Week 6

Question 1

Hypercholesterolaemia and AD

Answer 1

• May increase risk for AD but no causal relationship established* Cholesterol does not enter the brain so uncertainty of link

Question 2

Coronary artery disease and AD

Answer 2

• CAD is associated with an increased risk of dementia in general but there are overlapping risk factors for both

Question 3

A decline in skills is NOT a normal part of aging

Answer 3

• verbal fluency,* logical analysis,* selective attention,* object naming,* complex visuospatial skills

Question 4

types of dementia

Answer 4

• Alzheimer’s disease,
• Diffuse Lewy body dementia,
• Frontotemporal dementia (FTD)
• Posterior Corticoid Atrophy (PCA)
• Progressive primary aphasia (PPA)
• Young-onset Alzheimer’s disease (YOAD)
• Vascular dementia

Question 5

How does the health care team determine the degree of cognitive impairment?

Answer 5

• Neuropsychological testing in the major domains of thinking and memory, verbal and expressive abilities, constructional skills, and executive functions.* Can the patient continue to handle his or her own finances, to drive, or to perform instrumental activities of daily living?

Question 6

Types of rare dementias

Answer 6

Posterior cortical atrophy (PCA): mainly affecting visual and spatial perception
* Frontotemporal dementia (FTD): mainly affects behaviour, personality and language
* Familial AD: inherited – similar symptoms to late onset AD but can occur as young as 30
* Primary progressive aphasia (PPA): predominately affects language skills
* Lewy body dementia: Closely related to Parkinson’s Disease affecting movement and can cause hallucinations. May present with PCA
* Young onset dementias (typically YOAD and FTD)

Question 7

common cognitive assessment tools

Answer 7

General Practitioner Assessment of Cognition (GPCOG),* Memory Impairment Screen,* Mini-Cog, Mini-Mental State Examination (MMSE),* 7-Minute Screen,* Clinical Dementia Rating,* Global Deterioration Scale,* Brief Cognitive Rating Scale,* MOCA- Montreal Cognitive Assessment* CAM

Question 8

What neuroanatomic changes are seen in persons with AD?

Answer 8

destruction of the proteins of nerve cells of the cerebral cortex by diffuse infiltration with neurofibrillary tangles and plaques
death of nerve cells within the brain

Question 9

Length of time it takes for AD to fully disable someone

Answer 9

3-15 years

Question 10

Time of onset to death

Answer 10

3-20 years, avg is 8

Question 11

What is Donezepil?

Answer 11

Donepezil is indicated for the symptomatic treatment of mild to moderate Alzheimer’s disease. Donepezil may compensate for the loss of functioning cholinergic brain cells

Can help with namely functional ability, behavior, and cognition

There is limited and conflicting evidence that long-term donepezil treatment delays time to institutionalization. There is some evidence that donepezil may be cost-effective, especially when unpaid caregiver costs are considered

Question 12

Diffuse Lewy body dementia,

Answer 12

second most common type of dementia, characterized by the buildup of proteins into masses known as Lewy bodies. This protein also is associated with Parkinson’s disease, typically effects those over 60,

Question 13

Posterior Corticoid Atrophy (PCA)

Answer 13

Posterior cortical atrophy is a brain and nervous system syndrome that causes brain cells to die over time. It causes problems with eyesight and with processing visual information. Common symptoms include trouble reading, judging distances and reaching for objects

Question 14

Frontotemporal dementia (FTD)

Answer 14

In frontotemporal dementia, portions of these lobes shrink (atrophy). Signs and symptoms vary, depending on which part of the brain is affected. Some people with frontotemporal dementia have dramatic changes in their personalities and become socially inappropriate, impulsive or emotionally indifferent, while others lose the ability to use language properly, Frontotemporal dementia often begins between the ages of 40 and 65 but occurs later in life as well

Question 15

Progressive primary aphasia (PPA)

Answer 15

Symptoms begin gradually, often before age 65. They get worse over time. People with primary progressive aphasia can lose the ability to speak and write. Eventually they’re not able to understand written or spoken language

Question 16

Young-onset Alzheimer’s disease (YOAD)

Answer 16

Although often thought of as a disease of older people, around 5% of people with Alzheimer’s Disease are under 65. This is called early-onset or young-onset Alzheimer’s. It usually affects people in their 40s, 50s and early 60s.

Question 17

Vascular dementia

Answer 17

Vascular dementia is a general term describing problems with reasoning, planning, judgment, memory and other thought processes caused by brain damage from impaired blood flow to your brain. You can develop vascular dementia after a stroke blocks an artery in your brain, but strokes don’t always cause vascular dementia

Question 18

Alzheimer’s disease

Answer 18

Alzheimer’s disease causes the brain to shrink and brain cells to eventually die. Alzheimer’s disease is the most common cause of dementia — a gradual decline in memory, thinking, behavior and social skills. These changes affect a person’s ability to function.