W7_13 Dementia

Question 1

what is the definition of dementia?

Answer 1

a syndrome of progressive deterioration of cognitive function sufficient to impact on daily life and occupational functioning

Question 2

what problems are common in dementia?

Answer 2

attention;
memory;
language;
visuospatial;
executive;
praxia;
personality;
mood;
daily functions

Question 3

fact: cardiovascular risk factors increase risk of dementia of any sort

Answer 3

good

Question 4

what are the (petersen) criteria for mild cognitive impairment?

Answer 4

memory complaint;
memory impairment for age;
largely intact general cognitive function;
essentially preserved activities of daily living;
not demented;
CDR = 0.5

Question 5

what’s the relationship between mild cognitive impairment and dementia?

Answer 5

50% of MCI patients became demented in 3.5 years

Question 6

criteria for alzheimer’s?

Answer 6

memory impairment, social/occupational function loss and one of:
aphasia;
apraxia;
agnosia;
executive dysfunction

Question 7

what is the most common form of degenerative dementia?

Answer 7

alzheimer’s disease

Question 8

how many people are affected by dementia worldwide?

Answer 8

25 million

Question 9

what percentage of dementia patients are genetic?

Answer 9

2% (autosomal dominant); 98% are sporadic

Question 10

what’s the strongest risk factor for dementia?

Answer 10

increasing age

Question 11

name a genetic factor that is protective for dementia

Answer 11

apo E2 allele

Question 12

name a genetic factor that is a risk for dementia

Answer 12

apo E4 allele

Question 13

what are two characteristic pathologies of alzheimer’s disease?

Answer 13

amyloid plaques;

tau protein tangles

Question 14

how does amyloid beta cause issues in the brain?

Answer 14

aggregation can cause inflammation, which causes even more issues

Question 15

what is the biochemical reason for the decline of function in alzheimer’s disease?

Answer 15

decreased cholinergic transmission due to disease and cell death

Question 16

what do you expect on imaging with SPECT on alzheimer’s patient?

Answer 16

reduction in blood flow (signal) to the bi parietal areas

Question 17

fact: alzheimer’s brains have smaller temporal lobes

Answer 17

good

Question 18

how to image amyloid?

Answer 18

using pittsburg compound b (PIB) to bind and image on PET scanning

Question 19

what are the diagnostic criteria for alzheimer’s disease?

Answer 19

episodic memory impairment and >1 of:
medial temporal lobe atrophy;
abnormal CSF biomarkers;
specific pattern on imaging with PET;
proven AD autosomal dominant mutation in the family

Question 20

where are the deficits of Ach in alzheimer’s disease?

Answer 20

nucleus basalis Meynert;

septal nuclei

Question 21

what are pharmacotherapies for alzheimer’s?

Answer 21

-cholinesterase inhibitors;

memantine - NMDAR antagonist (later stages)