Call Girl Number in Panvel Mumbai📲 9833363713 💞 Full Night Enjoy
Understaing memory alziemer diseasepptx
1. Am I having dementia? Can I
prevent it?
Current understanding of
Alzheimer’s disease
DR. RUCHIR DIVATIA, M.D.,D.M. – NEUROLOGY (SCTIMST, TRIVANDRUM)
DEPARTMENT OF NEUROLOGY, K.D. HOSPITAL
2. We are who we are because of
what we learn and what we
remember
Eric Kandel (Famous neurobiologist)
6. How to recognise problems with higher
cognitive functions?
Cognitive domain Problems encountered
Executive Mislead by false advertisements, difficulty planning outing, function, maintaining
bank balance
Attention Forgetting everyday actions, difficulty concentrating, following plot of movie,
maintaining train of thought, recalling why they entered a room
Memory Forgets recent conversations/events, making repetitive statements, using lists,
misplace objects
Language Reduced vocabulary, word finding difficulty, using incorrect words, difficulty
following instructions
Praxis Difficulty with manual skills, clumsiness, inability to dress
Visuospatial Difficulty finding places, objects directly in front, inability to recognise familiar faces,
bumping into walls, poor driving
7. What are the types of memory?
A. Declarative/Explicit (Consciously evoked)
1. Episodic (Ability to store & retrieve past episode & experiences)
2. Semantic (General knowledge of people, objects, words, concepts)
B. Non declarative/Implicit (memories that do not need conscious
involvement)
1. Procedural memory – motor skills
C. Working memory – Ability to keep information trace active on the
brain for short period (executive function)
11. What is mild cognitive impairment?
• Transition state between normal cognition in older adult and
dementia
1. Is the cognitive symptom clearly a decline from patient’s previous
cognitive level?
2. Is the cognitive symptoms consistent?
3. Does the symptom have a clear effect on the patient’s day-to-day
function?
4. Does the patient show clear evidence of impairment on cognitive
assessment?
NORMAL COGNITION ↔ MILD COGNITIVE IMPAIRMENT → DEMENTIA
13. When to suspect a reversible cause of dementia?
• DEPRESSION SHOULD ALWAYS BE EXCLUDED FIRST
• Rapid unexplained decline
• Younger than expected age at symptom onset
• Prominent fluctuations
• High risk exposures (Drugs, alcohol)
• High risk behaviours
• Unexplained/Unanticipated findings on examination
• Incongruent cognitive testing
22. Sleep disorders ↔ Alzheimer’s Disease
• Advanced AD → Changes in suprachiasmatic nucleus→ Irregular sleep
wake cycle
• Shorter (≤5 hours) & Longer(≥10 hours) sleep duration → Increased
inflammatory markers (CRP, IL-6)→ Impaired cognitive function
• ↑Aβ deposition, ↓ Aβ Clearence (improved by lateral decubitus in
mice model)
• ↑ Biomarkers of cellular ageing (contributes to biological ageing)
23.
24. Temporal lobe epilepsy ↔ Mild Cognitive
Impairment
• Late onset TLE (LO-TLE) had similar pattern and magnitude of atrophy
as MCI
• LO-TLE & MCI – significant memory & language impairment
• LO-TLE – More consistent cortical thinning than Early onset TLE
• Histopathology in TLE – Aβ precursor protein & tau
• Aβ tied to epileptiform activity
• Silent seizures in subset of patients with AD
25. Leisure activity & risk of Dementia
Type of leisure activity Example Role in dementia prevention
Stimulating activity Doing crosswords, Playing cards,
Attending organizations, Practising
artistic activities
50% reduction in risk
Social support activity Visiting/inviting friends, relatives ↓ in low education, vascular
cognitive impairment
Physical leisure activity Doing odd jobs, Gardening, Walk
Passive leisure activity Watching TV/Mobile, listening to
radio/music, Knitting/sewing
Don’t contribute to Cognitive
reserve as stimulating activities
Association of each leisure activity in 1997–1999 with subsequent incident dementia CI = confidence interval; HES = hospital episode statistics; HR = hazard ratio.
