What is the pathology of Alzheimer’s Disease (AD)?
Amyloid-β plaques (extracellular) + neurofibrillary tangles (intracellular tau). Neuron loss starting in hippocampus → spreads to cortex.
What are the clinical pearls of Alzheimer’s Disease (AD)?
Gradual onset, progressive decline (no stepwise drops). Early: short-term memory loss, disorientation. Late: language, visuospatial, executive, personality changes. No focal neuro deficits early.
What does MRI show in Alzheimer’s Disease (AD)?
Hippocampal and temporal lobe atrophy.
What is the treatment for Alzheimer’s Disease (AD)?
Cholinesterase inhibitors (donepezil, rivastigmine, galantamine); memantine for moderate-severe.
What is the pathology of Vascular Dementia (VaD)?
Multiple infarcts or small-vessel ischemia → cumulative brain injury.
What are the clinical pearls of Vascular Dementia (VaD)?
Stepwise decline (each vascular event worsens cognition). Often executive dysfunction > memory loss. Focal neuro findings: weakness, gait issues, pseudobulbar affect.
What does MRI show in Vascular Dementia (VaD)?
Multiple infarcts, white-matter changes (leukoaraiosis).
What are the risk factors for Vascular Dementia (VaD)?
HTN, DM, hyperlipidemia, smoking.
What is the treatment for Vascular Dementia (VaD)?
Prevent further strokes (BP, antiplatelet, statin).
What is the pathology of Lewy Body Dementia (LBD)?
α-synuclein (Lewy body) deposition in cortex + brainstem.
What is the core clinical triad of Lewy Body Dementia (LBD)?
Fluctuating cognition (good days/bad days), visual hallucinations (vivid, detailed), parkinsonism (rigidity, bradykinesia).
What are other clues for Lewy Body Dementia (LBD)?
REM sleep behavior disorder (acts out dreams). Extreme sensitivity to antipsychotics (esp. haloperidol).
What does MRI show in Lewy Body Dementia (LBD)?
Relative preservation of hippocampus.
What mnemonic can help remember Lewy Body Dementia (LBD)?
👁️ “Lewy = Look! (visual hallucinations).”
What is the pathology of Frontotemporal Dementia (FTD / Pick’s Disease)?
Frontal and temporal lobe atrophy, often tau or TDP-43 protein aggregates.
What are the subtypes of Frontotemporal Dementia (FTD)?
Behavioral variant (bvFTD): Early disinhibition, apathy, loss of empathy, compulsive behavior, poor judgment.
Language variants (Primary Progressive Aphasia):
Semantic type: loss of word meaning.
Nonfluent type: effortful speech, preserved comprehension.
What are the clinical pearls of Frontotemporal Dementia (FTD)?
Younger onset (40s–60s). Early personality or language change, memory preserved early. No hallucinations early.
What does MRI show in Frontotemporal Dementia (FTD)?
Frontotemporal atrophy.
What mnemonic can help remember Frontotemporal Dementia (FTD)?
💬 “Front = Personality; Temporal = Speech.”
What is the pathology of Parkinson’s Disease Dementia (PDD)?
Same α-synuclein Lewy body pathology as LBD, but sequence differs.
What is the Rule of 1 Year for Parkinson’s Disease Dementia (PDD)?
If Parkinson’s symptoms appear ≥1 year before dementia, → Parkinson’s Disease Dementia. If dementia and motor symptoms start within 1 year, → Lewy Body Dementia.
What are the clinical pearls of Parkinson’s Disease Dementia (PDD)?
Gradual decline in attention, visuospatial, executive function. Hallucinations possible, but less prominent early.
What is the treatment for Parkinson’s Disease Dementia (PDD)?
Optimize Parkinson’s meds carefully; cholinesterase inhibitors may help; avoid typical antipsychotics.
What mnemonic can help remember Parkinson’s Disease Dementia (PDD)?
🕺 “Parkinson first, dementia later.”
