Alzheimers disease Flashcards
define, aetiology and RF of alzheimers disease
most common form of dementia (70%) with a steady progressuib
aetiology -
amyloid proteins - abnomral cleavage of B-amyloid protein which causes toxic aggregates
Tau- hyperphosphorylated tau proteins become insolutble and self-agregate- cause microtubule issues and damages neurons
4 pathophys - atrophy, plaque formation, neurofibrillary tangles, cholingergic loss
RF- Age is the main risk little genetic -8% of risk head injury vascular RF psycho- low IQ, poor education
Sx of alzheimers disease
steady and progressive decline -
early - failing memory, wandering, irritable
middle -4 A’s
late- fully depedent, incontience, primitive refexes, EPSE
tend to present during 4a
4A’s-
Amnesia - recent memory loss first, disonrientation
APhasia- aphasia in finding right words (Brocas), speech muddle, disjointed -not like wernickes because intellect fine
Agnosia - typical visual agnosia -not recognising faces
Apraxia - typically dressing -hard doing skilled task despite nomral physical function
BDSP- mood changes, abnormal dehabiours, delusion
can present as delusions, depression or GAP
and behavioural disturbances
Mx of Alzheimers disease
Bioligical-
mild/moderat e- anticholinestase 1st line
donzeprezile, rivastigmine
=> check ECG, GI, mental SE
contraindicated if anticholinergics, bblockersm NSAIDS, muscle relaxants
2nd line - NMDA partial recpetor antagonist- Memantine
psych-
1s lin -strucutral group cognitive stimulation sessions
exclude depression/GAD
group reminisence therapy, validation
social -
explain diagnosis -breaking bad news
Optimise health in other areas (hearing, HTn, glasses, etc)
identify future wishes (LPA, advanced directives)
Followup every 6m with same clinitian
Wear ID, dosset box for meds, remove gas from home
carers - OT, Social prescriber, etc
Social support- peronsal care, mal support, day centres
Legally must contact DVLA and INSURERS for ANY dementia - can either maintain, revoke or renew each year
