clinmed2test3: DEMENTIA ppt

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary difference between the MMSE and MoCA evaluations?

MoCA is used for differential diagnosis, while MMSE is used for disease progression.

MoCA is more sensitive to detecting executive dysfunction, while MMSE is more sensitive to memory impairment. (correct)

MMSE is more sensitive to detecting executive dysfunction, while MoCA is more sensitive to memory impairment.

MMSE is used for differential diagnosis, while MoCA is used for disease progression.

What percentage of Alzheimer's disease sufferers are women?

1/3

3/4

1/2

2/3 (correct)

What is the approximate increased odds of developing AD for carriers of two ε4 alleles?

2-3x

16-20x

4-6x

8-12x (correct)

What is the primary difference between early-onset and late-onset Alzheimer's disease?

Early-onset AD follows an autosomal dominant inheritance pattern, while late-onset AD has complex genetics. Signup and view all the answers

What is the primary purpose of Aducanumab in the treatment of Alzheimer's disease?

To decrease the amount of beta-amyloid in the brain. Signup and view all the answers

What is the approximate rate of decline on the MMSE per year for Alzheimer's disease patients?

2-3 points Signup and view all the answers

What is the primary reason for performing laboratory evaluations in dementia diagnosis?

To rule out reversible causes of dementia. Signup and view all the answers

What is the primary purpose of imaging evaluations in dementia diagnosis?

To support the clinical diagnosis and rule out other potential causes. Signup and view all the answers

What is the primary feature of Primary Progressive Aphasia?

Gradual language deficits in word finding, word usage, word comprehension, and sentence construction Signup and view all the answers

What is the characteristic of Lewy Bodies in Lewy Body Dementia?

Aggregates of protein in the cytoplasm Signup and view all the answers

What is the key difference between Lewy Body Dementia and Alzheimer's Disease?

Presence of Lewy Bodies Signup and view all the answers

What is the characteristic of Creutzfeldt-Jakob disease (CJD)?

Rapidly progressive cognitive decline Signup and view all the answers

What is the key feature of Vascular Dementia?

Stepwise decline over time Signup and view all the answers

What is the primary symptom of Normal Pressure Hydrocephalus (NPH)?

All of the above Signup and view all the answers

What is the treatment for Creutzfeldt-Jakob disease (CJD)?

None Signup and view all the answers

What is the prognosis for Normal Pressure Hydrocephalus (NPH)?

Will lead to improvement in symptoms with shunt placement Signup and view all the answers

Study Notes

Dementia

Dementia can be classified into several types, including Mild Cognitive Impairment, Alzheimer's Dementia, Frontotemporal Dementia, Lewy Body Dementia, Rapidly Progressive Dementia, and Normal Pressure Hydrocephalus.

Mild Cognitive Impairment (MCI)

MCI can be on the Alzheimer's spectrum, but not all MCI is early Alzheimer's disease.
Symptoms of MCI include cognitive impairment, but individuals are able to complete daily tasks.
Evaluation of MCI involves history, physical, and MoCA to assess domains affected.
Treatment of MCI involves treating reversible causes, and Aducanumab, a monoclonal antibody against amyloid beta, is currently in post-approval trials.

Alzheimer's Dementia

In the US, nearly 7 million individuals over the age of 65 are living with clinical Alzheimer's disease.
Incidence of dementia doubles every 10 years after age 60.
2/3 of Alzheimer's sufferers are women, and older Black Americans are twice as likely to have Alzheimer's as whites.
Alzheimer's pathology includes early-onset and late-onset forms, with different genetic patterns.
Risk factors for Alzheimer's include family history, brain trauma, lifestyle, T2DM, HTN, and cerebrovascular disease.
Clinical features of Alzheimer's include memory impairment, executive dysfunction, and imaging findings of generalized and focal atrophy.
Alzheimer's progression is measured with MMSE, MoCA, and Clinical Dementia Rating Scale, with patients declining 3-3.5 points on average on the MMSE each year.
Treatment of Alzheimer's involves no cure, but Aducanumab decreases the amount of beta-amyloid in the brain.

Frontotemporal Dementia (FTD)

Behavioral variant (BVFTD) is the most common subtype of FTD.
Primary progressive aphasias are a type of FTD, characterized by gradual language deficits.
Subtypes of primary progressive aphasias include nonfluent, logopenic, and semantic variants.

Lewy Body Dementia

Lewy Body Dementia is the second most common cause of dementia.
Cells die in the brain's cortex and substantia nigra, with remaining nerve cells containing abnormal Lewy bodies.
Clinical presentation of Lewy Body Dementia includes dementia "plus" symptoms such as fluctuating cognition, visual hallucinations, and parkinsonism.
Prognosis of Lewy Body Dementia is similar to Alzheimer's, but with a slightly faster rate of cognitive decline and shorter survival time.

Rapidly Progressive Dementia

Rapidly Progressive Dementia can be caused by Creutzfeldt-Jakob disease (CJD) or vascular dementia.
CJD is the most common human form of prion disease, characterized by spongiform encephalopathy and rapidly progressive cognitive decline.
Vascular dementia, also called multi-infarct dementia, is caused by multiple brain insults accumulated over time.

Normal Pressure Hydrocephalus (NPH)

NPH is characterized by large ventricular size with normal opening pressures (LP).
Epidemiology of NPH shows it is most common in adults over the age of 60, with equal prevalence in both genders.
Pathophysiology of NPH involves impaired CSF absorption.
Temporal course of NPH involves gait difficulty, urinary urgency/incontinence, and cognitive changes.
Treatment of NPH involves lumbar puncture to aid in diagnosis and ventriculoperitoneal shunt, with a good prognosis for improvement in symptoms after shunt placement.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz covers the diagnosis and evaluation of dementia, including types of dementia such as Alzheimer's and Frontotemporal, and diagnostic tools like neurocognitive assessments and laboratory tests.