A 73 year old man is brought in by his wife with concerns about his worsening me

Question

A 73 year old man is brought in by his wife with concerns about his worsening memory. He is a retired engineer who has recently been getting lost in the neighborhood where he has lived for 30 years. He has been found wondering and has often been brought home by neighbors. When asked about this, he becomes upset and defensive and states that he was just trying to get some exercise. He has trouble dressing himself and blancing his checkbook. A physical examination is unremarkable, except that he scores 12 points out of 30 on the Mini Mental Status Examination, a test of cogntive function. A metabolic workup is normal. A computed tomography scan of the head shows generalized brain atrophy, though perhaps only what would be expected for his age. He is diagnosed with dementia, likely from Alzheimer's disease.

If a brain biopsy is done, what is likely to be found?

Where in the brain are the changes most prominent, and how does this explain the progression of symptoms. Please be specific.

What is the role of the amyloid peptide in Alzheimer's disease?

Explanation / Answer

Brain biopsy of dementia patients generally shows right frontal full thickness resection of cortex, leptomeninges of white matter and its overlying areas, corticobasal degeneration

Dementia is not a disease, it describes a wide range of symptoms that occur in brain.

Dementia with Lewy bodies occur due to microscopic deposits of proteins that form in cortex of brain

Parkinson’s dementia: develop due to Lewy bodies in brain

Frontotemporal dementia: It develops when neurons of frontal and parietal lobes are damaged

Creutzfeldt-Jakob disease: It is a dementia that results from prions in brain

Wernicke-Korsakoff syndrome: This type of dementia develops from deficiency of thiamine (vitamin B1). It generally occur sin long term heavy drinkers

The subunit of amyloid peptide is found to be the main component of amyloid plaques that are found as extracellular deposits in brains of Alzheimer’s disease. They cause cerebrovascular lesions which become neurotoxic. They compete with insulin for binding sites on the insulin receptor, and thus impair glucose metabolism in the brain.

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