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29 Cards in this Set
- Front
- Back
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What's diff b/w Dementia and Alzheimer's?
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Dementia is a generic adjective that means "your thinking is declining"
Alzheimer's is the specific, well-defined disease |
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work up of Dementia
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Brain scan (CT or MRI) - (can't diagnose Alz from CT or MRI)
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gut feeling, new research associating what neuroanatomy to Alzheimers?
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larger size of temporal horns of lateral ventricles
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More refined definition of dementia
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a syndrome of acquired intellectual impairment characterized by persistent deficits in at least three of the following areas of mental activity: memory, language, visuospatial skills, personality or emotional state, and cognition (abstraction, mathematics, judgment)
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Laboratory Evaluation of the Demented Patient
Required lab tests |
Complete blood count
Serum electrolytes, calcium, glucose, blood urea nitrogen/creatinine, liver function tests Thyroid-stimulating hormone Serum vitamin B12 Structural imaging study |
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Laboratory Evaluation of the Demented Patient
Optional lab tests |
Syphilis serology
Sedimentation rate HIV testing Chest X-ray Urinalysis, 24-hour urine for heavy metals, toxicology screen Neuropsychological testing Lumbar puncture Apo-E genotyping, Aβ42/tau CSF analysis Electroencephalography (EEG) Single-photon emission computed tomography Positron emission tomography |
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Describe PET of Alzheimer's
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Bilateral reduction in temporo-parietal metabolism
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first part of the brain attacked by Alzheimer's
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Entorhinal cortex (frontal)
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The major areas of brain affected in AD
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the cortex, hippocampus, and nucleus basalis of Meynert (not shown).
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Risk factors for AD
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Age, Age, Age
Gender Head trauma Cardiovascular risk factors Depression ApoE-4 |
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2 groups of Alz
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Early onset disease (very rare.. late 40s early 50s... strong genetic component... Down synd.. .21 is same location of amyloid precursor protein)
after age 65 disease (no gene identified yet) |
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ApoE-4 gene?
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some research showing higher risk for developing late onset Alz.
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protein in Lewy bodies
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Alpha-synuclein
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Charac of Alz that people don't experience with normal aging.
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persistent, progressive decline in short-term, day-to-day memory
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Differential Diagnosis of the Dementia Syndrome
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Alzheimer’s disease
Frontotemporal dementia Vascular dementia Dementia with Lewy bodies Parkinsonian syndromes with dementia Huntington’s disease Prion disease Viral and other infectious dementias Toxic and metabolic dementias Hydrocephalic dementias Traumatic dementias Neoplastic dementias Myelin diseases with dementia Dementias associated with psychiatric disorders |
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Clinical Criteria for Diagnosis of Probable Alzheimer’s Disease
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Dementia Present
Onset between 40 and 90 years of age Deficits in two or more cognitive areas Progression of deficits >6 months Consciousness undisturbed Absence of other potential etiology |
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Clinical Criteria for Mild Cognitive Impairment (MCI)
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Memory complaint, preferably corroborated by an informant
Objective memory impairment for age and education Largely intact general cognitive function Essentially preserved activities of daily living Not demented |
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Neurofibrilliary tangles
Amyloid plaques Which are intracellular? |
Neurofibrillary tangles
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Neurofibrilliary tangles
Amyloid plaques Which are hyperphosphorylated tau? |
Neurofibrillary tangles
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most toxic type of amyloid
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beta amyloid 42
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new medicines that may possibly be able to clip amyloid so that they are shorter than "42"
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secretase inhibitors
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Characteristics of Stage 1 of Alzheimers
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Language: Anomia, empty speech
Memory: Defective Visuospatial Skills: Impaired Calculation: Impaired Personality: Indifferent EEG: Normal Structural scan: Medial temporal atrophy |
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Characteristics of Stage 2 of Alzheimers
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Language: Fluent aphasia
Memory: Severely impaired Visuospatial skills: Severely impaired Personality: Indifferent Motor system: Restlessness EEG: Background slowing Structural scan: Temporal-parietal atrophy |
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Characteristics of Stage 3 of Alzheimers
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Intellectual function: Severely impaired
Language: Palilalia, echolalia, or mutism Sphincter control: Incontinence EEG: Diffuse slowing Structural scan: Diffuse atrophy |
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What lobe of the brain is responsible for visuospatial thinking
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parietal
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Psychiatric Symptoms Associated with Dementia Syndromes
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Depression
Anxiety/Agitation Psychotic symptoms Sleeping disorders Bipolar disorder |
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What is the most common psychiatric symptom associated with dementia?
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Depression
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a specific clinical condition in which there is an impairment in the ability to learn new information despite normal attention, preserved ability to recall remote information, and intact cognitive functions.
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Amnesia
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PIB compound?
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hoping that it binds to amyloid. tag it with radioisotope to show accumulation of amyloid.
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