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Neuro 4 (sam > Dementia > Flashcards

Dementia Flashcards

(64 cards)

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1
Q

How much will the # of centenarians grow by?

A

500% in 2030

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2
Q

What is the max. number of years a human can live?

A

~120

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3
Q

What is the overall life expectancy?

A
  1. 8 overall
  2. 4 males
  3. 2 females
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4
Q

What is the average life expectancy for black males/females?

A

males 72.1

females 78.2

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5
Q

Hispanic female life expectancy?

A

live longer than white males

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6
Q

How has the survival curve changed since the 1900s?

A

Curve has moved to the right-life expectancy has increased over time but max life span has not

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7
Q

What is the cellular theory of aging?

A

Max. lifespan is predetermined and depends on number of mitotic divisions your fibroblasts undergo in a lifetime

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8
Q

What is the DNA mutation theory?

A

Aging occurs as a result of changes in DNA and RNA

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9
Q

What are some factors that can cause changes in DNA and RNA?

A

External factors
accumulation of errors that have occurred over time with transcription
Telomere destruction

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10
Q

What affect does inheritance have on aging?

A

Many inherited factors contribute to aging

They may affect one system primarily but usually affect multiple systems

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11
Q

What is the oxidative stress theory in regards to aging?

A

During aerobic metabolism, free radicals are produced as byproducts of using O2. These free radicals affect membranes and mitochondrial function which further accelerates aging

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12
Q

What diseases are associated with Oxidative stress?

A

Parkinsons (normal breakdown of dopamne leads to free radical formation)
Familial type of ALS

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13
Q

What is the 7th leading cause of death?

A

Alzheimer’s

5th leading cause in people >65

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14
Q

What is considered “ideal” aging?

A

1-2% of brain loss/decade for 40-80 year olds

total 6-10% brain loss by old age (>80)

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15
Q

What part of the brain looses volume at a faster rate than the rest?

A

Hippocampus ~5% a decade, so ~25% by 80 yo

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16
Q

What happens to the cortex and the ventricles?

A

Decrease in cortical thickness and ventricular enlargement

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17
Q

Where do you see the most profound loss of neurotransmitters and receptors?

A

See throughout the whole brain but especially in the basal ganglia and prefrontal cortex

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18
Q

Effects of aging on cell bodys?

A

Cell bodies shrink

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19
Q

What happens to the dendritic tree with aging?

A

Decreased branching, decreased spines ~(46% decrease in number of spines and density in people >50)

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20
Q

What happens to axon collaterals with aging?

A

Decreased number of axon collaterals

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21
Q

What are inclusions?

A

Neurofibrillary tangles

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22
Q

What abnormal structures are found in normally aging brains?

A

Senile plaques and inclusions albeit at a much reduced number than

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23
Q

What are glial cells active during?

A

Active in myelinization and transport of nutrients and maintaining homeostasis

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24
Q

Declines in what systems are related to postural control and aging?

A

Decline in sesory/motor systems
Decline in central processing
Decline in dual task abilities

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25
Two aging hypothesis?
Aging machinery and Negative plasticity
26
Ways to combat negative plasticity
``` exercise Control BP healthy diet reduce caloric intake reduce stress stable marriage rest (8 hour sleep) Life-long learning ```
27
Why do some people age "better" than others?
better genes better lifestyle higher education level/SES-->less dementia
28
What is the "cognitive reserve" theory?
the more education and cognitive processing you have, the more you need to loose to feel the effects of dementia and mental decline
29
Number of baby boomers expected to be diagnosed with dimentia?
1 out of every 8 baby boomers will be expected to develop dimentia
30
What is the direct cost of dementia? Indirect cost?
20 billion/yr direct | 50 billion/yr indirect (lost wages of family member caregivers etc)
31
What is the breakdown of different types of dementia?
60% alsheimers 30-40% vascular (dual pathology often exists) 15% other
32
What are some causes of the other 15% of dementia cases?
``` Huntingtons/parkinsons lewy body dementia alcoholism endocrine disorders depression AIDS and AIDS related CNS conditions Fronto-temporal dimentia ```
33
What areas of the brain are affected with Alzheimers?
Neuronal degeneration of all areas of brain espesially forebrain and cortex
34
Which areas of the brain are reported to be affected first with Alzheimer's?
hippocampus and left parietal cortex
35
What are the microscopic changes associated with Alzheimer's?
``` Neurofibrillary tangles (NT, tau proteins) Amyloid plaques in extracellular spaces (AP) ```
36
What are used to diagnose Alzheimers?
Neurofibrillary tangles and amyloid plaques
37
What type of process has recently been implicated in Alzheimer's?
Inflammatory process
38
How do you make a definite diagnosis of Alzheimer's?
Can only make a definite diagnosis postmortem
39
What are some neurotransmitter changes in Alzheimer's? What is treatment aimed at?
Decreased acetylcholine in basal forebrain. treatment aimed at raising Ach levels
40
What is the clinical presentation of Alzheimer's at the initial onset?
Characterized by short term memory deficits
41
What are later signs if ALzheimers?
Apraxia is a later sign as wel
42
What are some risk factors for ALzheimer's?
Advanced age Women Previous TBI with unconsciousness
43
Stage 1 on Functional Assessment Stage for Alzheimer's
No impairments
44
Stage 2 on Functional Assessment Stage for Alzheimer's
Very mild cognitive decline (may be normal age related changes or earliest signs of AD)
45
Stage 3 on Functional Assessment Stage for Alzheimer's
Mild cognitive decline
46
Stage 4 on Functional Assessment Stage for Alzheimer's
Moderate cognitive decline greater difficulty performing complex tasks Becoming moody or withdrawn
47
Stage 5 on Functional Assessment Stage for Alzheimer's
Moderately severe cognitive decline
48
Stage 6 on Functional Assessment Stage for Alzheimer's
Severe cognitive decline lose awareness of recent experiences as well as surroundings
49
What is the APP gene?
Amyloid precursor protein | located on chromosome 21 (probably why increased risk of AD in those with down syndrome (trisomy 21)
50
IN what stage of alzheimers is apraxia a sign?
Later stage sign
51
What is a medical treatment for dementia?
ACE inhibitors act by inhibiting the enzyme that breaks down ACh, thus raising level of ACh in brain
52
What are the effects of AcH inhibitors in Dementia?
Modest benefit early in disease but effect peaks afteral several weeks or months
53
What % of dementias do vascular cerebral infarcts acount for?
30-40% by recent studies
54
What is important to manage with dementia?
Blood pressure and lipid management
55
What is binswanger's disease?
Affects subcortical white matter | disease of microcirculation (amyloid plaques in vessels)
56
What is Binswanger's disease associated with?
Hypertension and other vascular diseases (Stroke, TIA)
57
What do you see on imaging with Binswanger's disease
White matter lesions, shrunken gyri, enlarged ventricles
58
What are the symptoms of lewy body dementia?
Pronounced fluctuations in awareness visual hallucinations Parkinsonian-like motor signs (rigidity, tremor, bradykinesia)
59
What causes Lewy Body dementia?
Build up of Lewy bodies(alpha synuclein protein) in neuronal cell bodies
60
What is the course of Lewy Body Dementia?
Progressive, with an average life expectancy after diagnosis 8 years with increasing disability
61
What are lewy body dementia treatments aimed at?
Controlling the cognitive, psychiatric and motor symptoms of the disorder
62
What medications are used for Lewy Body Dementia? Which ones should you avoid?
Use-ACh inhibitors, may have benefit from L-dopa for motor symptoms Avoid- antipsychotics
63
What disease has a high incedence of dimentia associated?
AIDS has a high incidence with exact cause unknown
64
What other neurological complications is AIDS related dementia associated with?
CNS infection CNS lymphoma Toxic enxephalopathy

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