Week 06 - Neurological disease Flashcards
In Alzheimer’s:
- Cortex shrivels, damaging areas involved in thinking, planning and remembering
- Ventricles filled with cerebrospinal fluid grow larger
- Hippocampus shrinks significantly
Dementia is a …
a chronic/persistent disorder of the mental processes caused by brain disease or injury and marked by memory disorders, personality changes, and impaired reasoning
Alzheimers disease (type of dementia): ____% of dementia cases
50-75%
Other forms of dementia (apart from alzheimers)
- Vascular dementia: 20-30%
- Frontotemporal dementia (including Pick disease): 5-10%
- Lewy Body Dementia: <5%
- Other causes: Parkinson’s, Huntingdon disease, Creutzfelt-Jakob disease, HIV/AIDS, trauma-related dementia, mixed dementia
Pathophysiology of Alzheimer’s Disease
Chronic, degenerative illness of the brain
Neurons degenerate and die
- Beta-amyloid proteins and fibrils accumulate between and within the nerve cells (tangles)
- Block neural transmission = cell death
Can progress to full disability
Definitively diagnosed upon autopsy only
Risk factors of alzheimers?
Lifestyle:
- CVD
- Diabetes (by 65%)
- High cholesterol
Family History - genetic
Head injury
……… leading risk factor for alzheimers disease
Physical inactivity
May be prescribed to treat the psychiatric symptoms of….
- Depression
- Psychotic behaviour
- Agitation
- Aggressive
- Sleep Disturbances
Possible side effects of alzheimers drugs:
- Orthostatic hypotension
- Poor balance
- Dysrhythmias
Goal of exercise training in alzheimers….
Minimize problems arising from the declining physical and mental health
Low or high intensity for alzheimers?
Low-intensity is recommended — for safety but high intensity better results
Parkinson’s Disease
- Second most common neurological disorder, affecting 80,000 Australians
- Progressive neurologic disorder
Symptoms of parkinsons?
tremor, bradykinesia, rigidity, dyskinesia, dystonia, gait and postural abnormalities, mask-like face; gait: slow/shuffling
Parkinsons: death of ______ cells within the basal ganglia resulting in decrease in the neurotransmitter dopamine
dopaminergic
Symptoms occur when > ____% loss of the dopaminergic cells in the basal ganglia
80%
Cause of parkinsons?
No known cause
Risk factors of parkinsons?
- gender (men more susceptible), environmental toxins (herbicides, pesticides), genetics, older age (usually diagnosed >50 years)
- Motor symptoms affect many aspects of movement eventually leading to dependence as the disease progresses
Dopaminergics function and side effects
Metabolic precursors of dopamine, that cross the blood-brain barrier, presumably convert to dopamine in the brain.
- side effects: Cardiac irregularities, muscle pain, dyspnoea & Δ’s in mental activity
Monoamine Oxidase type B inhibitors function and side effects
Reduces breakdown of dopamine in the brain.
- Side effects: Movement disorders, dystonia’s & clinical fluctuations of motor activity.
Exercise Considerations for parkinsons?
- Symptoms vary from day to day and week to week
- ANS dysfunction is common: exacerbated sweating response altered HR & BP responses (orthostatic hypotension)
- Poor movement and rigidity - increased HR and O2 consumption
- Dyskinesia and dystonia Dystonia can aggravate degenerative joint disease
- Mask-like face makes it difficult to interpret patient reaction or RPE
- The disease can interfere with motor planning and memory: Use repeated demonstration along with visual cues
Evidence for exercise in parkinsons?
- Health benefits with exercise for parkinsons (balance, gait speed, strength)
- Neuroplasticity: exercise improves motor control and corticomotor function (nerve transmission increases)
Can exercise prevent parkinsons???
PA can prevent development parkinsons, more activity = less risk.
