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23 Cards in this Set
- Front
- Back
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What is dementia? What age groups are most affected?
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Dementia = progressive cognitive decline that interferes with daily function over the course of years in ABSENCE of delirium
Delerium affects 30-50% of those over 85; prevalence doubles every 5 years after 60 until 90 |
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What is the biggest risk factor for AD?
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Age
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What's the difference between MCI and Dementia?
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MCI patients are fnal
Demented patients have impaired fn |
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What is MCI?
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Mild Cognitive Impairment describes cognitive loss (often memory) not severe enough to meet dementia criteria
(up to 50% of pts with MCI that affects memory develop dementia within 3 years) |
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How do you differentiate between age-related cognitivite changes and the beginning of a cognitive disorder?
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Age-Related Change: doesn't substantially progress or impair daily fn
Cognitive Disorders interfere with Activities of Daily Living (ADL); pts often are repetitive, can't come up with names/words no matter how much time passes Can't recall that conversations/events ever took place Don't realize they have a memory problem |
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What is the most common cause of dementia?
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AD and something else (Lewey Body, Vascular event, Tau tangles)
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How does beta-amyloid deposition lead to dementia?
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beta-amyloid deposition
microglial activtn neurofib tangles neuronal loss/neurochemical changes DEMENTIA |
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What to amyloid-beta plaques consist of? What is the reason for forming plaques?
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neurites (axons, dendrites), astrocytes, microglial cells around an amyloid core
Plaque = less toxic than amyloid (product of defense) |
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What do neurofibrillary tangles consist of?
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Helical filaments that contain hyperphosphorylated tau protein
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What pathological finding in AD correlates with dementia?
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Number of tau-tangles present
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What brain areas are affected in AD?
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Medial Temporal Lobe
Hippocampus Assocn Cortices (Vision/sensory are intact) |
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What is the expected decline in MMSE scores for patients with AD?
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2-3 points per year
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What are the main recommendations for screening of dementia?
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Primare care MD's should provide most of care, dx, and tx for pts with dementia
Ask pt AND a knowledgeable informant about fn Do baseline MMSE and clock drawing |
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What patient populations can benefit from the Montreal Cognitive Assessment Battery?
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Patients with milder signs of dementia
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How do CSF levels of amyloid-beta and tau differ in patients with AD?
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Amyloid-beta decreases in CSF in early stage AD
Tau increases in CSF |
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What is the relationship between the ApoE 4 allele and odds of developing AD?
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0 alleles: 20% risk, onset at 84
1 allele: 47% risk, onset at 75 2 alleles: 91% risk, onset at 68 |
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Memantine: use, mechanism
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Namenda: NMDA inhibitor for AD tx
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Donepezil: use, mechanism
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Aricept: Cholinesterase inhibitor for AD tx
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Galantamine: use, mechanism
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Razadyne: Cholinesterase inhibitor for AD tx
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Rivastigmine: use, mechanism
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Exelon: Cholinesterase inhibitor for AD tx
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What are the benefits of cholinesterase inhibitors and memantine for AD?
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Stabilize fn during first year and make decline more gradual
May decrease bhvrl syx BUT DZ PROGRESSES |
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What are the most common side-effects associated with cholinesterase inhibitors?
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Procholinergic effects (increased stimuln of GI tract)
GI (nausea, vomiting, diarrhea) Anorexea, wt loss |
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What is the function of tau protein? How does it contribute to AD?
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Tau protein is involved in microtubule stabilization
When neurons degenerate and MT subunits fall apart, get clumps of tau proteins TAU HYPERHOSPHORYLATION |
