Week 06 - Neurological disease

Question 1

In Alzheimer’s:

Answer 1

• Cortex shrivels, damaging areas involved in thinking, planning and remembering
• Ventricles filled with cerebrospinal fluid grow larger
• Hippocampus shrinks significantly

Question 2

Dementia is a …

Answer 2

a chronic/persistent disorder of the mental processes caused by brain disease or injury and marked by memory disorders, personality changes, and impaired reasoning

Question 3

Alzheimers disease (type of dementia): ____% of dementia cases

Answer 3

50-75%

Question 4

Other forms of dementia (apart from alzheimers)

Answer 4

• 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

Question 5

Pathophysiology of Alzheimer’s Disease

Answer 5

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

Question 6

Risk factors of alzheimers?

Answer 6

Lifestyle:
- CVD
- Diabetes (by 65%)
- High cholesterol
Family History - genetic
Head injury

Question 7

……… leading risk factor for alzheimers disease

Answer 7

Physical inactivity

Question 8

May be prescribed to treat the psychiatric symptoms of….

Answer 8

• Depression
  
  • Psychotic behaviour
  • Agitation
  • Aggressive
  • Sleep Disturbances

Question 9

Possible side effects of alzheimers drugs:

Answer 9

• Orthostatic hypotension
• Poor balance
• Dysrhythmias

Question 10

Goal of exercise training in alzheimers….

Answer 10

Minimize problems arising from the declining physical and mental health

Question 11

Low or high intensity for alzheimers?

Answer 11

Low-intensity is recommended — for safety but high intensity better results

Question 12

Parkinson’s Disease

Answer 12

• Second most common neurological disorder, affecting 80,000 Australians
• Progressive neurologic disorder

Question 13

Symptoms of parkinsons?

Answer 13

tremor, bradykinesia, rigidity, dyskinesia, dystonia, gait and postural abnormalities, mask-like face; gait: slow/shuffling

Question 14

Parkinsons: death of ______ cells within the basal ganglia resulting in decrease in the neurotransmitter dopamine

Answer 14

dopaminergic

Question 15

Symptoms occur when > ____% loss of the dopaminergic cells in the basal ganglia

Answer 15

80%

Question 16

Cause of parkinsons?

Answer 16

No known cause

Question 17

Risk factors of parkinsons?

Answer 17

• 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

Question 18

Dopaminergics function and side effects

Answer 18

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

Question 19

Monoamine Oxidase type B inhibitors function and side effects

Answer 19

Reduces breakdown of dopamine in the brain.
- Side effects: Movement disorders, dystonia’s & clinical fluctuations of motor activity.

Question 20

Exercise Considerations for parkinsons?

Answer 20

• 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

Question 21

Evidence for exercise in parkinsons?

Answer 21

• Health benefits with exercise for parkinsons (balance, gait speed, strength)
• Neuroplasticity: exercise improves motor control and corticomotor function (nerve transmission increases)

Question 22

Can exercise prevent parkinsons???

Answer 22

PA can prevent development parkinsons, more activity = less risk.