6b. Dementia

Question 1

what are 3 causes of dementia?

Answer 1

1. neurodegenerative disorders (Alzheimer’s disease, Pick’s disease)
2. vascular (multi-infarct) dementia
3. reversible causes

Question 2

what are 4 characteristics of Alzheimer’s

Answer 2

1. cognitive deficits
2. behavioral deficits
3. no sensory or motor deficits
4. age of onset: 70s-80s

Question 3

what are 3 cognitive deficits of AD?

Answer 3

1. profound memory loss
2. language - anomic, empty, circumlocutory
3. visuospatial disturbance

Question 4

what are 3 behavioral deficits of AD?

Answer 4

1. no significant early changes in personality
2. unawareness/denial of illness
3. psychosis

Question 5

what are 2 types of pathology of Alzheimer’s?

Answer 5

1. neurofibrillary tangles (tau protein)

2. amyloid plaques (beta amyloid)

Question 6

what region can show atrophy during Alzheimer’s?

Answer 6

hippocampus

Question 7

what are 2 types of treatment of Alzheimer’s disease?

Answer 7

1. cholinergic replacement

2. anti-amyloid agents

Question 8

what specific nuclei can show degeneration?

Answer 8

basal forebrain nuclei

Question 9

what is degeneration of the basal forebrain nuclei due to?

Answer 9

loss of acetylcholine

Question 10

what are 5 genes linked to Alzheimers?

Answer 10

1. APP
2. PS
3. Down’s Trisomy 21
4. APoE4
5. MTAP

Question 11

what are some factors of Alzheimer’s?

Answer 11

• causal genes
• risk genes
• head trauma
• cerebrovascular disease
• education
• neuronal number
• synapse number
• NTs

Question 12

what are 4 characteristics of Pick’s disease? (frontal dementias)

Answer 12

1. cognitive deficits
2. behavioral deficits
3. frontal release signs on neurological exam but no sensory/motor deficits
4. age of onset 50s-60s

Question 13

what re 2 cognitive deficits of PIck’s disease?

Answer 13

1. profound executive dysfunction

2. good memory, language problems (aphasia), visuospatial skills preserved early on

Question 14

what are 2 behavioral deficits of Pick’s disease?

Answer 14

1. early prominent personality changes

2. poor judgement, insight, disinhibited, labile, euphoric, socially inappropriate, sexual indescretions

Question 15

what is the pathology of Pick’s disease?

Answer 15

Pick’s bodies (dark spots)

Question 16

what is another type of dementia?

Answer 16

vascular (multi-infarct) dementia

Question 17

what are 3 reversible causes of dementia?

Answer 17

1. intoxications (delirium)
2. metabolic abnormalities
   - renal failure
   - substrate deficiencies (B12)
   - hypothyroidism
   - depression
3. infectious agents
   - neurosyphilis/fungal meningitis/HIV

Question 18

what are 7 things that can be involved in a workup of dementia?

Answer 18

1. careful history
2. complete mental status + neuro exam
3. blood studies CBC etc.
4. lumbar puncture
5. EEG
6. MRI
7. PET