Dementia and major neurocognitive disorders Flashcards
1
Q
What is a major neurocognitive disorder?
A
Dementia - new name
2
Q
Gender more affected by dementia and maybe why
A
- Females more than males
- Females are more likely to be carers for those with dementia = depression and isolated = risk factor for dementia (visicous cycle)
3
Q
What is dementia?
A
- Substantial cognitive decline from previous level in 1 or more domains
- Sufficient enough to interfere with daily function
- Cognitive deficits do not exclusively occur in context of delirium
- Not another cause from mental disorder eg depression, scizophrenia
4
Q
Neurocognitive domains
A
- Perceptual-motor function
- Language
- Learning and memory
- Social cognition
- Complex attention
- Executive function
5
Q
Tests for executive function
A
- Category fluency - name all animals, all words beginning with A
- Tap test - tests for inhibition, if I tap once tap, if i tap twice don’t tap
- Conceptualisation - what is similar between apple and orange
- Clock drawing - how detailed?
- Abstract thinking - what does ‘fought like a lion mean’
- Judgement - if you see a smoking house what do you do?
6
Q
Tests for visualspatial awareness
A
- Hemineglect - draw clock
- Test praxis - tell me how to use a hammer, comb, scissors
- Intersecting pentagon draw
7
Q
Perceptual motor test
A
- Copy designs
- Show movement and copy movement
8
Q
Language tests
A
- Impaired word finding?
- Impaired fluency?
- Hesitant speech?
9
Q
4 most common types, in order, of dementia
A
- Alzheimers 50-75%
- Vascular 20-30%
- Dementia with Lewy bodies 10-25%
- Frontotemporal 10-15%
10
Q
What is lewy body dementia sometimes meaning?
A
- Dementia with Lewy Bodies OR
- Parkinsons dementia
11
Q
RF for dementia
A
- Physical inactivity
- Smoking
- Excessive alcohol consumption
- Air pollution
- Head injury - eg ex boxers
- Infrequent social contact
- Low eduction
- HTN
- Obesity
- Diabetes
- Depression
- Hearing impairement
12
Q
Pathophysiology of Alzheimers
A
- Extracellular amyloid plaques
- Formed by amyloid beta
- Intracellular neurofibrillary tangles - from tau proteins
13
Q
Normal role of tau
A
- Stabilise microtubules in neurones
- Microtubules help nutrients travel around neurone
14
Q
Amyoid plaques and contribution to disease
A
Removing them does not reduce clinical progression
Are they waste product of already damaged thing?
15
Q
Subtypes of amyloid beta
A
40
42
38
16
Q
What happens in alzheimers?
A
- Apoptosis of neurones = widespread cortical atrophy
- Increase in some neurotransmitters
- Decrease in others eg Ach
17
Q
Symptoms of Alzheimers
A
- confusion with time and location
- Poor judgement
- Withdrawal from social activities
- Difficulty with words
- Problem solving difficulty
- Difficult to complete regular tasks
- Misplacing items
- General memory loss
- Difficulty with words
- Random emotions
- Trouble with images and spaces
18
Q
Biomarkers of Alzheimers
A
- CSF - Decreased amyloid beta 42, decreased 42:40 ratio, increased P and T tau, increased neurofilament light chain
- Plasma - increased T tau, increased neurofilament light chain
