Lecture 16 Alzheimer Disease Flashcards
(19 cards)
What is dementia?
Cognitive or behavioural symptoms that interfere with function, show decline, are not due to delirium or psychiatric illness, and involve cognitive impairment in 2+ domains.
What are some key epidemiological facts about dementia in Australia?
2nd leading cause of death; leading for women
What percentage of dementia cases are caused by Alzheimer’s Disease?
About 70%.
What percentage of people aged over 85 have AD pathology?
Approximately 30%.
What is the underlying biological cause of Alzheimer’s Disease?
Amyloid-mediated tauopathy (proteinopathy involving Aβ and tau).
What are the two forms of AD aetiology?
Sporadic (late onset, ≥98%, failure to clear Aβ); Familial (rare, due to mutation in APP, presenilin-1/2).
What is the typical pathological sequence in AD?
Aβ + tau → synaptic dysfunction → cell loss → cognitive decline/dementia.
How long does it take to go from no amyloid to AD-level amyloid?
Over 30 years (12 years to ‘at risk’, then 19 years to AD level).
Which cortical areas are affected first in AD?
High-level association cortex, with primary sensory and motor areas relatively spared early.
What happens in the terminal stages of Alzheimer’s Disease?
Patient is bedridden and at risk of respiratory complications.
What are the diagnostic criteria for probable AD?
Dementia with insidious onset, clear decline, initial deficits in memory or other cognitive domains, and no better explanation.
What are typical memory-related symptoms of AD?
Recent memory difficulties, failure to learn/retain new info, with poor subjective insight.
What are orientation difficulties seen in AD?
Getting lost, losing track of time and place.
What language issues are observed in AD?
Anomia (difficulty naming), circumlocution (talking around words).
How is dementia diagnosed clinically?
By assessing decline in cognition/behaviour that impairs function, using tests and comparing to norms.
What is Mild Cognitive Impairment (MCI)?
Cognitive decline without functional impairment; may be prodromal AD.
Why is early diagnosis of AD important?
Allows for planning, safety, treatment access, driving assessment, and patient autonomy.
What are anti-amyloid treatments and their status?
Aducanumab (2021, discontinued), Lecanemab (2023), Donanemab (2024); TGA rejected Lecanemab (2025).
What are anti-tau and downstream treatment strategies?
Antibodies and ASOs (early phase), BDNF promotion, iron removal, anti-inflammatories (mixed results).
