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The Ageing Brain and Risk of Dementia - Coggle Diagram
The Ageing Brain and Risk of Dementia
Mini Mental State Examination
Advantages
Relatively quick and easy to perform.
Requires no additional equipment
Can provide a method of monitoring deterioration over time.
Disadvantages
Biased against people with poor education due to elements of language and mathematical testing.
Bias against visually impaired.
Limited examination of visuospatial cognitive ability.
Poor sensitivity at detected mild/early dementia.
Diagnosing Alzheimer's Disease
Blood test for other conditions
Liver and kidney function
Hemoglobin Ac1 (diabetes)
Vitamin (B12) and mineral (folate) levels
Dementia Brain Scan
MRI
- shrinkage of specific regions, i.e., frontal, and temporal lobes.
CT Scan
- turmoil or stroke (not used for structural information).
Probable Alzheimer's Disease as a Diagnosis
Information informs us of the presence of Dementia or a form of cognitive impairment.
This is typically diagnosed as
probable Alzheimer's disease
Until more recently, post-mortem brain examinations were the only way to confirm the diagnosis.
Specific
biological markers
(biomarkers) are being developed to provide an earlier diagnosis.
Biomarkers in Diagnosis
Biomarkers allow measurement of what is happening inside the living body.
Specific biomarkers do not rely on the symptoms of diagnosis (i.e., memory loss)
Positron emission tomography
- radioactive tracers to measure glucose, amyloid-beta and Tau accumulation.
Cerebrospinal fluid
- lumbar function to measure protein concentrations, low AB1-42, high phosphorylated Tau, and high NG-L
Genetic screening
- APOE alleles, family history, and rare genetic mutations.
Pathological hallmarks of AD
Amyloid- β accumulation
Neurofibrillary tangles
Neurodegeneration
Synapse degeneration
Familial AD
Early onset from the age of 35
Aggressive pathogenesis
Autosomal dominant
PSEN1, PSEN 2, and APP mutations
Not teh same as genetic risk factor.
Low PA and Sedentary Lifestyle are MAJOR Risk Factors for AD
(Tan et al., 2017)
Framingham heart study (running since 1948) assessed every 4-8 years routinely.
Participants who were dementia free, at least 60 years at baseline were included.
n = 3,714; 54% women; mean age = 70 ± 7 years
Participants were followed up for incidence of dementia and AD for 10 years.
Hazard ratio = 1.50, 95% confidence interval = 1.12 – 2.01, p = .006.
Appears to be a threshold for PA and dementia risk.
Low PA and Sedentary Lifestyle are MAJOR Risk Factors for AD
(Yan et al., 2020)
Meta-analysis of 18 cohort studies involving over 250,000 participants.
The pooled
RR
of dementia for SB was 1.30, with substantial heterogeneity across studies (p = .000, l = 66.99%
30% increased risk of dementia in sedentary populations
, irrespective of age, sex, education level or ethnicity.