Ageing Brain and Nervous System

Question 1

In ageing which of the following functions can be affected if the frontal lobe is affected?

1 - visual processing
2 - reaction time, sensory processing, balance
3 - spatial and episodic memory
4 - planning, working memory, abstract thinking, attention, motor control

Answer 1

4 - planning, working memory, abstract thinking, attention, motor control

Question 2

In ageing which of the following functions can be affected if the parietal lobe is affected?

1 - visual processing
2 - reaction time, sensory processing, balance
3 - spatial and episodic memory
4 - planning, working memory, abstract thinking, attention, motor control

Answer 2

2 - reaction time, sensory processing, balance

Question 3

In ageing which of the following functions can be affected if the temporal lobe is affected?

1 - visual processing
2 - reaction time, sensory processing, balance
3 - spatial and episodic memory
4 - planning, working memory, abstract thinking, attention, motor control

Answer 3

3 - spatial and episodic memory

Question 4

In ageing which of the following functions can be affected if the occipital lobe is affected?

1 - visual processing
2 - reaction time, sensory processing, balance
3 - spatial and episodic memory
4 - planning, working memory, abstract thinking, attention, motor control

Answer 4

1 - visual processing

Question 5

In the brain there are structural, physical, cellular and chemical changes that can cause neurocognitive changes as we age. There is evidence that there is cerebral atrophy occurs after 50 y/o. What % is this expected to reduce each decade after 50 years of age has been reached?

1 - 0.5%
2 - 5%
3 - 15%
4 - 30%

Answer 5

2 - 5%
- even more rapid decline beyond 70 y/o

Question 6

In the brain there are structural, physical, cellular and chemical changes that can cause neurocognitive changes as we age. There is evidence that there is 5% cerebral atrophy occurs after 50 y/o, which accelerates further beyond 70 y/o. Which lobe has the largest reduction?

1 - parietal lobe
2 - frontal lobe
3 - temporal lobe
4 - occipital lobe

Answer 6

2 - frontal lobe

Question 7

In addition to changes in structural, physical, cellular and chemical changes that can cause neurocognitive changes as we age, neurovascular changes can also occur. These changes include narrowed arteries due to atherosclerosis and fluctuating BP. What reduction in perfusion is estimated to occur in ageing?

1 - 1-5%
2 - 5-7%
3 - 5-20%
4 - 15-30%

Answer 7

3 - 5-20%

Question 8

In addition to changes in structural, physical, cellular and chemical changes that can cause neurocognitive changes as we age, neurovascular changes can also occur. These changes include narrowed arteries due to atherosclerosis and fluctuating BP leading to around a 5-20% reduction in perfusion. This can have which of the following implications?

1 - increased risk of stroke (3/4 occur in >65s)
2 - vascular dementia
3 - increased risk of syncope and pre-syncope
4 - all of the above

Answer 8

4 - all of the above

Question 9

Which of the following cellular changes occur in the ageing brain?

1 - synaptic dysfunction reducing synaptic plasticity (reduced long term potentiation)
2 - increased oxidative stress and neuron loss
3 - increased abnormally folded proteins (amyloid plaques, lewy bodies and neurofibrillary tangles)
4 - all of the above

Answer 9

4 - all of the above

Question 10

Cellular changes that occur in the ageing brain include:

• synaptic dysfunction reducing synaptic plasticity (reduced long term potentiation)
• increased oxidative stress and neuron loss
• increased abnormally folded proteins (amyloid plaques, lewy bodies and neurofibrillary tangles)

Which of the following conditions is NOT associated with these cellular changes?

1 - Parkinsons disease
2 - Stroke
3 - Lewy body dementia
4 - Alzheimers disease

Answer 10

2 - Stroke
- is increased in ageing but not due to these cellular changes

Question 11

There is evidence to show some neurotransmitter levels are reduced in ageing. Reductions in which of the following neurotransmitters would be responsible for memory impairment?

1 - dopamine
2 - serotonin
3 - acetylcholine
4 - adrenaline

Answer 11

3 - acetylcholine
- this is the target for dementia patients

Question 12

There is evidence to show some neurotransmitter levels are reduced in ageing. Reductions in which of the following neurotransmitters would be responsible for mood disorders?

1 - dopamine
2 - serotonin
3 - acetylcholine
4 - adrenaline

Answer 12

2 - serotonin
- this is the target for depression

Question 13

There is evidence to show some neurotransmitter levels are reduced in ageing. Reductions in which of the following neurotransmitters would be responsible for abnormal movements and Parkinsons?

1 - dopamine
2 - serotonin
3 - acetylcholine
4 - adrenaline

Answer 13

1 - dopamine
- dopamine producing neurons are reduced in ageing
- substantia nigra is reduced by 50% in elderly

Question 14

Is dementia and mild cognitive impairment a part of normal ageing?

Answer 14

• no
• they are a disease
• patients in their 90s and 100s can be fine, so no reason why this is part of the normal ageing process

Question 15

There are specific aspects of cognition that have been shown to be reduced with ageing. Which of the following is NOT typically affected by ageing?

1 - speed of cognitive processing
2 - working/fluid memory
3 - executive function
4 - long term/crystallised memory

Answer 15

4 - long term/crystallised memory
- memories accrued over years has been shown to be maintained

Question 16

In ageing there are changes in the PNS. Proprioception and touch has been shown to be reduced in ageing. Specifically which 2 types of receptors specifically have been shown to be reduced?

1 - meissners corpuscles
2 - pacinian corpuscles
3 - thermoreceptors
4 - nociceptors

Answer 16

1 - meissners corpuscles
2 - pacinian corpuscles

• suggested that there is a 50% reduction in light touch and vibration by 50 y/o

Question 17

In ageing there are changes in the PNS. Proprioception and touch has been shown to be reduced in ageing. Which if the following implications could this have on the patient?

1 - increased postural swap
2 - increased falls
3 - exacerbation of morbidities (peripheral neuropathy in diabetes)
4 - all of the above

Answer 17

4 - all of the above

Question 18

In ageing there is a gradual deterioration in vision. All of the following are common effects, but which of the following has the highest incidence?

1 - cataracts
2 - retinal pathologies
3 - glaucoma

Answer 18

1 - cataracts
- 16% in >65 y/o

• retinal pathologies = 9% in >65 y/o
• glaucoma = 3% in >65 y/o

Question 19

In ageing there is a gradual deterioration in vision, which can also lead to cataracts, retinal pathologies and glaucoma. Which of the following can reduced vision cause that has the highest association with morbidity and mortality?

1 - inability to read prescriptions
2 - inability to mobilise
3 - increased falls
4 - all of the above

Answer 19

3 - increased falls

Question 20

Ageing has been shown have a significant effect on reactions times beyond 60y/o. What can this increase the risk of?

1 - falls
2 - burns
3 - cachexia
4 - all of the above

Answer 20

1 - falls
- patients unable to respond to a trip quickly enough and fall