8 Questions
What percentage of Alzheimer disease cases occur at a young age?
Less than 1%
What is a primary genetic risk factor for late-onset Alzheimer disease?
APOE genotype
What is a characteristic of Alzheimer disease-affected individuals at a younger age compared to age-matched controls?
Higher burden of plaques and NFTs
What is the most prominent neurotransmitter deficit that correlates with Alzheimer disease severity?
Cholinergic activity
What is a proposed mechanism for Alzheimer disease-related changes?
Mitochondrial dysfunction
What is a common risk factor for vascular disease that is also a risk factor for Alzheimer disease?
Hypertension
What is a characteristic signature lesion of Alzheimer disease?
All of the above
What is the primary pathology in most forms of Alzheimer disease?
Unknown
Study Notes
Alzheimer's Disease Overview
- Affects approximately 7.5 million Americans of all ages
- Characterized by loss of cognitive and physical functioning, often with behavioral symptoms
Genetic Factors
- Late onset AD primarily linked to apolipoprotein E (APOE) genotype
- Genetic-environmental interaction may contribute to AD development
- Young onset AD (<1% of cases) attributed to chromosomal alterations affecting amyloid precursor protein processing
Risk Factors
- Age
- Decreased brain reserve capacity
- Head injury
- Down syndrome
- Depression
- Mild cognitive impairment
- Vascular disease risk factors:
- Hypertension
- Elevated homocysteine
- Elevated low-density lipoprotein cholesterol
- Low high-density lipoprotein cholesterol
- Obesity
- Metabolic syndrome
- Diabetes
Pathological Characteristics
- Signature lesions:
- Intracellular neurofibrillary tangles (NFTs)
- Extracellular plaques in the cortex and medial temporal lobe
- Neuronal and synaptic degeneration
- Cortical atrophy
- AD individuals have a higher burden of plaques and NFTs in younger years compared to age-matched controls
Proposed Mechanisms
- β amyloid protein aggregation, leading to plaque formation
- Hyperphosphorylation of tau protein, leading to NFTs
- Synaptic failure and depletion of neurotrophin and neurotransmitters
- Mitochondrial dysfunction
- Oxidative stress
- Amyloid cascade hypothesis: β amyloid production and clearance imbalance, leading to AD
Neurotransmitter Deficit
- Loss of cholinergic activity is the most prominent neurotransmitter deficit, correlating with AD severity
- Cholinergic cell loss is a consequence of AD pathology, not the cause
This quiz covers the pathophysiology of Alzheimer's disease, including its genetic susceptibility, environmental interactions, and rare forms of the disease that occur at a young age.
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