Week 9: Degenerative Diseases Flashcards
What is the mortality transition?
Decreases in the rates of death for age groups across the lifespan
What happens when the mortality transition is lower?
Life expectancy increases
what happens when the mortality and fertility transition occur together?
the number of older adults grows at a faster rate than the number of children
What is the aging transition?
The percentage of the population represented by older adults increases as the percentage of children shrinks
Increases in longevity are a success when…
extra years are healthy ones
Most adults experience how many years of disability prior to their death?
10 years
What are the three developmental stages of adulthood?
- early adulthood (20-39)
- middle adulthood (40-64)
- late adulthood (65+)
Public health goals focus on what stages of adulthood?
early and middle
what are the most common causes of death in early adulthood?
Injuries and infections (by middle adulthood the burden is NCDs)
True or false. any death of a young or early adulthood is considered premature death?
true
What is the most common cause of YLD in early adulthood?
mental health disorders, especially depression
What are the most common causes of YLD in middle adulthood?
musckulosketeal disorders (especially low back pain)
what is the most cost effective way to improve the health status of older adults?
prevent or delay NCD onset
what is the dependency ratio?
the number of dependent children on older people for every person of working age (15-64)
what is the elderly support ratio?
any number of peoples ages 15-64 for every 100 people age 65+ in a population
what is the aging index?
the number of people 65+ for every 100 children under age 15
the dependency ratio is ___ in high income countries and ___ in low income countries
increasing; decreasing
is the elderly support ratio increasing or decreasing in high and middle income countries? Hint: aging index follows the same trend
increasing
Onset for AD is usually what age group?
65+
Incidence and prevalence of AD is highest where?
in developed nations where there is a greater number of older adults
what are AD early symptoms?
-mood swings, behavioural changes, deficits, confusion, irritability
Dementia accounts for _% of YLD in 60+
11.2
what is the hallmark of AD?
loss of neurons in the brain
the healthy adult brain has how many neurons?
100 billion
why do older memories last longer?
because they do not depend as much on the hippocampus
what is affected later than the hippocampus?
amygdala
amyloid forms plaques ___ while tau forms ___
outside of cells; tangles inside them
Is AD higher among women or men?
women
the survival after AD diagnosis is reduced by at least __ compared to the general population
50%
survival and case fatality rates depend on what?
- level of care
- age and gender at diagnosis
- ratio of disease progression
- severity of the disease at diagnosis
who survives AD longer?
- younger > older patients
- women survive longer than men
- patients with mild disability at diagnosis
Incidence __ after age 65
doubles
what are risk factors for AD?
- hypertension
- tobacco smoking
- insulin resistance and diabetes
- obesity
- genetics
Weight loss with dementia diagnosis
is associated with greater disease severity and mortality rate
What are 3 protective factors for AD?
- ERT
- NSIDs
- anti-angiogenic drugs
What is PD?
a degenerative disorder of the CNS involving death and destruction fo dopamine synthesizing neurons of the substantia nigra of the midbrain
what causes PD?
depletion of the neurotransmitter dopamine
PD symptoms
bradykinesia, cogwheel rigidity of the joints, difficulty walking, loss of balance, tremor and shaking of extremities
what is the second most common brain disease next to AD?
PD
what is the average age of diagnosis for PD?
60
2 of what 3 symptoms are needed for a PD diagnosis?
resting tremor, stiffness, slowness of movement
what does dopamine do?
signal feelings of motivation and reward
true or false. PD diagnosis is two-fold higher in men than women starting at age 50
true
true or false. there is no protective effect of smoking
false
dementia affects how many PD patients?
2/3
which polymorphism elevates dementia risk?
APOE
risk of death compared to general pop is how much higher for PD patients?
1.6x
what is the most common medication for PD?
levodopa
what is a downside of levodopa?
produces cognitive decline
populations with highest DALY for PD are?
war torn countries
what are some PD risk factors?
- genetics
- maganese exposure
- pesticides and herbicides (dose-response relationship)
- 2x increased risk in relatives who have the disease
what are protective factors for PD?
- tobacco smoking
- NSAIDs
- coffee consumption
what drug is the gold standard for PD?
lovadopa especially for motor symptoms. Prevents motor complications and psychosis
what 3 drugs are used for PD?
- lovodopa
- dopamine agonists
- monoanise oxygen inhibitors
what is MS?
an autoimmune inflammatory disease in which the myelin sheaths surrounding the axons of neurons (nerve cells) are damaged or destroyed
what is the usual age of onset for MS?
20-40
where does the name sclerosis come from?
scar in the white matter of the brain and spinal cord
what is myelin?
a lipoprotein synthesized by gilia cells
what happens when myelin is lost?
nerve cells cannot effectively conduct impulses
true or false? MS is more prevalent among women?
true
what is the average MS life expectancy?
20 years after being diagnosed
in terms of MS prevalence there are __ rates in high income countries and ___ rates in low income countries
high; low
why is MS and autoimmune diseases more common in females?
incompatibility of x chromosomes
what is usually used for MS management?
corticosteroids
