Memory & Aging + Transplant Psychiatry

What is the Papez circuit?

A neural circuit involved in the regulation of emotional expression and memory, including structures like the hippocampus and cingulate gyrus.

What role does the hippocampus play in memory?

It helps to consolidate information as it comes in, and damage to it can result in memory loss or amnesia.

What are common structural changes in the brain due to normal aging?

Mild brain volume reduction, particularly in the frontal lobes and hippocampus, and ventricular enlargement.

What neurochemical changes are expected with aging?

Reduced dopamine receptors, decreased synaptic density, and changes in neurotransmitter systems.

How does aging affect working memory?

There is a reduced capacity and it becomes harder to multitask.

What is the difference between normal aging and pathological change in cognition?

Normal aging involves subtle, non-progressive changes, while pathological changes, like dementia, involve measurable cognitive decline.

What is Alzheimer's disease characterized by?

Key pathologies include amyloid-B plaques, tau neurofibrillary tangles, neuronal loss, and brain atrophy.

What is the most common cause of dementia?

Alzheimer's disease, accounting for 60-80% of dementia cases.

What are the stages of cognitive impairment in Alzheimer's disease?

Stages range from asymptomatic with biomarker evidence to severe functional impairment requiring assistance.

What is Limbic-Predominant Age-Related TDP-43 Encephalopathy (LATE)?

A condition characterized by significant hippocampal atrophy and associated with cognitive decline, primarily affecting those over 80.

What is the role of the basal forebrain in memory?

It provides cholinergic input that modulates activity in the hippocampus and is important for memory retrieval.

What are some preserved cognitive abilities in aging?

Vocabulary, general knowledge, procedural memory, and recognition memory.

What is the significance of subjective cognitive decline?

It can be an early warning sign of dementia, especially if concerns are recent and progressive.

What are common diseases associated with memory change?

Alzheimer's disease, vascular dementia, Lewy body dementia, frontotemporal dementia, and mixed dementia.

What is the expected prevalence of Alzheimer's disease in older adults?

Approximately 32% of people over 85 have Alzheimer's disease, with prevalence doubling every 5 years after age 65.

What are the key components of a multi-disciplinary approach to diagnosing cognitive changes?

Includes observation of cognitive changes, primary care evaluation, lab work, brain imaging, and neuropsychological assessment.

What is the impact of medications on cognitive function?

Certain medications, like anticholinergics and benzodiazepines, can mimic or exacerbate memory disturbances.

What are the characteristics of vascular cognitive impairment (VCI)?

Cognitive impairment associated with vascular changes, such as those caused by strokes.

What is the role of the amygdala in memory?

Heavily involved in emotional memory processing and the formation of memories associated with emotional events.

What is the importance of the entorhinal cortex?

It serves as a major input to the hippocampus and is crucial for memory formation.

What are common symptoms of mild cognitive impairment?

Includes mild difficulty with recall, reduced multitasking ability, and increased distractibility.

What is the expected change in processing speed with aging?

Processing speed typically slows down, making it take longer to learn new information.

What are the activities of daily living (ADLs) affected by dementia?

Includes tasks like brushing teeth, taking a shower, and picking out clothes.

What is the clinical significance of biomarkers in Alzheimer's disease?

Biomarkers like hippocampal size and cerebrospinal fluid composition help in staging the disease and assessing progression.

What is the typical progression pattern of Alzheimer's disease?

Progression typically starts in the temporal lobes and moves to frontal, parietal, and occipital lobes.