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Neuropsychology Exam 3
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Neuropsychology Exam 3Lecture 1: The Cortical Dementias - ANS:)
Cognition and Aging - ANS-Cognitive abilities develop through young adulthood and reach a peak in 3rd
or 4th decade of life
-Relative stability through 5th and 6th decade, some decline in the 7th
-Declines found in processing speed, focusing attention, mental flexibility, and learning efficiency.
Age-Associated Memory Impairment (AAMI) - ANS-Patient is 50 years old
-Has noticed a decline in memory performance
-The patient performs below "normal" levels on a standard memory test
-All other obvious causes of memory decline other than aging have been ruled out
Mild Cognitive Impairment (MCI) - ANS-Memory complaint by informant
-Objective memory impairment
-Normal general cognitive function
-Intact activities of daily living
-Not demented
What is Dementia? - ANS-An acquired disorder of behavior and cognition that affects customary
activities of daily living
-Many different disorders cause dementia
Reversible vs. Irreversible - ANS-Reversible: B12 deficiency
-Irreversible: Alzheimer's disease
Cortical vs. Subcortical vs. Mixed - ANS-Cortical: Alzheimer's disease
-Subcortical: Multiple sclerosis
-Mixed: Dementia with Lewy bodies
,Cortical Dementias in the Elderly - ANS-Alzheimer's Disease (~70%)
-Dementia with Lewy bodies (~10%)
-Pick's Disease/Fronto-temporal dementia (~10%)
-Focal atrophy w/out distinctive histology (~10%)
Criteria for Alzheimer's Dementia - ANS-Development of multiple cognitive deficits manifested by both
memory impairment and one or more of the following cognitive disturbances: aphasia, apraxia, agnosia,
executive functioning.
-Significant social or occupational
impairment
-Gradual onset and continuing cognitive decline
-Not due to other CNS conditions
Top 10 Alzheimer Warning Signs - ANS1. Recent memory loss affecting job
2. Difficulty performing familiar tasks
3. Problems with language
4. Disorientation to time or place
5. Poor or decreased judgment
6. Problems with abstract thinking
7. Misplacing things
8. Changes in mood or behavior
9. Changes in personality
10. Loss of initiative
Plaques and Tangles - ANS-Precursor molecules is abnormally cleaved beginning a cascade of reactions
resulting in plaques and tangles leading to decreased Ach in "memory centers."
-Plaques most prevalent in temporal and posterior association cortex
-Primary sensory cortex largely spared
-Eventually, plaques distributed in frontal cortex.
, Early Cognitive Impairments are not Global - ANS-Memory deficits prominent early
-Many present with other symptoms like language, mood, visuospatial, and executive abilities
-Eventually, most AD patients follow a common pathway
-AD changes brain structure
Diagnostic Criteria for Dementia with Lewy Bodies (DLB) - ANS-Dementia may have less prominent
memory impairment on onset.
-Cognitive deficits in attention, frontal-subcortical skills, and visuospatial abilities
-Fluctuation of cognition
-Hallucinations
-Spontaneous parkinsonism
Other Features of DLB - ANS-Repeated falls
-Syncope
-Delusions
-Sensitivity to neuroleptics
Pathological Hallmarks of DLB - ANS-Cortical Lewy bodies
-Beta amyloid plaques
-Neurofibrillary tangles
-Neuronal and synaptic loss
Pick's Disease and Fronto-temporal Dementia - ANS-aka "Frontal lobe dementia"
-Heterogeneous disorders with similar, but distinguishable behavior profiles
-Mainly temporal lobes affected
Presentation of Frontal
Dementias - ANS-Both present with a "Frontal Syndrome":
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