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Dementia: Progressive global decline in cognitive function- Conscience…
Dementia: Progressive global decline in cognitive function- Conscience clear
Dementia w/ lewy bodies.
1) Parkinsonism
2) Hallucinations
Associated with Parkinson's
3) Disease fluctuates
Pathophys: Lewy bodies, ubiquitin and α-synuclein
Can use levodopa, may exacerbate psychotic symptoms
Vascular Dementia (15%)
1) Following stroke
2) Multi-infarct dementia following multiple stroke
Pathophys: Infarcts of small and medium vessels.
3) Binswanger disease following infarcts.
RF: CADASIL
Amnesia, self care, personality changes
Treat HT, diabetes, aspirin.
Alzheimer's (50%)
5 As: Agnosia, amnesia, aphasia, apraxia, associated (personality, behavioural, thought changes).
Pathophys: B-amyloid plaques (Due to precursor protein) deposited in/on neurones- neuritic plaques -> Inflammation, Acetylcholine, Neurofibrillary Tangles (From hyperphosphorylated Tau protein).
RF: APP , hypothyroidism, FH, head trauma.
Meds
Donepezil: AChase inhibitor
Rivastigmine: AChase inhibitor
Memantine- Blocks NMDA inhibiting glutamate
Amyloid protein normally protects vs Ca2+ influx and glutamate excito-toxicity. Abnormal AP= cell damage