Understanding Alzheimer's Disease and Diagnosis
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Questions and Answers

What percentage of dementia cases is accounted for by Alzheimer's disease?

  • 90%
  • 70% (correct)
  • 50%
  • 80%

    • Which of the following is the first and most prominent symptom of Alzheimer's disease?

  • Visual impairment
  • Depression
  • Gradually progressive memory loss (correct)
  • Behavioural impairment

    • What is required for the diagnosis of dementia according to the diagnostic criteria?

  • Cognitive decline affecting one domain only
  • Concerns expressed only by the individual
  • Cognitive impairment severe enough to interfere with independence (correct)
  • Cognitive impairment occurring in a delirium

    • How does Alzheimer's disease typically progress regarding cognitive domains?

    <p>Multiple cognitive domains become affected</p> Signup and view all the answers

    Which of these symptoms are common neuropsychiatric symptoms of Alzheimer's disease?

    <p>Apathy</p> Signup and view all the answers

    What does the clinical diagnosis of dementia not specify?

    <p>The cause of the dementia</p> Signup and view all the answers

    In what condition is cognitive impairment not attributed to according to the diagnostic criteria?

    <p>Delirium</p> Signup and view all the answers

    What is meant by the aetiological subtype in the context of dementia diagnosis?

    <p>The specific brain pathology causing dementia</p> Signup and view all the answers

    What is a characteristic cognitive profile associated with MCI due to Alzheimer's disease?

    <p>Prominent impairment in episodic memory</p> Signup and view all the answers

    What factor greatly influences the likelihood of developing dementia after an MCI diagnosis?

    <p>The age of the individual at diagnosis</p> Signup and view all the answers

    Which subtype of MCI is the most consistent predictor for progression to Alzheimer's dementia?

    <p>Amnestic MCI</p> Signup and view all the answers

    In Mr. Campbell's MoCA score, which area did he score the lowest?

    <p>Word recall</p> Signup and view all the answers

    What is a possible outcome for individuals diagnosed with MCI?

    <p>Some may remain stable or even improve over time</p> Signup and view all the answers

    Which of the following factors is NOT mentioned as a way to predict progression from MCI to dementia?

    <p>Genetic testing</p> Signup and view all the answers

    What does the term 'amnestic MCI' refer to?

    <p>A stage prior to Alzheimer's dementia with episodic memory impairment</p> Signup and view all the answers

    What notable symptom did Mr. Campbell NOT report during his appointment?

    <p>Difficulty finding his way in familiar areas</p> Signup and view all the answers

    What is characterized as fibrous intraneuronal aggregates of protein in Alzheimer's disease?

    <p>Neurofibrillary tangles</p> Signup and view all the answers

    Which protein is primarily associated with the extracellular plaques found in Alzheimer's disease?

    <p>Amyloid-beta protein</p> Signup and view all the answers

    Which individual is credited with introducing the eponym Alzheimer's disease?

    <p>Alois Alzheimer</p> Signup and view all the answers

    What advanced imaging techniques are being used for in vivo assessment of Alzheimer's disease pathology?

    <p>CT and MRI, amyloid and tau PET imaging</p> Signup and view all the answers

    What does the amyloid cascade hypothesis propose about the pathogenesis of Alzheimer's disease?

    <p>Abnormal accumulation of amyloid-beta is the primary driver.</p> Signup and view all the answers

    What type of dementia is associated with patients diagnosed at a relative young age?

    <p>Presenile dementia</p> Signup and view all the answers

    What leads to the degeneration of nerve cells in Alzheimer's disease?

    <p>Accumulation of neurofibrillary tangles</p> Signup and view all the answers

    What is necessary for the definitive diagnosis of Alzheimer's disease?

    <p>Post-mortem autopsy and neuropathology examination</p> Signup and view all the answers

    What does FDG-PET primarily measure in the brain?

    <p>Cerebral metabolic rate for glucose</p> Signup and view all the answers

    Which brain regions exhibit glucose metabolism abnormalities in early Alzheimer's disease?

    <p>Temporo-parietal regions</p> Signup and view all the answers

    What type of PET scan is currently mainly used for research purposes?

    <p>Tau PET</p> Signup and view all the answers

    What is a typical cerebrospinal fluid profile for Alzheimer's disease?

    <p>Decreased amyloid-beta and increased tau and P-tau levels</p> Signup and view all the answers

    What is one advantage of cerebrospinal fluid diagnostics over amyloid PET scans?

    <p>It is quicker and lower in cost</p> Signup and view all the answers

    Why are amyloid PET scans not recommended for routine examinations?

    <p>Abnormal scans can be found in older individuals without dementia</p> Signup and view all the answers

    In what situation may amyloid PET scan be considered despite its non-routine status?

    <p>In younger adults (&lt; 65 years) to differentiate types of dementia</p> Signup and view all the answers

    How does the diagnostic value of CSF biomarkers for Alzheimer’s change with age?

    <p>It decreases with age.</p> Signup and view all the answers

    What is the primary issue observed in the patient's speech?

    <p>Fluent speech but notable word-finding problems</p> Signup and view all the answers

    Which brain regions exhibit the most pronounced atrophy in the patient's MRI results?

    <p>Parietal lobe</p> Signup and view all the answers

    What aspect of cognitive function remains within the normal range for the patient?

    <p>Visuospatial functions</p> Signup and view all the answers

    What is a dominant symptom of the behavioural/dysexecutive variant of Alzheimer’s disease?

    <p>Apathy or disinhibition</p> Signup and view all the answers

    How is early-onset Alzheimer's disease different from typical Alzheimer's disease?

    <p>Symptoms may initially resemble other age-related issues</p> Signup and view all the answers

    Which of the following cognitive abilities is most likely impaired in the patient based on the neuropsychological test results?

    <p>Focused attention</p> Signup and view all the answers

    What kind of changes can be expected in a patient with the behavioural variant of frontotemporal dementia?

    <p>A wide range of behavioural changes like disinhibition</p> Signup and view all the answers

    What was the patient's MoCA score, indicating cognitive impairment?

    <p>19/30</p> Signup and view all the answers

    Study Notes

    Alzheimer's Disease

    • A neurodegenerative disease causing dementia, affecting about 70% of all dementia cases
    • Characterized by gradual, progressive memory loss, eventually affecting multiple cognitive domains
    • Leads to increasing interference with daily activities and development of neuropsychiatric symptoms like depression, apathy, and anxiety
    • In the final stage, complete cognitive loss occurs, requiring assisted living

    Diagnostic Criteria

    • Dementia is a clinical syndrome defined by significant cognitive decline interfering with independence in daily activities
    • Alzheimer's disease, a specific cause of dementia, is diagnosed based on the presence of Alzheimer's disease pathology in the brain
    • NIA-AA criteria provide guidelines for diagnosing Alzheimer's disease dementia with high, medium, or low probability

    Case: MCI

    • Mr. Campbell, 67 years old, presents with increasing forgetfulness, positive family history of Alzheimer's disease, and minimal interference with daily activities
    • His MoCA score is 26/30, with minor impairments in word recall and orientation in time
    • Neurofibrillary tangles are observed, a characteristic pathology of Alzheimer's disease
    • Based on his age, a possibility of a new syndrome, presenile dementia, was initially considered, but later recognized as Alzheimer's disease

    Aetiology and Neuropathology

    • Characterized by the deposition of amyloid-beta plaques and tau tangles, leading to neuronal degeneration and brain atrophy
    • The amyloid cascade hypothesis postulates amyloid-beta accumulation as the primary driver of Alzheimer's disease
    • Supported by research on APP gene mutations, leading to amyloid-beta overproduction and Alzheimer's disease development
    • FDG-PET scans reveal abnormalities in glucose metabolism, particularly in temporo-parietal regions, as an early indicator of Alzheimer's disease progression
    • Amyloid-beta and tau deposition can be visualized through PET scans, allowing in vivo detection of Alzheimer's disease pathology
    • CSF analysis can also determine amyloid-beta, tau, and P-tau concentrations to detect Alzheimer's disease pathology

    Atypical Variants:

    • Logopenic Primary Progressive Aphasia (lvPPA):
      • Starts with predominant language impairment, specifically difficulty finding words and completing sentences
      • MoCA score of 19/30, with impairments in naming, repeating sentences, and phonology
      • MRI shows symmetrical parietal atrophy, more pronounced left-sided frontal and temporal lobe atrophy

    The behavioural/dysexecutive variant

    • Presents with behavioural changes and impairments in executive function and social cognition as predominant symptoms
    • Behavioural changes range from disinhibition to apathy
    • Cortical atrophy is initially most pronounced in the frontal lobe regions
    • Clinical presentation resembles the behavioural variant of frontotemporal dementia, but underlying Alzheimer's pathophysiology is evidenced by PET and CSF biomarkers

    Early-onset Alzheimer’s disease

    • Alzheimer's disease, with memory impairment as the primary symptom, beginning before the age of 65
    • Can be a diagnostic challenge due to potential atypical presentation and initial symptom overlap with other age-related causes

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    Alzheimer's Disease Chapter 19 PDF

    Description

    This quiz explores Alzheimer's disease, its characteristics, and diagnostic criteria. It covers neurodegenerative aspects, cognitive impairment, and specific case studies such as mild cognitive impairment (MCI). Test your knowledge on this prevalent form of dementia.

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