Dementia Training Certification Dementia Training Understanding Cognitive Decline & Its Stages 3 — Questions and Answers
Question 1: Which neurotransmitter is most significantly reduced in Alzheimer's disease, contributing to cognitive symptoms?
- Acetylcholine (Correct answer)
- Dopamine
- Serotonin
- Norepinephrine
Correct answer: Acetylcholine
Degeneration of cholinergic neurons reduces acetylcholine levels in Alzheimer's, which is why cholinesterase inhibitors are a primary pharmacological treatment.
Question 2: In vascular dementia, cognitive decline is primarily caused by:
- Reduced blood flow to brain regions due to cerebrovascular disease (Correct answer)
- Accumulation of amyloid plaques in the cortex
- Loss of dopaminergic neurons in the substantia nigra
- Progressive neuronal loss in the frontal lobes due to TDP-43 protein
Correct answer: Reduced blood flow to brain regions due to cerebrovascular disease
Vascular dementia results from strokes or chronic reduced cerebral blood flow that kills brain tissue, producing stepwise or sudden cognitive decline.
Question 3: What does the term 'sundowning' refer to in dementia care?
- Increased confusion, agitation, and behavioral symptoms that worsen in the late afternoon or evening (Correct answer)
- Gradual functional decline that accelerates as a person ages
- Sleep disturbances that occur exclusively at sunrise
- Memory loss that is more pronounced during morning hours
Correct answer: Increased confusion, agitation, and behavioral symptoms that worsen in the late afternoon or evening
Sundowning describes worsening neuropsychiatric symptoms—confusion, restlessness, agitation—that typically emerge or intensify in the late afternoon and evening.
Question 4: A patient scores 17/30 on the MMSE. Which range best categorizes this score?
- Moderate cognitive impairment (Correct answer)
- Mild cognitive impairment
- Severe cognitive impairment
- Normal cognition
Correct answer: Moderate cognitive impairment
MMSE scores of 10–20 indicate moderate cognitive impairment; the patient scoring 17 falls within this range requiring assistance with many daily activities.
Question 5: Which pathological hallmarks are most closely associated with Alzheimer's disease on autopsy?
- Amyloid plaques and neurofibrillary tangles (Correct answer)
- Lewy bodies and alpha-synuclein deposits
- TDP-43 inclusions and frontotemporal atrophy
- Prion proteins and spongiform encephalopathy
Correct answer: Amyloid plaques and neurofibrillary tangles
Alzheimer's is defined pathologically by extracellular beta-amyloid plaques and intracellular neurofibrillary tangles made of hyperphosphorylated tau protein.
Question 6: Frontotemporal dementia (FTD) most commonly presents first with changes in:
- Personality, behavior, and social conduct (Correct answer)
- Visuospatial skills and navigation
- Short-term episodic memory
- Motor coordination and balance
Correct answer: Personality, behavior, and social conduct
FTD primarily affects the frontal and temporal lobes, so the earliest signs are often personality changes, disinhibition, apathy, or loss of social awareness rather than memory loss.
Question 7: When a person with dementia is unable to recognize their own reflection in a mirror, this is an example of:
- Agnosia (Correct answer)
- Apraxia
- Aphasia
- Anosognosia
Correct answer: Agnosia
Agnosia is the loss of ability to recognize familiar objects, faces, or stimuli, which can include failure to recognize one's own reflection.
Dementia Training Certification Dementia Training Understanding Cognitive Decline & Its Stages 3
Which neurotransmitter is most significantly reduced in Alzheimer's disease, contributing to cognitive symptoms?