Neuropsychology - Dementia Review

Alzheimer’s Disease causes

• neurofibrillary/ amyloid tangles and neuritic plaques

• Genetic- ApoE4 gene increases risk

• aluminum accumulation in brain

• antibodies that attack neurons in brain

• extreme reduction of cerebral blood flow/ glucose metabolism

Frontotemporal dementia cognitive

• profound executive dysfunction

• language deficits (progressive aphasia)

• preserved memory (mostly) in early stages

Lewy body Dementia cognitive symptoms

cognitive

• early fluctuation in attention and alertness

• hallucinations (visual)

• parkinsonism (slowness of movement and rigidity)

Vascular dementias Cognitive Symptoms

• stepwise or gradual decline

• prominent executive dysfunction

• slowed processing speed

• memory deficit (more retrieval)

• impaired attention and problem solving

Vascular dementias cognitive symptoms

• emotional liability (sudden mood changes)

• depression, apathy, lack of motivation

• urinary incontinence

• slow or shuffling gait

Vascular dementias key features

• abrupt onset or stepwise progression

• history of strokes increase risk

• hypotension and diabetes increase risk

• MRI shows multiple diffuse white matter changes

Vascular dementias neurological testing

• trail making test- assesses executive function and processing speed

• stroop test- measures cognitive flexibility

AD symptoms

• characterized by gradual impairment- memory loss before cognitive loss

• olfactory dysfunction is early sign- linked to plaques in neuropathways

• early episodic impairment

• progressive language decline, visuospatial abilities, executive function

• apathy, depression irritability

• later- delusions, agitation wandering

• trouble with complex discourse, okay with conversational

• loss of stored knowledge, object naming/distinguishing objects in a category

  Neurological testing

AD Neurological testing

• WAIS- intelliegense testing for object assembly, information recall, vocabulary, digit symbols and span, block design recall

• Montreal cognitive assessment- for early AD

• Rey auditory verbal learning test- for encoding and retrieval deficits

frontotemporal dementia behavioral

• disinhibition, impulsitivity, socially innapropriate behaviors

• apathy/ loss empathy

• hyperorality (excessive eating and putting objects in mouth

frontaltemporal dementia key features

• earlier onset (50s to 60s)

• severe personality changes before memory loss

frontotemporal dementia

• frontal assessment battery- for executive dysfunction

• verbal fluency tests- check for aphasia

• social cognition tests- check for defecits in emotional processing

Lewy body dementia behavioral symptoms

• REM sleep behavior disorder- acting on dreams

• autonomic dysfunction (hypotension/ low blood pressure and constipation)

• depression and anxiety

Lewy body dementia key features

• cognitive symptoms appear before or within 1 year of parkinsonism

Lewy body dementia

• moCA- detects early cognitive defecits

• digit span- measures attention fluctuations

• Rey osteirrith complex figure test- visuospatial defecits