degradarea in imbatranire

Question 1

what is the typical cognitive decline

Answer 1

since the age of 20 there is cognitive decline in most cognitive functions
e.g.
memory
reasoning
spatial visualisation
perceptual speed

Question 2

what is pathological ageing

Answer 2

not all people age as well

modifications which take place due to age based illness, as independent from modifications correlated with typical healthy ageing

Question 3

what is dementia

Answer 3

significant cognitive decline
Affects cognitive abilities
Dementia is heterogenous - different types of dementia will lead to different cognitive difficulties

Also associated with behavioural and psychological symptoms

Question 4

What is the prevalence of dementia

Answer 4

7.1% of all ppl will develop dementia in their lifetime
There will be 1 million by 2025 and 2 million by 2050

Question 5

what are risks for developing dementia

Answer 5

age
genetic facotrs
male
ethnicity
smoking

depression
high blood pressure
lack of excercise
diet/eight

Question 6

what are the cognitive difficulties associated with different dementias

Answer 6

Alzheimer’s disease
-episodic memory

Vascular Dementia
-executive function
-attention and processing speed

Question 7

what is the background of how Alzheimer’s disease was discovered

Answer 7

one of his patients has gone through 7 years of memory problems and confusion

he identified plaques and tangles after autopsy

Question 8

what is AD

Answer 8

most common form of dementia

neurodegenerative - loss of neurones in the brain

slow, progressive, fatal, incurable

prominent episodic memory deficit - loss of personal unique recollection of experiences

Question 9

What is the prevalence of AD

Answer 9

increases with age
84 year+ is 42% prevalance

Question 10

How do you get a diagnosis of definite AD

Answer 10

you can’t be sure until autopsy until you look at the number of plaques and tangles

Question 11

How do you get a diagnosis of probable AD?

Answer 11

Dementia observed
Cognitive impairment in memory and 1 other area
Decline progressive
Onset between ages 40-90
No other cause for symptoms

Question 12

where does AD start

Answer 12

in hippocampus

atrophy of hippocampal formation

Study found that atrophy 2.5 times greater in AD than controls

Question 13

what are causes of AD?

Answer 13

not fully understood

associated with age

plaques and tangles are present in temporal lobe which contains the hippocampus

Question 14

what are plaques

Answer 14

-they form outside of neurones
-clusters of beta amyloid proteins
-plaques are not broken down normally and become insoluble
-they build up between neurones which affects
functioning
-block communication between neurones

Question 15

how to plaques form

Answer 15

they form around amyloid precursor protein - which helps neurones grow and repiar

Question 16

what are tangles

Answer 16

twisted fibres of protein tau within neurones

in a healthy CNS tau has important role for stabilising microtubules which transport nutrients around neurone

in AD tau protein is abnormal and microtubule collapses

cell dies due to lack of nutrients

Question 17

what was found about brain in people with dementia

Answer 17

People with dementia had reduced blood flow in entorhinal cortex

Blood flow in entorhinal cortex is associated with memory tasks

They demonstrated cognitive difficulties primarily in memory

Memory is a hippocampal related task

Question 18

what is vascular dementia

Answer 18

second most common type of dementia

150,000 ppl in UK

progression of symptoms

problems with blood supply to the brain

neurones rely on blood for oxygen and glucose
without they die

associated with damage to white matter and deep grey matter structures

Question 19

symptoms of VAD

Answer 19

Memory loss not necessarily main presentation

main problems is executive function and attention deficits

Question 20

What is the vascular dementia criteria

Answer 20

cognitive decline is due to decline from previous functioning

in diagnoses we are looking for impairment in 2 or more cognitive domains: executive function, attention, language, visuospatial, motor control, memory

physiological: evidence for cardiovascular disease, with or without stroke

Question 21

what are causes of vascular dementia

Answer 21

based on damage to large OR small vessel disease

narrowing of blood vessels deep in the brain

gradual slowing of thinking and problem solving

Question 22

What is the progression of vascular dementia

Answer 22

Progression from risk factors through cardiovascular disease to vascular dementia

Therefore preventable

Question 23

what are the precursors of dementia

Answer 23

dementia is a gradual process

there are many steps preceding a dementia diagnosis

Question 24

what is mild cognitive impairment (MCI)

Answer 24

Transitional stage before dementia
Not always converts to dementia

Question 25

whats the conversion from MCI to dementia

Answer 25

not always

studies 105 patients with MCI over the course of 3 years
22% of them diagnosed with dementia
38% cognitive decline but not dementia
32% stable
8% showed cognitive improvement

Question 26

What are the sub types of MCI?

Answer 26

Amnestic MCI
Non-amnestic MCI

Question 27

What is Amnestic MCI

Answer 27

when memory is primary deficit
precursor to alzheimers

Question 28

What is non-amnestic MCI?

Answer 28

memory is not major diagnoses

there is a decline in cognitive function but memory is not primary one

precursor to vascular dementia where executive function and attention is impaired

Question 29

Why is much of the research conducted on people who have MCI rather than dementia

Answer 29

They are able to give consent
Actively take part in research - complete cognitive tasks

Have brain scans without sedation

Question 30

How can we identify likelihood of conversion from MCI to AD?

Answer 30

compared resting state in fMRI machine
compared patients with AD, MCI and healthy adults

2.4 years later they followed up to see who has AD

fMRI distinguished MCI who converted to AD versus those who don’t

Question 31

what are the early stages of vascular dementia

Answer 31

VaD is the result of cardiovascular damage

Usually referred to as small vessel disease (SVD)

A common presentation of SVD is a stroke

Question 32

What is cardiovascular damage (SVD)

Answer 32

when there is major disruption of blood supply to brain causing a shortage of oxygen and glucose (ischaemic)

visible damage on MRI scans

a single large stroke can affect cognitive processes

Question 33

SVD related to white matter damage

Answer 33

found progressive white matter damage in patients with SVD

so increase in white matter lesions (WHM)

Question 34

type of VAD- multi infarct dementia

Answer 34

series of small strokes across the brain that occur over time and lead to cogntiive deficits

Question 35

What does multi infarct dementia involve?

Answer 35

step wise progression

with each new stroke, you find worsening of the condition

Question 36

What is test to distinguish between dementias?

Answer 36

Cognitive performance can distinguish between AD and VaD with 89% accuracy

Cognitive deficits in:
-episodic memory = AD
-VaD = executive function

Question 37

what are things to consider about AD

Answer 37

although early AD sings are in temporal grey matter,
later changes occur throughout the brain,
affecting both grey and white matter

Question 38

what are some things to consider about VAD and AD

Answer 38

although early primary cognitive deficits usually distinguish VAD and AD,

some studies have shown no difference on executive function task performance

by the time dementia occurs and progresses, cognitive difficulties are widespread

in late stage-dementia, there are fewer cognitive differences between different types of dementia

Question 39

Does normal ageing brain also have plaques and tangles

Answer 39

normal ageing brain also has some plaques and tangles

Question 40

Why has the purity of dementia been questioned

Answer 40

AD and VAD often co-occur