Dementia with Lewy bodies presentation
- Attention decline
- Inefficiency in activities of daily living
- Hallucinations
- Constipation, violent dream enactment, occassional dizziness
- Slow movements
- Balance difficulties
- Orthostatic hypotension, decreased sense of smell, moderate weakness in executive function and visuospatial processing
- Bradykinesia and gait instability, Parkinsonian gait
Dementia with Lewy Bodies ___ a focal disease
Dementia with Lewy Bodies is NOT a focal disease
(substantia nigra Lewy bodies, Lewy neurites, cortical Lewy bodies)
Treat Dementia with Lewy bodies with ___, ___, ___, and ___
Treat Dementia with Lewy bodies with cholinesterase inhibitors (donezepil, rivastigmine), antipsychotics (quetiapine), environmental interventions, and cognitive retraining
Vascular cognitive impairment risk factors are ____, ____, ____, ____, ____, and ____
Vascular cognitive impairment risk factors are age, HTN, HLP, AFib, smoking, and diabetes
(also cerebral amyloid angiopathy and CADASIL)
Treatment for vascular dementia includes ____, ____, and ____
Treatment for vascular dementia includes cholinesterase inhibitors (donezepil and galantamine), NMDA receptor antagonists (memantine), and preventive
Describe the three types of frontotemporal lobar degeneration
Three types of frontotemporal lobar degeneration
- Language type: primary progressive aphasia, early onset (<65)
- Behavioral type: behavioral variant frontotemporal dementia (Pick’s disease), early onset (<65)
- Motor type: corticobasal syndrome, progressive supranuclear palsy, FTD-MND
Pick’s disease is ____ and involves ____
Pick’s disease is behavioral variant frontotemporal degeneration and involves progressive deterioration of behavior and cognition
- Early behavioral disinhibition
- Early apathy or inertia
- Early loss of sympathy or empathy
- Early perseverative, stereotyped, or compulsive/ritualistic behavior
- Hyperorality and dietary changes
- Sparing of memory and visuospatial symptoms
Frontotemporal lobe degeneration involves ___ inclusions in Pick’s disease or ___ inclusions
Frontotemporal lobe degeneration involves tau inclusions in Pick’s disease or TDP inclusions
Genetic mutations involved in frontotemporal lobe degeneration include ____, ____, and ____
Genetic mutations involved in frontotemporal lobe degeneration include MAPT, PGRN, and C9ORF72
- MAPT (microtubule associated protein tau): FTLD-Tau
- PRGN (progranulin): FTLD-TDP type A
- C9ORF72: FTLD-TDP type B
_____ is a syndrome of progressive language decline caused by neurodegenerative pathology
Primary progressive aphasia is a syndrome of progressive language decline caused by neurodegenerative pathology
Frontotemporal lobe degeneration motor type symptoms include ____, ____, or ____
Frontotemporal lobe degeneration motor type symptoms include cannot look down voluntarily, asymmetric balance / vision / speech / swallowing problems, or muscle weakness / shrinkage / jerking
