Lecture 10 - Alzheimers Disease Flashcards Preview

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Flashcards in Lecture 10 - Alzheimers Disease Deck (72)
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1

Outline Alois Alzheimer 1901

Progressive neurodegenerative Disorder
Presented case Auguste D 1907

2

Outline Auguste D 1902

Profound cognitive and behavioural impairments
Difficulty memory, recognition, learning

Found strange deposits - Augustus triangles of filaments
1/3 cortical cells died off some way

3

Outline symptoms of Alzheimer’s

Impaired memory
Depression
Poor judgements
Confusion

4

Outline Neuropathology of Alzheimer’s Disease

Amyloid plaques

Neurofibrillary tangles

5

What proportion dementia cases are Alzheimer’s disease

50-80%

6

Outline symptoms of Vascular dementia

Similar Alzheimer’s
But memory less affected

7

Outline neuropathology of Vascular dementia

Decreased blood flow to brain owing series small strokes

8

Outline proportion dementia cases accounted for by vascular dementia

20-30%

9

Outline symptoms of frontotemporal dementia

Changes in personality and mood
Difficulties with language

10

Outline neuropathology of frontotemporal dementia

Damage limited to frontal and temporal lobes

11

Outline proportion dementia cases explained by frontotemporal dementia

5-10%

12

Outline symptoms of dementia with Lewy bodies

Similar Alzheimer’s
Also hallucinations, tremors

13

Outline neuropathology of dementia with Lewy bodies

Cortical Lewy bodies (of protein a-synuclein) inside neurons

14

Outline proportion dementia cases be explained by dementia with Lewy bodies

<5%

15

Outline statistics of dementia between 2015-2050

Low income countries increase 264%
227% upper middle
223% lower middle
116% high income

16

What regions have most people living with dementia

East Asia - 9.8million

Western Europe - 7.5million

South Asia - 5.1million

North America - 4.8million

17

What will the global increase in number people with dementia be from 2018 to 2050

From 50 million 2018 to
152 million 2050
204% increase

18

Main reason increase in dementia

Living longer
Biggest impact is age

19

Every day symptoms

Regularly misplacing items
Problems everyday tasks - eating
Disorientation - confused, don’t recognise familiar streets
Difficulty finding words - inappropriate words
Diminished judgement - dressing inappropriately, unaware danger
Mood or behavioural problems - depression, agitation, irritability, lack care

20

How does DSM-V categories Alzheimer’s Disease

Evidence causative genetic mutation from family history or genetics OR
All 3 of:
1. Decline memory and learning based neuropsychological testing

2. Steadily progressive gradual decline cognition

3. No evidence other causes

21

Outline stage 1 of Alzheimer’s Disease

Early, less energy and spontaneity
No one notices
Minor memory loss, mood swings
Slow learn and react
Start shy away and prefer the familiar
Affect job performance
Confused, lost easily and exercises poor judgement

22

Outline stage 2 of Alzheimer’s Disease

May need assistance more complicated activities
Speech and understanding slower, lose train thought
Lost whilst travelling, forget pay bills
Aware loss control depressed, restless
Distant past recalled. Recent events difficult remember
Affect comprehension where are, day, time
Invent words not recognise familiar faces

23

Outline stage 3 of Alzheimer’s Disease

Lose ability chew and swallow
Essence person vanishing
Memory very poor no one recognisable
Lose bowel and bladder control
Need constant care
Vulnerable pneumonia, infection, illness
Respiratory problems worsen - bedridden
Terminal

24

What happens to the brain as dementia progresses

Healthy: lots crevices
As develop fewer crevices and folds, shrinkage, loss gray matter
Cells destroyed

25

Outline histopathological feature of dementia Amyloid Plaques

Small insoluble deposits around neurons.
Start hippocampus and entorhinal cortex = responsible spatial learning and memory

26

Outline neurolitic plaques-dystrophic as histopathological features Schiz

Neurotic plaques-dystrophic and degenerating neuronal processes. Large bulbous structures

27

Outline how to diffuse amyloid plaques as histopathological features of dementia

Diffuse plaques - contain b-amyloid Ab protein fibres some unstructured amyloid earliest

28

Outline histopathological features of Neurofibrillary Tangles of dementia

Helical filaments

Paired filaments wound around each other, helical arrangement

Mainly abnormal tau (protein) also immunoreactive number other substances

29

Outline Perrin et al 2009 trends in plaques and tangles

Increase amyloid plaques and neurofibrillary tangles
Decrease neuronal integrity

30

Outline formation of Plaques according to Perrin et al 2009

Formed protein molecule amyloid precursor protein molecule APP
Number enzymes come along and cut this protein unusual position
Liberating small fragment - peptideA-B insoluble doesn’t break down
Fathers up forms A-B plaques