Module 4 Part 1: Introduction

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Do curso por University of California, San Francisco

Introdução à Neurologia Clínica

404 classificações

University of California, San Francisco

Introdução à Neurologia Clínica

404 classificações

An overview of the relevant aspects of the epidemiology, clinical presentation, basic disease mechanisms, diagnostic approaches and treatment options of the most common neurological diseases.

Na lição

Epilepsy & Neurodegenerative Diseases

The description goes here

Module 4 Part 1: Introduction4:19

Module 4 Part 2: Epidemiology4:28

Module 4 Part 3: Pathophysiology, Neurodegenerative Diseases & Dementia3:49

Module 4 Part 4: Clinical Presentation, Neurodegenerative Diseases & Dementia24:35

Conheça os instrutores

Daniel Lowenstein, MD
Professor and Vice Chair, Department of Neurology
School of Medicine
S. Andrew Josephson, MD
Associate Professor
School of Medicine
Wade Smith, MD
Professor
School of Medicine

[BLANK_AUDIO]

Today's topic is going to be dementia.

Dementia is one of the most important public

health topics that we deal with and is

an interesting mix of important pathophysiology and frontiers

to new treatments that are currently being developed.

It really sits at the heart of what we do in neuroscience.

Once again, here are my titles and no conflicts of interest.

The learning objectives

for this session are the following.

Learn how to define dementia and name its most common etiologies.

Be able to name the most common

neurodegenerative conditions and describe their clinical presentation.

Discuss current treatments for dementia.

And then finally detail some reversible causes

of cognitive impairment that should be recognized.

So dementia is defined as a decline in cognitive

function that impairs the ability to perform activities of daily living.

Activities of daily living would include bathing, dressing, being

able to care for your finances, cooking, et cetera.

Now, when we think of dementia we think of it as a chronic problem.

Obviously, I could give somebody a drug that would impair their

ability to perform activities of daily living for a few hours,

for instance if somebody had general anesthesia,

but we're talking about a chronic condition.

Now any of the cognitive domains can be involved, and we'll

talk about what those are, but memory is the most common.

The most common dementia illnesses lead to memory being impaired.

And while most commonly it is neurodegenerative

conditions that are the cause of dementia.

Sometimes to dementia

can be caused by easily reversible etiologies

and we'll focus on these because it's important

for a physician to be able to

identify these reversible etiologies and treat them rapidly.

Now there's a couple other terms to define.

One of which is mild cognitive impairment.

Mild cognitive impairment or MCI is a diagnosis that you can think of

to some extent, as a milder form of dementia.

It exists when a measurable clinical problem exists.

But it does not lead to problems with activities of daily living.

Now some of these patients will progress over time to develop dementia.

For instance, in some cases this is a pre-stage to dementia and it will worsen.

In other instances, mild cognitive impairment

will remain stable.

Or, if caused by a reversible etiology,

mild cognitive impairment may then return to normal.

But MCI or mild cognitive impairment is an important term to be familiar with.

Let's contrast that with normal aging.

So, what does it mean to just normally get older?

What should the cognitive changes that we expect.

Well, subtle slowing or decline in memory skills or

in cognitive speed is really common in elderly populations.

And doesn't necessarily represent a pathologic condition.

However, the difference between this condition, slowing problems with

memory and older age and MCI or dementia remains somewhat difficult to

define, even among experts and has been an important focus of research in this area

in the past few decades.

Interestingly, as you'll hear about there are new techniques

that visualize dementia or neurodegenerative

pathology during a patient's lifetime.

And as we're able to see their, these changes

during a lifetime, rather than just being able to

see them at the time of death, we've learned

that some patients who have just mild changes as

they get older, actually have underlying neurodegenerative

conditions that are in the ultra early stages.

So we continue to work to define what is normal

aging, and what are the earliest stages of these neurodegenerative conditions.

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