The risk of developing late-onset Alzheimer’s dementia in first-degree relatives of patients with late-onset Alzheimer’s dementia compared with controls is:
B. An actual predicted risk of developing Alzheimer’s disease in first-degree relatives of probands with Alzheimer’s disease is 15–19%, compared with 5% in controls. Thus, the risk to first-degree relatives of patients with Alzheimer’s disease who developed the disorder at any time up to the age of 85 years is increased to 3–4 times relative to the risk in controls.This would seem to translate to a risk of developing Alzheimer’s disease of between one in fi ve and one in six.
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In CJD pathological study of brain tissue shows spongiosis with neuronal loss, gliosis, and amyloid plaques. These amyloid plaques contain:
C. The core neuropathology of CJD is characterized by spongiform change, neuronal loss, astrocytosis, and amyloid plaque formation. The amyloid plaques in CJD are generally made of insoluble prion proteins. In addition, abnormal neuritic dendrites with white matter necrosis and beta protein amyloid angiopathy may also be seen.
Pulvinar sign is a MRI finding in which of the following conditions?
B. vCJD causes rapidly progressive dementia, often leading to death in relatively young patients. Symmetrical hyperintensity in the posterior nuclei of the thalamus, called the pulvinar sign, is seen on brain MRI images of most patients with vCJD. This is described as a specific, noninvasive, and highly accurate diagnostic sign of vCJD; FLAIR (fluid-attenuated inversion recovery) sequences are more sensitive than T1 weighted, T2 weighted or proton density MRI. The pulvinar sign is reported to have a sensitivity of 78% and specificity of 100%. The pulvinar sign has been so far demonstrated only in symptomatic patients; its validity as a screening test in presymptomatic patients is unclear.
The most prevalent neurotic disorder among elderly people above the age of 65 is:
A. Phobic disorders are the most common neurotic conditions noted in epidemiological studies of elderly people. Despite great variations in the reported rates of all neurotic disorders in elderly people, the overall prevalence of neurotic disorders is thought to vary between 2.5% and 14.2% of the population aged 65 years or older. The reported prevalence of phobic disorders varies enormously from 1.4% to 25.6% in various studies due to differences in the instruments used, and variable application of hierarchical case ascertainment rules when dealing with agoraphobia. More recently, a longitudinal population study from Europe reported current prevalence rates of 14.2% for anxiety disorders as a whole, 10.7% for phobia, 4.6% for generalized anxiety disorder, 3% for major depression, and 1.7% for psychosis in elderly people.
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Suicide is a significant risk when treating elderly patients with mental health problems.
Compared with suicides in younger adults, older patients who kill themselves are:
A. Older patients who commit suicide are more likely to suffer from depressive illness but are less likely to be known to mental health services or to have been treated for depression than younger adults who kill themselves. It is also known that older people are more likely to enter into suicide pacts. In older people, male suicide rates are higher than female suicides. It is generally accepted that the conversion rate of suicidal thoughts to acts is higher in older patients.
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