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1. Which of the following is NOT an accurate statement about this disease?
A. AD is an irreversible, progressive brain disease that slowly destroys memory and thinking skills, eventually even the ability to carry out the simplest tasks
B. In the majority of people with AD, symptoms first appear after age 65
C. AD is caused by a disease that affects the brain, and in the absence of disease, the human brain often can function well into the 10th decade of life
D. AD is the most common cause of dementia among older people, and it presents a major problem for our health care system and society as a whole
2. Our aging society makes Alzheimer’s an especially critical issue, and recent estimates of how many people in the United States currently have AD range from _____________________ depending on how AD is measured.
A. 3.5 million to 5.8 million
B. 4.2 million to 6.1 million
C. 1.7 million to 3.6 million
D. 2.4 million to 4.5 million
3. For a neurodegenerative disease like AD the number of people with the disease triples for every 5-year age interval beyond age 65.
4. Since 1906 a great deal about Alzheimer’s Disease has been learned, as accurately demonstrated by which of the following:
A. In the 1950s, scientists discover a link between dementia and the number of plaques present in the brain, and AD is recognized as a distinct disease, not a normal part of aging
B. In the 1970s, scientists find that levels of dopamine, a neurotransmitter important in memory formation, falls sharply in people with Alzheimer’s, and this discovery is one of the first to link AD with biochemical changes in the brain
C. Diagnostic criteria for AD are established and genetic links to early-onset AD begin to surface in the 1980’s
D. In the 1990’s, the U.S. Food and Drug Administration (FDA) approves rivastigmine (Exelon) as the first drug used to treat AD and begins to use memory and cognitive tests, structured interviews, and other technologies to identify people at high risk of AD
5. Which of the following is an accurate statement about the structure and function of the brain?
A. The brain is made of nerve cells called neurons and an enormous network of blood vessels, and it receives 20 percent of the body’s blood supply
B. Two cerebral hemispheres account for 75 percent of the brain’s weight, and the left hemisphere appears to focus on details, while the right focuses on broad background
C. The frontal lobe of the brain deals with the perception and integration of stimuli from the senses, while the parietal lobe controls activities like thinking, organizing, planning, and problem solving, as well as memory, attention, and movement
D. The hypothalamus, located at the top of the brain stem, receives sensory and limbic information, while the thalamus monitors activities such as body temperature and food intake
6. Groups of neurons in the brain have special jobs including being involved with thinking, learning, and memory, receiving information from the sensory organs, and:
A. Processing and remembering strong emotions such as fear
B. Controlling our heart rate, blood pressure, and breathing
C. Communicating with muscles, stimulating them into action
D. None of the above
7. Each of the following represents an accurate statement about the healthy aging process of the brain EXCEPT:
A. Certain parts of the brain shrink, especially the prefrontal cortex and the hippocampus
B. Changes in neurons and neurotransmitters affect communication between neurons, and in certain brain regions, communication between neurons can be reduced because gray matter is degraded or lost
C. Changes in the brain’s blood vessels occur, and blood flow can be reduced because arteries narrow and less growth of new capillaries occurs
D. Inflammation, which is the complex process that occurs when the body responds to an injury, disease, or abnormal situation, increases
8. Some people remain cognitively healthy as they get older while others develop cognitive impairment or dementia, perhaps because the healthier adults have a greater amount of “cognitive reserve".
9. The brains of people with AD have an abundance of two abnormal structures which are:
A. Glial cells and temporal bundles
B. Myelin vesicules and beta receptors
C. Amyloid plaques and neurofibrillary tangles
D. None of the above
10. The AD process not only inhibits communication between neurons but can also damage neurons to the point that they cannot function properly and eventually die.
11. Several other factors besides age affect how long a person will live with AD, and these include all of the following EXCEPT:
A. The person’s sex
B. The presence of other health problems
C. The severity of cognitive problems at diagnosis
D. The level of dementia prior to AD diagnosis
12. About _____ percent who fit the definition of amnestic MCI go on to develop AD within 7 years, while only _____ percent of people older than 65 who have normal cognition will develop AD in any one year .
A. 90; 5 to 7
B. 85; 9 to 11
C. 80; 1 to 3
D. 75; 3 to 5
13. Researchers found that older adults with mild cognitive impairment had more movement difficulties than the cognitively healthy participants but less than those with AD.
14. Signs of mild AD can include confusion about the location of familiar places, trouble handling money and paying bills, poor judgment leading to bad decisions, and:
A. Shortened attention span
B. Inappropriate outbursts of anger
C. Difficulty organizing thoughts and thinking logically
D. Loss of spontaneity and sense of initiative
15. Hallucinations, delusions, suspiciousness or paranoia, irritability, and loss of impulse control usually occur during the advanced stage of Alzheimer’s Disease.
16. In the final stages of Alzheimer’s Disease, people cannot recognize family and loved ones or communicate in any way, and they are completely dependent on others for care.
17. When comparing a healthy brain to the brain of a patient with severe Alzheimer’s, which of the following is NOT a characteristic of the brain of a patient with severe AD?
A. Extreme shrinkage of the cerebral cortex
B. Severely enlarged ventricles
C. Extreme shrinkage of the hippocampus
D. Extreme enlargement of the entrohinal cortex
18. In 1998, Northwestern University’s Cognitive Neurology and Alzheimer’s Disease Center began a buddy program to match first-year medical students with people diagnosed with AD or another form of dementia.
19. Genetic studies of complex neurodegenerative diseases such as AD have shown that early onset AD tends to run in families, and children have about a 30 percent chance of developing the disease if one of their parents has it.
20. Neurodegenerative diseases like AD, Parkinson’s Disease, Amyotrophic Lateral Sclerosis (ALS), and dementia share clinical characteristics including difficulty moving, sleep-wake disorders, delusions and:
A. Repetitive motions and muscle twitches
B. Psychiatric disturbances and memory loss
C. Restlessness and agitation
D. All of the above
21. Insights about the cause of AD come from the most basic of all risk factors—aging itself . Each of the following is an accurate statement about the aging process EXCEPT:
A. Cells and compounds that are known to be involved in age-related inflammation are found in AD plaques, so some researchers think that components of the inflammatory process may play a role in AD
B. The brain’s unique characteristics, including its high rate of metabolism and its long-lived cells, may make it especially vulnerable to oxidative damage over the lifespan, and may contribute to AD
C. Age-related reductions in levels of particular growth factors, such as tissue growth factor and vascular endotheial factor, also may cause important cell populations to be compromised and may effect the development of AD
D. Age-related changes in the working ability of synapses in certain areas of the brain may reduce the ability of neurons to communicate with each other, leading to increased neuronal vulnerability in regions of the brain important in AD
22. AD vascular research has studied a constellation of factors that may be related to an increased risk of cognitive impairment and accelerated cognitive decline. This group of factors is known as:
A. Metabolic syndrome
B. Anabolic disorder
C. Glycogen resistance syndrome
D. None of the above
23. A growing body of evidence now suggests that various lifestyle factors may be related to cognitive decline and Alzheimer’s Disease. Which of the following is an accurate statement about these factors?
A. Clinical trials show some evidence of short-term positive effects of exercise on cognitive function, especially reasoning functions
B. One study showed that old dogs perform better on learning tasks when they eat diets high in DHA, a type of healthy omega-3 fatty acid found in fish
C. One study evaluated older people who were involved in significant information processing activities such as listening to the radio, reading newspapers, playing puzzle games, and going to museums, and showed that the risk of developing AD was 37 percent lower in the people who participated most frequently compared with the people who did the activities least frequently
D. Studies indicate that older adults who have a full social network and participate in many social activities tend to have less cognitive decline and a decreased risk of dementia than those who are not socially engaged
24. The drugs now available to treat AD can help some people maintain their mental abilities for months to years, as well as changing the underlying course of the disease.
25. Which of the following is NOT one of the causes of dementia?
A. Frontoparietal lobar degeneration
B. Certain tumors or infections of the brain
C. Metabolic imbalances
D. Chronic alcoholism
26. Four medications have been approved by the FDA for use in treating AD symptoms. These drugs maintain abilities to carry out activities of daily living and:
A. Help to maintain higher levels of dopamine in the brain, which tend to fall sharply in people with AD
B. May help individuals maintain some thinking, memory, or speaking skills, and can help with certain behavioral symptoms
C. Prove to be effective for several years
D. All of the above
27. Between ________ percent of people with AD eventually develop one or more behavioral symptoms including sleeplessness, wandering and pacing, aggression, agitation, anger, depression, and hallucinations and delusions.
A. 75 and 95
B. 65 and 85
C. 60 and 80
D. 70 and 90
28. Rapid advances in our knowledge about AD have led to the development of many promising new drugs and treatment strategies.
29. The main goals of Phase I drug trials are to establish the highest dose of a new drug that people can tolerate and to define the dose at which people may begin to experience harmful side effects, while studies that compare an experimental treatment with a placebo or standard treatment to determine safety and efficacy occur in Phase II.
30. One of the greatest costs of AD can be the physical and emotional toll on family members, caregivers, and friends of people with the disease.
31. Each of the following is an accurate statement about helping caregivers EXCEPT:
A. The information and problem-solving needs of caregivers evolve over time as AD progresses, so support programs should be tailored to the needs of the caregiver at various stages of caregiving
B. Traditions and attitudes about caregiving vary across cultural groups, as demonstrated by research that indicates that Hispanic and Asian Americans use fewer formal in-home services than other ethnicities, so programs and services for caregivers must be culturally appropriate and sensitive
C. Use of multiple types of support over an extended period of time has helped caregivers feel more confident in working with their loved ones, improved their caregiving ability, improved the care recipient’s life, and helped them keep their loved one at home
D. It is very helpful if caregivers are taught how to read the emotional and physical cues of the person with AD, learn to understand the sequence of events that often leads to inappropriate behaviors, and know how to respond to the needs of the person with AD in a variety of creative ways
32. One clinical trial tested the effects of an enhanced counseling and support program on nursing home placement and caregiver health. Participants in the program were able to delay placement of their loved ones in nursing homes by about ____ months.
33. AD support groups provide a place where caregivers can seek respite, express concerns, share experiences, get tips, and receive emotional comfort.
34. Apolipoprotein E is a protein that carries cholesterol in blood and that appears to play some role in brain function and in the development of Alzheimer’s Disease.
35. An imaging technique using radioisotopes that allows researchers to observe and measure activity in different parts of the brain is known as:
A. Functional magnetic resonance imaging
B. Positron emission tomography
D. Single photon emission computed tomography
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