Behavioral Science
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
114 Deja Review: <strong>Behavioral</strong> <strong>Science</strong><br />
What are the major risk factors for<br />
Alzheimer disease?<br />
On postmortem examination, what<br />
changes are normally seen in the<br />
brain of an Alzheimer disease patient?<br />
What areas of the brain show cell loss<br />
in Alzheimer disease?<br />
What class of medications is used<br />
to slow the progression of Alzheimer<br />
disease?<br />
Age, family history, Apo E4 allele, and<br />
Down syndrome<br />
Neurofibrillary tangles and senile<br />
(amyloid) plaques<br />
While there is also often global cortical<br />
atrophy, neuronal degeneration is<br />
classically in the cholinergic neurons<br />
of the nucleus basalis of Meynert.<br />
Cholinesterase inhibitors such as<br />
donepezil, rivastigmine, and<br />
galantamine may be used. Memantine<br />
(Namenda) is an NMDA (N-methyl-Daspartate)<br />
receptor antagonist that<br />
shows promise for slowing progression<br />
in AD.<br />
Table 15.1 Delirium vs Dementia<br />
Delirium<br />
Dementia<br />
Onset Develops quickly (hours to days) Develops over weeks<br />
to years<br />
Key feature Impaired attention and level of Impaired memory<br />
consciousness<br />
with normal level<br />
of consciousness<br />
Course Fluctuates within the course Usually stable within<br />
of a day with lucid periods<br />
a day<br />
Worsens at night<br />
May worsen at night<br />
(sundowning)<br />
Occurrence Most common in elderly and Increases with age<br />
young children<br />
Psychiatric Hallucinations and delusions Hallucinations and<br />
Symptoms may be present delusions may be<br />
present<br />
Physical Abnormal EEG Normal EEG<br />
findings Acute medical illness No acute medical<br />
illness<br />
Prognosis Symptoms tend to resolve with Usually progressive<br />
treatment of underlying cause
Change language