by mtoom


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When are pathological changes in Alzheimer's disease present relative to symptoms?
Present at least 10 years before full onset of disease
What does mild cognitive impairment (MCI) mean?
Borderline impairment
  • Impaired memory compared with others of same age and education but who function well and don't fulfill criteria for dementia.
What would indicate probable Alzheimers?
Criteria for dementia met, insidious onset, clear-cut history of worsening
  • Initial presentation and cognitive deficits are:
    -Amnestic (only long-term memory intact)
    -Non-amnestic (language, visuospatial, executive dysfunction)
What happens to glucose utilization in Alzheimers?
It goes down
What would you see on a PET scan for an Alzheimer's patient?
  • Reduced glucose levels
  • Can also detect amyloid somehow
What markers are found in CSF in Alzheimer's disease?
  • Decreased Aβ42
  • Increased total and phosphorylated Tau
How is dementia staged?
  • Cognitive testing
  • Functional staging
How can dementia be prevented? (4)
  • Avoid head injuries
  • Eat well and exercise
  • Stay mentally active
  • Attention to vascular risk factors
What are non-drug treatments for dementia? (4)
  • Exercise
  • Diet
  • Socialization
  • Mentally stimulating activities 
What classes of drugs are acceptable treatment for Alzheimer's? (2)
  • Acetylcholinesterase inhibitors
    -donepezil
    -rivastigmine
    -galantamine 
  • NMDA receptor antagonists
    -memantine 
What are side effects of cholinesterase drugs?
  • NVD (Nausea, vomiting, diarrhea)
What are goals of drug treatment? (2)
  • Slow progression of disease
  • Possible short-term improvement
What is the major excitatory neurotransmitter in the CNS?
Glutamate
How can glutamate result in death of neurons?
Dysfunction of glutaminergic receptors (excitotoxicity, specifically) is involved in Alzheimer's disease

Increased extracellular glutamate can lead to excessive activation of NMDA receptors and intracellular Ca2+ accumulation
  • Memantine (NMDA receptor antagonist) is an uncompetitive antagonist
What has happened with attempts to produce Alzheimer's drugs?
  • Failed biologicals
  • Failed vaccine
  • Failed gamma-secretase inhibitor
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