Dementia Flashcards
Frontotemporal dementia
Pathology
Macroscopic changes seen in Pick’s disease include:
- Atrophy of the frontal and temporal lobes
Microscopic changes include:
- Pick bodies - spherical aggregations of tau protein (silver-staining)
- Gliosis
- Neurofibrillary tangles
- Senile plaques
Frontotemporal dementia
Clinical Features
- personality change
- impaired social conduct
- disinhibition
- increased appetite
- perseveration behaviours
Alzheimer’s disease (AD
what is it?
is a progressive degenerative disease of the brain accounting for the majority of dementia seen in the UK
Alzheimer’s disease (AD
Risk factors
Down’s Syndrome
Alzheimer’s disease (AD
Pathology
Macroscopic
Microscopic
Biochemical
Macroscopic:
- widespread cerebral atrophy, particularly involving the cortex and hippocampus
Microscopic:
- cortical plaques due to deposition of type A-Beta-amyloid protein
- intraneuronal neurofibrillary tangles caused by abnormal aggregation of the tau protein
- Hyperphosphorylation of the tau protein has been linked to AD
Biochemical:
- deficit of acetylcholine from damage to an ascending forebrain projection
Alzheimer’s disease (AD
Medical Management
First line: Anticholinergics = donepezil (contraindicated in bradycardia), galantamine and rivastigmine
Second line: Memantine (an NMDA receptor antagonist)
(if first lines don’t work, if intolerant in anticholinergics, or severe disease)
Alzheimer’s disease (AD
Managing other symptoms
NICE does not recommend antidepressants for mild to moderate depression in patients with dementia
Antipsychotics should only be used for patients at risk of harming themselves or others, or when the agitation, hallucinations or delusions are causing them severe distress
