What is AD?
A progressive degenerative disease of the brain accounting for the majority of dementia seen in the UK.
What proportion of AD cases are genetic?
5% of cases are inherited as an autosomal dominant trait. Most cases are sporadic.
What is the mode of inheritance in genetic AD?
What are the most common mutation sites of inherited AD? (3)
Amyloid precursor protein (Chr 21) Presenilin 1 (Chr 14) Presenilin 2 (Chr 1)
How are the pathological changes seen in AD classified? (3)
Microscopic Macroscopic Biochemical
What are some microscopic pathological changes seen in AD? (2)
Cortical plaques due to deposition of type A-beta amyloid protein. Intraneuronal neurofibrillary tangles caused by abnormal aggregation of the tau protein.
What is the main macroscopic pathological changes seen in AD?
Widespread cortical atrophy, particularly involving the cortex and hippocampus.
What is the biological pathological change seen in AD?
Deficit of acetylcholine from damage to an ascending forebrain projection.
What are neurofibrillary tangles?
Paired helical filaments which consist of tau protein.
What is the abnormality found in tau proteins in AD?
Tau is excessively phosphorylated.
What three drugs are recommended for the management of mild-moderate AD? (3)
Donepezil. Galantamine. Rivastigmine.
What is the drug of choice in the management of moderate-severe AD?