Pearson Edexcel lnternatlonal A' Level Biology Unit Five

IAL Biology pre-release scientific article- October 2024

Article 1 We've been studying the same people for 76 years - this Is what we've found out about
Alzheimer's disease & Article 2 New Alzheimer's drugs don't deserve the hype - here's why.

Some terms that may be unfamiliar and their meanings:

1. Cohort: a group of pe
2. Dementia: the lo

3. processes by
ems.
4. al abilities, including lea
, cision making, and atte
s. tent feeling that people
sive attention by others
normal fibrous, extracel
id is insoluble.
tubule-associated glob tein, predomin
eins clump within nerv n the form oft

e science of the cau iseases, especi

als with the laborat f samples of bo
purposes
tting fluids, including dr
1
smic inclusions of abno
'

CHSE/ Department ofBiology /Grade12- Semester 4 / Unit 5-Artlcle/ October 2024 1

Content related terms

1. Hypertension: A condition characterized by {persistent abnormally high

blood pressure},
leading to {damaged blood vessels/ endothelial damage} and increase the
risk of (heart
disease/stroke/ kidney problems/ eq)

2. Cardiovascular Risk: The {likelihood or probability} of an individual develop

ing (diseases of
heart or blood vessels}, such as h.,eart.disease or stroke.~
a,111... • ,. -
.,... • t' J ·~

3. ~ardlovascul~r R!s~ Ef~o~s:.Jb~s~ ~e{~~ab le'tr~ lts or{iif~stv_le related

behaviors} that
increase the hk~Niloo(:f of developing {diseases o.f heart or bloOcfvl}!sels}'-.
Common risk
factors includ~"';'rtJ9k1ng, lack of pbf/fc~L~y,--~,~he'aJSPY di~t:. hrli'Gtobtl
J?ressure, high
cholester~t{a~~\mabetes•/ :· ..J~.Il'~ -·~•-,: ; ' 1 r~. ·~,
• 1 v~
... ti'\'
t "'" it~ ..., ..
4. Cereb_ r~\\it1a rjiseas :•;,.!lie fer~bj e disease of the {blood
ch~~fct~rfzed -~Y$jrro~ir:ig)of luJnb f arteries, high blood p{i~i re, atheros
Is of the·~~ai~ ~q} t:~~·
clero:.is;
thf?.rnpus ca_u~g.,.'redu{ecPtbloocf!sl:f~ply/oxygen/glucose} to ~h~-_t,ssues of
the bra,~. .
}(:.~"' l'i_i:}l l· ·~. J-1>~{ ,·;\~] ' '
5. S~f~~~e: A irc;{lca l condifiOJl~wher,e:~~f blood supply to part of~~~tlbrain
is interrupted ~r "
.(r~~~uced ~~;{oa blockag~ i_p a cet~~~al vessel as a result of a jhr~mbus or atheromatous
p~1~que, e~.~lenting brai~ tis~ue flo~12' getting oxygen and nutriflil_f~j
' :lJ'
f. I']:, I ., ·iI I !
i If, t'r ,\) ~1,c
~
, '
,.,,,.,,.
~•,('• ). '·>
.,Jr._~
i ' • L. ~;,.' '
-~!~~~~~l>J.~~ogi~?!.t,~espo se, o ha~!!! ~~~~~ ~ch asf~~~ ~~!';~d~ag~~~-c~II~,_ ?~
t ·""
61;~~~ _lam

1 a,;herosef;~losrs,-wher~~a-,les buile~ti ·-IMsiae•tnelam:e,rj~s. ?>}i;~ • , -.....-...., ......~ • • • ,

~ 'J.i..~- ~~i i}.r ~!t ; ,!11 ,~':
1:; /4JJssue'~~~'rv also resulti¥i'~ release of {histam ine/ JftoRines i~fJJi
mone / chemical} causing
i,z~i~? dilailf{a ding to J~{~ of inflammation such a{J~klliney/~b.~dema}
due to {increase/
entcy} of {ma(t,;ophages f~,~~~ite blood cells/ fluid} to~\1lt:l¢. damag~djarea.
t rc , , ~ ~f]"llii 1 fi.J"'~ 1
i~\'-.\l , llff' ~ ~1'(1,,•
~~if •t,j . •
i
8. A~i·, ~y: Af"' ~§j}pwn aiJ,i\munoglobulins, are globlli~ protjff~ olecule
s produce,,d:by the
imm ~~·~,syste '-t~ respO:rn.~e to the presence of a spe.S!~iianti~~-~}1 Binding site of)he.
anti~~~ 1is {co p~erne1rtJr.~ to a specific antigen}. Atl_ti.001 dies~-.M~;1in identifying·~'nd
--c,.,.IJ~_g.._ ij ~... ~ t \'I, t,,..~, <'\l,
neutra'tii~mz)pathogens lf~~ as bacteria and viruses. r: '~ ;r-.:,:_
a~J\~,~- liUf:, f'',
9. Monoclonfi~~t~p~ies;rti-profili?t~:rq~l;,~.ules-~n~r~~eredf.:Q~t~rve ,a9·i~tiW
~;~~::
1 ...~f' ·': '
..~~J\~ '~·to
t~te
antibodies. T~~c~ ~:ii~it~ o sp~cttttJ.a'1'.itiWol~~~eci ifft~atml~!s~!~f~l~-~~-
~s such as cancer,
autoimmune d1se1se;;;~i~9J!,rd1ovascular cond1t1ons. ;h-'.,"~;~' ,i"
•·;,\~~ &i~· ~~ :J~ .,, ),;,.•

10. MRI Scans (Magnetic Re~on tt\idJ~~ j)i~~?~ (ci~~\j° Jlgingttc~niq ue

- ~ ,I,,, ,,_ i. that uses strong
magnetic fields and radio waves to create detailed 30 images of the organs
and tissues in the
body. MRI is often used in diagnosing cardiovascular diseases and brain disorder
s.
11. CT Scans (Computed Tomography): A type of medical imaging that uses
X-rays to create
detailed cross-sectional images of the body. CT scans are often used to detect
abnormalities
in the brain, heart and blood vessels.

CHSE/ Depart ment of Biology /Grade1 2- Semester 4 I Unit 5-Artic le/ October 2
2024
12. PET Scan (Positron Emission Tomography): An imaging te(h11i4ue that helps to reveal how
Lbsues and organs are functioning. It often involves a radioactive tracer to visualize areas of
the body with high metabolic: (!Ctivity, which cau indicc1te disease .

.. ' . ' .

CHSE/ Department of Biology /Grade12- Semester 4 / Unit 5-Artic/e/ October 2024 3

 Some plau sible questions and ans wers {Thi • r15t 0,
s is not an exh aus tive
que stio ns. feel free to do you r own research
and add que stion s.}
'
Article 1 We've been studying the same peop
le for 76 years - this is wha t we'v e foun d out
abou t Alzheimer's disease

1. large group of
AW} (follo wed

• I study men tione d in a

1
, reached their mid-30s, to measure phy
.lood pressure, lung fun
rformance and
: 3).

1. Hlg ~s the {endothelial cells

of art 1 cerebrum cont rollin g
c
i
lnfla mm
2. I
Whlt eblo eln
dam aged are
3. Leading to /orm a
4. {calcium salts andflbr
5. As a result {elasticity of arte
n}
6. Reduced bloo d flow to cer_ebrum, so brain ce
s/tissues receive less {oxygen/glucose}
ACCEPT reduced respiration In brain cells
7. reference to necrosis/death of brain tissue Incre
asing risk of stroke

CHSE/ Department of Biology /Grade12- Sem

ester 4 / Unit 5-Ar tlcle / October 2024 4
4. At what age was cognitive function reassessed, and what new emphasis was placed on the
types of skills evaluated (paragraph 4) (1)

1. Cognitive function was reassessed at age 43 with a new emphasis on skills vulnerable to
decline, such as memory, concentration, and mental speed.

cerebral hemisphere
I~ ~(•"
I•• \

,.,,1:0. •• '
:]\j{;f,;,
-.:J,!._'t.fftjJj;.?t~,•~•~ {,;~~n ( '.'&\\ i:_'-~~\,~

(b) Different parts of the brain coffi'f~·i

t·i~~.i':~_nfic{ ~,faate the function of the parts,
cerebellum, medulla oblongata and hypothalamus. (3)

1. Cerebellum: coor.dinatlon of voluntary movements.

2. Medulla oblongata: control of heartbeat and breathing.
3. Hypothalamus: homeostasis/ thermoregulation/ regulation of release of hormones from
the pituitary gland.

CHSE/ Department ofBiology /Grade12- Semester 4 / Unit 5-Article/ October 2024 5

 u

·
7. Paragraph 6 mentions how along with cogn·itive
· f t·
unc 10 ns, dementia can be accompanied by
depression.
(a) Name the neurotransmitter responsible for
depression (1)
1. Serotonin

(b) Drugs called selective serotonin re-uptake

inhibitors (SSRls) are used to reduce depressio
n.
They work by inhibiting the rea?sorption of sero
tonin 'a(~: !yna pst Explain how SSRls help to
I .
maintain a feeling of we,11-being. '(4) ~~,\1~1,.} 1/I, • I\,

r, ,li , ~ ·: •
I

l
' ' ••

• '1V 1( 7
1 ,.

1. SSRls bind to:chal) 11tl/reuptake P.rotPirls -~-·~ ,,. ~."

i(~>-/'i~,.,?· ' . 'r -.:.;. -,.; 1'

2. Serotoni?flt!f.'f)s'remalnihigh In syna flse
,\
· .
3. Serot~Ql;f1$Jitcls to recept~~ prot~lns {n post syna
1 ptic membr~ne_ .J
4. Depo,{c.!r.lt.~tlon of post syndptlc membrane
-~ ;'1•1 •
Ac~tppfe,otentjp.,(~1.fmpulses/transt ~lssi
., t'!J
~
11
s.
,....
r:, ··~1·~
I \I
'
,If<:
.. '
.,..
;.,.
, '
1on continues ~ "'· ,
I
)l, ,ir;~../
'I:
. I · ,• It ..

8. f\l~~.eimer's· ."fldis~a se is the commo~est form of dementia (para I

\ .,. ' ' '· • .- graph 7).
tM~/ . \
a!fine1~:r1~•~imer's dis~ase and stat~ how it affec
'/ ' ~
I

.
ts brain fun~ti'o~ (2).
'
1. A'i~heime;•,s • dlsease is a {n~iJrode:;~Jratlve
\ 'i ;: ( •
condition} (1} i";i
l ,, j
2. It c~use~_tprogr~}sif~5?..@."it,ve i,;,pai;fne
~ . ~, rfJand·{brain dtrop~.Yl;'ii} (})
.er,-.~ l, ., l ~
.).I :'r '·. ~
.•
t-,_,
"' ' _,
l
j ,, l H \.
,.;
•..,. ,. :c:
l t,
'• • 1 • 'j :.
, I..
'
~
u• •

(9)'Explain1~h~~significance of l~ngitudinal studi

es like lnsignt 46 in i.J~derstanding the
\

progression of Alzheimer's disease. (3)

~- 'i "' 1
• ,
1 ,). 1 •

• \ •t • ◄ l
,, . ,· i,
1. Loniqit'~~ina/5;,t';'.,tlirs track the same Indiv
I ' 1
iduals over long peridd~,, pl/owing researcher
obseive {prain c~anges} before symptoms appe s tq
ar (1) 1 \ •; •
2. Thes!stuaies hilp i<lentiiyiarly {blomarker
\'. ~ ,, \, J s} (e.g., amyl6id plaqu'es, tau tangles) linked
Alzhelmtr:s'progre'sslon (1) .' 1
• I
I • •
to
, ,, . ,
3. Findings ~an'improve {prever.>tlve strategies
} and suppo~'early Inter 1
' ' ~ ' •~., ventions (1)
• \~
0
"-ilt
SI
~~,¥,~li:j
~ ,, 1 I
• ~
.._ •'
,. ~ ·~ :' nr ., , ~.
.. , ,·_\
,'

, , ./►,: ~l'-,<y1 ,, l
9. Accumulation of'befa-amyloid pro etn"ln. the 1•1,t/ ., I' ' •
••

'1~•~l brain can trigg er infla mma tion '(paragraph 7).

!JJ ~'
'I I i, • .,
r,t ' j

(a) State 2 symptoms of infl'ammation q,nq desc 'f1 .;_ •

ribe the. roJ~ 9f these _symptoms. (4)
~ ... \
1. pain- alerts the person that ther1·!~',f};[' i$~~-e ~
I\
'
_(1) • ~
2. warmth- speeds up {chemical reactions1
skin cell division/ phagocytosis / increases rate
enzyme activity (of person) I defense mechanism of
s} (1)
3. swelling- results In more {blood I white bloo
d cells /pla tele ts/ phagocytes/ antibodies/
tissue fluid} (to the wound) (1)
4. redness- results In more {blood I white bloo
d cells / plat elets / phagocytes /~ntibodies}
the wound) (1) (to

CHSE/ Depa rtme nt of Biolo gy /Gra de12 - Sem

ester 4 / Unit 5-Ar tlcle / October 2024
6
(b) Describe the inflammatory response which leads to the symptoms stated in part (a) (2)

1. Mast cells (in connective tissues) and basophlls release histamine.

2. This causes local vasodilatlon, Increasing blood flow.
3. Histamine also causes capillaries to be leakier causing oedema.
4. Bring phagocytes to the site of damage
5. Overall, results in redness, swelling, increased temperature and pain

,.
)'
\'
J'
"
) '
t .,
... ·' + • It ~
10. A key process in the clevelopmeht of Alzheimer's is th'e depositing of beta-amyloid protein in
I
the brain. This is a protein that comes from the fatty membrane surr~:>U,ndirig Qerve cells
(paragraph 7). •• • • , · •. _\ .. \. J :~.,
•' ', "' I •
.,,A, t if" • \
•
I:•
'
1
•
'
'); •
I
,, I 1; .,,.,. l •• ;
} , •.. 1
, l, :\ , •,' 1 •
◄
I
I ♦ ~-,, i 1 ,... 'l
(a) Name t~,e fatty'"membrane· surrounding nerve cells and state t?e' cells that make l!P. this
membrar)e:;~(2) '
~
(J :·~·' • ' i
,•,\~'! 1 ,;1 ( ' , , l

,.-" .' ~• \. l .r- .,. •

1. fatty membrane:
"-,::.·?,\ ~ \\ ..
myelin sheath.,
,,..
2. name;of cells: Schwann~cells
~(':~;t~t~ ' '•• ,1 \•
. \ ~. \•._. (1

:J
4 I f

:>:··'l l i I
1 1

(b) Eipi ain how \~e structure ofthe /ynabse and axon membrane ensure that nerve impulses are
onJv· able to trayel in one ditectibn? (~) '.) ; .
~ ,, i :i • .- t
1
1., Ref to refractoey,pertod • ,~
1 1f' • ... ~ ~ - , ,,
·,d ,,.,,. . , • •·- •

2.;' •D~ring ~~tc!!J~'if!~ i~n ~hannJ1;·-~~d~~t reop~~ which;preve~t_s..':'!!'?the~ action potential

~ be,ing trigg~red • 1 ' •· ~
3/.')ynapses o.~ly have receptqrs on the postsynaptic me,:nbrane aci'~ neurotransmitters
·, ., . ·, ., ~ .. ~ .
,;: released from presynaptic membrane
·.-., '\°'.1
, $ 1·, ·r.• ····l
l ', • ' • I .!
,', • 1
'
1 ~
1
1
(c) ~~:~~ raph 7 fu~her describes how beta amyloid protein~- gradi_ai1J clump and gather between
the ner;ve cells of~~lzhfimer:~ patients. ;: •
Explain hoy) clumpini~of am~loid protein between nerve,~~lls can~~fte1ct nerve impulse
transmission. ·(i) 1 •
1
'. _· 1

1. reference.~oi~'/Jm~/~ti~niof arl/f.tiitd/'.rote/n ).in (~yha~tic clefts~~q~·-:~&~PT interferes

with synapt,c tra!1f-{llJS$~On from ~fesynaptl~ n_£~ron to·postsyna~t~c~neuf.on.
2. Less neurotransmlt ttrs f}iffuses across the synapse t' , ·.,, .
3. Less bind to the receptor: postsynaptic membrane · 1
·r '.,::,v• o~
4. Less sodium channels open/fess sodi(I~ ions enter post 1ynaptlc neuron
s. Less depolarization of postsynaptic neurons I fewer action potentials generated.

CHSE/ Department of Biology /Grade12- Semester 4 / Unit 5-Artlcle/ October 2024 7

 w

(d) There is emerging evidence that beta amyloid aggregates forming

plaq_ues lead to .
impairm ent of myelin sheath. Describe how this could affect the
transmission of nerve impulse
along a neuron. (3)

l. loss of {insulating layer} around neurons. Accept loss of Schwa

nn cells.
2 • so {nerve Impuls es/ action potent
ials} cannot Jump from node to node I reduced
saltato ry conduction {l) Accept description of reduced saltato ry
conduction.
3. slowin g the rate of conduction of nerve impulse;:(1}1accepf nerve
impulses travel
slower. Accept fewer impulses transmitted. •·~ t ·
1.. . "' ~·.,.,
-
1'1"

~ '
• ► ~ •1 ,, ..., ~ ,... ~
' ',. •' ,,.. 's" - \: } ., - ' '-·~
,.J: ..... ~jt;,.':il# "i~ i;,, .
.. • • ~ ~ • '

11. In additi~:~. l~;p~ta amyl~ld ~roteihs, accum u~;i~;· of fau protein

slalso play a ke'y role in the
developm~!lr oJ,:«\lzheimer's disease according to paragraph 8.
~·. '\~t:'
~ . 't '-

(a) Des,c~ibe;~ow an rhRNA for tau protein can be made during transcr
~-
~

iption? (5)
l. idea th'at DN,1 (molecule){unwinds I unzips / uncoil s/ eq} (DNA)
st~bnds separa te;
2. (RNA mono),nqcl,eotldes (line up against/eq} (template /ant/sense
strand I eq};
3. ref to}com ple~~n tary bale palrlng~(beJ'ween DNA and mononu~leotides);
l ~ •
4. ref t9 format ion of phosppod{esteri~o els through condensatlon;I t

reactlon;
5. correct name of enzyme (hel/~ase/ RNAlpolymerase} Involve
d; .
6• 1'dea tha t mRN'A detaches ~rom
1 the IDNA;
·'.\ .. - ,-:, .. . --- --
. I ; , I I• ' l I I ,, I

(b) _0Jscribe•how'the ta~·protein is rriade"'from ifs mRNA,durr,ng trarisl,a

tioh? (5)
l. mRN~ ~eaves the nucleu.s; IGNORE mRNA enters cytoplqsm l
I I

2. ldiQ,, o(~sso c(ati~n /blndln glf ,r,RNA with ribosome; , • l

3. eacli.tRNA attaches/binds to a specific amino acid/ eq; 1
• •.
4. tRNA ,t1'!nsfers th'e amino a'cid (to the ribosome I mRNA) I
e_q; ·:~~ii
5. idea offoinp lemep tary base pdiring between tRNA and '('RNA;
A.CC:f.PT anticodon codon
Interac tion \ j • !
•
' ,•

.
1
6. reference tq ~~pt/de bonds [~~ming between amino acid\\ :
·i{ . t ~- l .
.,, ,,
,
(c) Describe the r~l~s ?f mess~.eger RNA,(m~NA) a~d transf~r RN1
(tR~A) in ~rJ synthesis of tau
protein. (4) 1
,~
1 ) , .,; , t .,.,

f
mRNA
I • ,.

• : ' . , ' . ••
l. Is a copy of the (genetic) {c'od! f!~(~;m atjon tse~~ li~IDN A /gene}
(l}
2. mRNA {move s/ carrfes code} {out ofthe nucleus:).:tothe ribosom
es} (l}
tRNA
3. (binds to/ carries} its specific amino acid (l} ACCEPT approp
rfate I particular I a certain
4. (tRNA) anticodon (binds I pairs} with (mRNA} codon (1}
5. holds the amino acid {in place I until the peptide bonds have
formed } {1}

CHSE/ Department of Biology /Grade12- Semester 4 / Unit 5-Artic

le/ October 2024 8
(d) Describe the role of epigenetic modification in the synthesis of tau protein. (3)

1. reference to {hlstone acetylatlon) switching on the gene for tau protein.

2. DNA becomes {less/loosely) wrapped around histones. ACCEPT euchromatin formed
3. transcription of (active) gene to produce (active) mRNA/ (active) mRNA translated at the
ribosomes to form tau protein (1)

' v
(e) In humans, six differe~~~A.~ ~~~~!!f;if9Jl be,.produ~eq ~1m a t~,~le gene.
Explain how more th~n·one type of protein can be synthesized trdm the.mRNA produced from a
s. - - ,, ....,.... ' , ~

single gene (Pa~~~~~~i~►'(4) • ~; <( ,~::iSt·i:;·~:,;t:·.. • : • Ii: .~~... - . ·~

1. referenct; fo {§,feet post transcriptionai changes~ A·cetJr m~NA kplic/ng (l}
2. intro~f6n.~9tcodi~g reg/on's remo,v~d by {enzyme/spliceoson!e.s}_71} • ,
3. rear~?~~fmentiJ~lf{exons/ coding re~ions) I removal of some:~~ors {1)
4. tr~.~~f~t,~n oy~fJve/matur e m~N~ results in a different {primary sequence I sequence of
a~~no ac,d~J~fo.lypeptide) ,(1) .,. 1 :, . A
:,\!),' \'ii "
, ~ l..,~ • .
l ' I C I
~
' .ll
) -'\ •• '

12.:~J~~t of ~1zJ~imer's di~eas~ can b~

.a:ssociated with the accu~ulalion of amyloid plaques
al~~-g with t~fptoteins (pa~ag~~ph 8) '· ,. 1 ' J
]' ' ! •
(a) P,tdteins'a·re·made up of 1amino acids. Describe how amino aciqs joih together to form the
ttf~~i• dime'~slonai stiucture ot'~ protein.'(4)'· , -
' 1 , ,. " ,
~ .t
' l
~ '·,.> 1r.:'·· ~ ••,··v ·~1
1.j
J
'

•
' \,• •, J • ,, •

1.: Referenc~ lo'7i,eptiJ/b~n isJ joining ~mino acids '1

' t~"' " f ,-,,; • r ...

2.' Between-amino group of o·ne amino acid and carboxyl roup of._,another
3. \:',Th.~ {se4~f~e/orde r} oJ~➔ino acids is the primaryfr,'.ufture of the protein
4. ,_Reference.to folding of~rlinary structure to form seconi:Jary/ tertiary structure
1
5. Ref.erence. io .'ff!l.med boh~~1{Disulfide bridges/ hydrogeri/ ionic bonds/ hydrophobic
intera~tion}J'/i,fmed be\w~en {R groups} • f •'.
~~ .
'· ,;',:lit~ t,,~. • ~ ·; L:
!' ,
(b) Amyloid ·p.roteinslre fibtpys proteins while tau prot~ins ~re globular proteins. distinguish
,, V ., , ~ ~~tJt, I ( ! \ ·,
between fi~rq~s,~nd globul~_r;proteins 4). ; ; i
1. long (chains,'of amino a'i:idst/ polypeptides I proteins) lnlfibrous proteins, however in
globular protei~s pplyp~~tldes afirtp{d~~;,to,JorlJl·sJh~~jcal slruJure (1)\~·,
2. repeating seque'nct!s,_19f amino acidJ!lh1li?i;i>~~:pJot~irrdnlike glphular proteins {1)
3. high proportion o"f {{rri~"f(1,:,.9f1polar I hydrophobic} {R grou~~/,, a'h,{no~"'~cids} in fibrous
proteins while {polar/hydrophilic}'{R groups/ a_mino acias) foun'iJ in globular proteins (1)
i.'!U.,. - t ( #,

4. In fibrous proteins hydrophobic group~ on, the outside while hydrophilic groups facing
outside in globular proteins
5. (parallel) chains held with {cross links I hydrogen bonds) in fibrous proteins whereas in
globular proteins structure is maintained by hydrogen bond, ionic bond and disulfide
bridges between R groups of amino acids

CHSE/ Department of Biology /Grade12- Semester 4 / Unit 5-Artic/e/ October 2024 9

 (c) Explain the role of transcri ption factors in the expression of beta amyloid
proteins
(paragraph 8) (3)

1. Activated {transcription factors} bind to (promoter regions} of beta amyloid

gene (l)
2• RNA polymerase bind to (promo
ter regions} with transcription factors / transcription
Initiatio n complex formed (1)
3. reference to activation of beta amyloid gene forming mRNA (1)
4. translation of mRNA forms polyp~p.tide/ amyloid protein. (1)

13. Suggest how amyloid,,pla·qJ~s a~d tau t;ngles lea,d t·brain shrink~g
e, and how this can be
detecte d. (3) ,~·!:f.;:"?;:;~x, ,:!-J!\' .. '-'. / i-w· Lt·,\ ., .
"': ,c- ,- • •.. • . .,. • J.·>~.;-,.
. -" ~

1. Accum ulatij}f~ ~{~iii;~ oi~ plaques anJ·ta~ ta~·gles} ca'C}ses (d~!\1 ~ini~''
c'ill} (1)
2. This resu{ts_fl!,.(brain shrinl(age /atr.,ophy} (1) {J ,: , .
3. {MR/~ 1l~~ Scan,~{ can re~ect th'.s ;hrinkage (1/
\ .fl, ..
:f j ', .
• . \' f
, . , , _,.,,¼ ~ • ,1 '' L •
J.
14. Explain·why early detectio n of Altheirti er's is importa nt but challeng ing
, ,
(paragraph 9). (3)
~- < • 'i' • l f ~
I
\:
1. Ear!r det~ctio~ Is impo'1ant to slpw ,~isease progression witliLfner treatme
nts} (1) .
2. : However, early symptoms often 'tesemble (normal aging}, suc6 as mlld
memory loss (1)
3•. ~- Diagnosis requires advdrice~ lma_gi~~ techniques like {PET} ah'tl (MRI}
II. (1)
J •
'•' •., ,. l •i ' . I
<

,;- ;j I l ,½l ,, ' . t :'

1~'.if>JT scans can be usecrtfo th to viefualize,ancl quantify abnormal protein
. .-:'"l1b . i (P ,, . •
I1yml!., ram. aragrapn~ . -~~, ;h~
L•·9')' ~~-
,·i
1 •; ·,,
•
••. •
..
., J
.
' •\ t ,.t•'• cfeposit
..
'', •
•
iorfwithi n the
' I '
(a;·~si'ng the informa tion give~1and your own knowledge>delcribe
tomograph~,(PE,~) could be ks~~ in detecting Alzheimer's. dis~ase,;(4i ~
positron emission hhl
1. '{sotope {t~qt''emits pos{tro&s / is incorporated into glucose} (ijjt~ce pt
suitable named
is~t(Jpe e.g. ~qr~on-11 cir qx.ygen-15, radioactive material in glu~ose.
2. mbre active 'neurones ...Jith Jincreased respiration (1) . ,. ,
3. wllhetio ire inb:ea"sed sbpp,ly of glucose (1) Accept will {obsoJbJuieJ more
j!f ~ ~... ' • ., glucose
4. posit'rdn~:(emitted from/glucose) produce gamma rays. that detected and
~·! ,1,'.\i -1· ' •i are converted into
•
an image, ;fl}\.., ?: •. : ~ , ,
s. allow doctq_~s·t,o.(assesf't~~ level of amyloid buildup). ACCEPT'tolvisualize amyloid
deposits} inVhe -~r,a(n (1) ('.";, ',_~''.' · • ,...
... .., ,;
.•• j
!.1.t.• ..
~-·i ,•
'v.,..,.

CHSE/ Departm ent of Biology /Grade12- Semester 4 / Unit 5-Artic le/ October
2024 10
(b) The diagram below shows part of a PET scan of two individuals from
the cohort Insight 46

. '. ~

. , ;~Jo
, , Diagram X Diagram Y ~..t~ ;'r:t\\t,,
' I ;/,/.
,,..
'~ -. --a~hv,' ' \ • • \\jl ( ,..~, ,_.~.•
""li·i ~

Identify which of ~h~ diagra~ifeprese~~\he individual with Alzhe\'~Jr's

' ' ~,,,~,~~ '

' ti '
! ;
and ~i~e;rreason for
1':( ,• I
your answer. (2) , r '' 1:; ~ ,,
t f ,\ I ""· .-~ , ••
.1-,~'- (i. (J!;~1[i~~ t, • •~ '
.
1. D1agram y ,c ·•• 1, l •• ', ,;,;..• :-,'-! , 1

\ 1.,., : •.
,,
. •
'",;T
·f' ;, -'
•
2. Higher accum'ti~tion o'~Beta amyloid protein or amyloid posftll(~:regio
. } ' • 'I •. l I ' l ' '/'
ns/ plaquestlg~eater
s_hrinkage of o·lerall bra~,:t-tlssue. ,,, •
"
~{t
ti,
•1 .,,

I
~I • ~)'_I,
"·~ \ ~

"' I .,. ·: 'I 1 ~ \

'
; •• '

J ~,* \!
J!, •• '\

f_;ft f,
16~ Describe;'h9~ cerebrovasc_ular diseas~s could lead to brain atr1.PJ1-Y
- and a decrease in
•r1

cognitive function and (Paragraph lOy,(4)' !'~ •4

'f ,I •
l ~~

1. R~feren~ft~,.~a,inpfes''of cerebr~q,~lil~m~ues sUch b/aaJ ~-:,,

narrowm'g, :•blockage oribleeding."'...w:.&.,-...~... •:;,.,,, • 'i'. ,~.
thf
• · ,~,_. ·' ' ~ •.. _ .... ~ •
°,~ Ot l'~i" •. :
2.: Riduce~·bl<!_od flow to ~er,~~rum, so brain cells/tissJes-~eceiv~ie.ls {oxyge
n/glucose}
3. Re~uced;,~~rfbic re~pir~tio_~/r~duced ATP productior iry brain f-!l{s
1 . .
4. ref~fenceJ,t%_aecros1s of ~ram t1ssue/neurones/nervet ceus/ neu_r,Ci{
connections leadm_g, ~o
b~aln shrin,Kage/atrophy • 1!. -~ ., ~\;- ':,,
5. inc(fqsing tis~'.!?{ stroke ._l~ading to loss offunction. , ' 1.,i~ t ,. N\
~'\ ~~l•t'.\-,'-'.
\1-V_iit-.l -

i\fi:;f' ~ ~ -\ ;'
! ~
I t I 'tl
,c',, t
•

l -~~i
' \,..(, . . . . .
,!:

t
.
•
,,
~\.. -
"' ~
~~
~. , I
t·. ,
• ~ 'l
\• .
,
~
f' ., , \ ~
,,- '

, ,.,,, ~ •
~
,-:", ..,,
,! '(
~ t 'ex1 . .,. .:;~ ,. • ,~\
17. MRI scan:b3n be used to stuay the changes in brain tissqes of Qatient
s with a/a.re genetic
form of Alzheim.er's disease. . " i . J~:•'·', t
i' ·\··'
?~ • , '', ~ ', '(, "I;•.•,•/-!,,;• -~•\,;, t ' lti f,,
I l '\\

(a) Suggest the advan~a~~; of using MRI scanning to identify changes

,ii) br~in tissues, compared
with using CT scanning (paragraph 9). (2) ' ,·: '. '
~ ,
•·f'f,..,;.¼''t.
;
l ,t
. .

'; " ' ' './ . ~ .• ,'.rt~· i:'.,;,7!.la# ~ 1•

<I

1. reference to better resolution;.. ,( 1! .l ~--- .r;~;f:2::1~1

2. idea of more detail seen e.g. smaller parts seen, finer detai; greate
r detail / clearer picture
I sharper image
3. no use of X rays;
4. idea of safer e.g. less risk of cell damage, mutation; 4. ACCEPT less
harmful, less dangerous,
use on pregnant women therefore can use more often I eq;

CHSE/ Department of Bioloyy /Grade12- Semester 4 / Unit 5-Artic

le/ October 2024 11
 IJJ

--
Q
. .0

(b) Describe how microarrays and bioinformatics could be used to investigate the genetic basis of
Alzheimer's disease (paragraph 12) (4)
1 • microarrays
allow identification of {active genes/ gene transcription} {l)
2 • the activity
of many genes can be analyzed In a single sample (1)
3
• by collecting information about genetic differences from many individuals (with or without
Alzheimer's) (1)
4, bioinformatics
/computers /databases /algorithms used to analyze the data (1) ALLOW
Develop algorithms to Identify genof11eS / gene sequences
(key) differences between healthy.and Alzheimer's disease Individuals can be identified (l)
~;. . .
~~•r
' tft\j1• ~,~. ..

I
...
•

18. "We foun~d,{ij'f{;found 18~ of "cognitively normal" people from the cohort had amyloid PET
scans like t~~~f/een in pedple with Alzh~imer's disease - a finding that tallies With other studies
in peopl~ ·~t~,und the world who don)t have symptoms."
,.-1 ,i , w~

(a) Whai,furthe
) . "OU
r information would ,., need about these studies before coming to a valid
concl~sion? (1)

1. Sample size , l'

2. Control variables maintained
3. ,O~her cJ.etails of patients
4., Results - evidence
t ; •
I .,. ... -, .. t
(b) St9te 2 Ways in which rese~rchers can pr.esent their results? (1)
~ ~

1. P_~blis~;e~flts and findings In medical/ scientific journal

2. , Shpre fipd_lf1.gs in relevant conferences '.
l I. \,.; • ~~'\
l,.
• L *:'t.r<-.,,~ ;., .. ..

19. Pa~agraph'k;\~\)ters to ip,a~ing technique involving a scanner that ·allowed MRI and PET to be
)! .. ,_,\ . I I,,,· ~i;,.. I 1
measure~:~1mu ta!'.)e\~~s y. ' :·
t •• :i '\· <"'
(a) Des:1\b;:~_~y a ~\+bined P.ET and MRI scan may be bett~r for diagnosing of Alzheimer's
disease (3h ,.. ··,

.
·'
"~~;~.
.. ' .
1 Image by"'P-it~can shows Uunctipn/b rain activity} while MRI shows structures/anatomy
~
with better resolution. h.., ,
z. PET scan show;!Jar~~~Jb9,:tJ1re {more (metabolically) active / dividing more} {1)
1
3. MRI provides clear i'in'iig~:~lf19.c_a~~CJ~f,.siz~} a~,yloid a~cumulation {1)
4. Reference to superimposmg boJ~-~Qg~s view anatorrucal structures more clearly {1)
·~~-- /.~

CHSE/ Departmen t of Biology /Grade12- Semester 4 / Unit 5-Article/ October 2024 12

(b} Describe the advantages and disadvantages of using positron emission tomogra
phy (PET) and
magnetic resonance imaging (MRI) to investigate brain function. (4)

1. advanta ge of MRI (1)

e.g. MRI gives detailed image, 3D images, no (ionizing) radiatio n, good
soft tissue contrast,
high resolution, can see diseased tissue uses magnet ic field so safe for pregnan
t women
ignore safe for all individuals
2. advantage of PET (1)
e.g., PET detects bioche11Ji~al chgri_ges in brain, can observe cancer growth,
used to diagnose
dementia, shows which pqrts of brain are {active/ metabo lizing} PET scan
3D •
3. disadv~~tag~..Pt~?.RJ (1) I '
. ., : .• , · , . • 1 •.1 •• ' •
e.g., diff,cul tfor people wpo d1sl1i<e enclosed spaces, lon1g time, sc;,me need fedat,on
,
expensi'!ti.i~O~sn't shoi[cic tivity of brain, limiting accessibility in some couf)tri!
fs?
noisy{,9.,n'it6~ us~d on ~~~ient with pacemaker or metal imp{a?tI
_, -.
4. dlsad~a.ntage ofP~T (1) , . J
1 v. ',.,,• . •

e.q:/~~ posur(t *11amma / beta) radiation, uses radioactive t~~c"er, lower

1 resolution,
ej[J:~.nsive, !/?,';i!]'age ' -
.
t~•--1·, •
i:~
"l.,~... .~'
.,.
,, ,.
-·~ •
'.
' ,,
1
~ ,,_..,. ,\ ' 'l l l
(c) tompare,and contrast CT and PET- scanning techniques (4).
. ·.. _, 1
• ' t > l l
Similari ty ~ ,' •• • ~· ·.:.. :1 .
l ..,_ :~oth cdi~ flf~dl!,fe J!/.? fma~~; (oft~,~ brajr_1 and nervous tissue) {1) ignore ref,~renc
e~ to ?QI
3D '· • - ·
i i - • : - ; , . -· ,, · ,. • , .;
:.··.
2. . both are non-invasive procedure~ (1}'
Difference (max 2) , :·
3. • CT uses {x-rays / electron.beams} whereas PET {uses {tracers I isqtopes
t ' .-..,
..,
} I detects
''

~production of gamma rays}' (1) ACCEPT named tracer e.g. (radioactive)

glucose

e15pen~ivef(fh~n a CT sc~Q):
.
4. 'er is {quicke r/ cheaper} (than PET scan) {1} ACCEPT PET scan {takes
. ' longer I more
• \
5. PET scan can s~ow {(metab_olic) activity I biochemical changes} (wherea
s CT scan. does not)
(1) ACCEPT Pir·scbn can {show which parts of the brain are active/ assess
brai!f<activity/
show· brain/u nction} (wh·er~as CT does not)
,·,
.I!. If.~~: \11,l

~\·t..,,..,~\;':],
\;. ·~ \,
•-'f..
...'I;._

~:;,,.~\,
~'il-4
,.
,, '
l~
rt_

'i,

CHS£/ Departm ent of Biology /Grade12- Semester 4 / Unit 5-Artic le/ October
2024 13
 N

{fMRI) and
(d) Compare and contrast the use of functional magnetic resonance imaging
in the brain (4 ).
compu ted tomogr aphy (CT) scans to identify structures like amyloid plaques

Similar ity
1. both are (neuro- imaging ) methods giving high resolut ion (1)
2. both give images of areas with plaques in the brain (1)
Differences
3. /MRI expensive CT cheaJ!~r (1.J ACCEPiTJMRI 4.5 min{_CT f-10 m,if!.~
shows structures (l}
4• /MRI w/11 show {metc.,b·oiism / oxygen uptake / brain activity } CT only
er developing)
/MRI does not '!fe /oi,iz}n gradiat lon, CT does (so increased risk o/.,ctmc
/MRI uses ."J~~~.~tf~reso~~;ce CT ~ses ~ ranJ1) ign~re JMRlha s:hi~h~
r ;~~o!.~tion than CT
5.
( ;\. • ,. ~>~! :{}\
.....~'' ; ·.,..-.""' /{ :&\
\ .., • •,
l :\
Alzhei,:ner's
l

{e) Discusrt~~,poten~i.al ben~fi~s and lin,-itations of using PET scans/or early • !,,.'
,I
t' "

diagno~is.:(~) /· l . ,1.1= ,,_.~ \.

/-;;_ #-. . . . ' :f'~... J 'ft•··) I

1. lf~t~ca ns 1!'~!f1he
visvalii ation o/.(beta -amylol d plaques} i~--thJ brain (1)
2. ir'!t/
pro~f!I , 1arly detection before {clinical symptoms} appea_r (f)
3. ff,owever;· PEt scans are {expensive}' and not widely accessible (1JJ
p will develop
4. •Fa!se pqsltlve s may OCC~(i cis not;'<f.ll'i~divlduals with amyloidtbufl'du
{Alzhei mer's disease} (1.) ;,- ,; 1
l,•J
~,!,)Li~ \ t I
r" "~, 11~~-~~
•

... "
.,
~ - ') '
....
,,
l ,
' • t~ ~~, ~I ; ; ';\ .•.
,..1'QOI'~~~
I • • t ·: !
,· • ~-
." ,... -~ • ... -

.,,_ ;

20: ~"Our protqCOl$2_qnq consent proce;iJ.slfi~~b:tfii:inJl'it~\bm e {MRI:0bc;fJngs. w~ do not give the

1
~: ~ 1 ;- ,. ;
!: results to, participant" {paragraph 14 & 15).
D~Cu;1 the eth i~.a I issues cot~e!" i ng the non-disclosure ii,~~ sc;~ ,Jsults to patients. (3)
·Polhts in favor. r·- _;·;, ' . <i ,,'. 1

1.. Patient s Wlthl'}JzhelmJr-.tbisease} may have Impaired cognitive function

}, making it f
dl/ficul t to fully unders t~ndthe {implications} even if dlsc/oseci:(1.)
.
2. Idea 'off'!" dlla!p~pre of;e~ults subjecting patient s tp h_ihher [if f develop
ing cognitiv e Ff
' ..-' '.i
impairment in future (1.)" , I• ),
\ ..,v... "~ ,i • .
1 \: • • ... { ,
Points agains t i: : • •
1
_quence (1.)
3. Patient s ·ha,_ve. the right ~o,.'know the result_~_o! their~ Jc~,:,~ irrefg;t five o{p~ns~
~octor:/ patlentf .~\,~J?k conduc t.
ACCEPT not giv}ng p_atients thelr}ts u/ts y1ola~e
guar~r. ,s~'oi·d .btalnin g consent
4. Ensuring {ethlcti l standards} involves'app'olnting {legal
from family members•if'/i~ti~a,~f-:f!:.f,!,'ognitively notfi..U l) >· ,,·. tti?r .
r~sp(!ct for pafient {autono my} & dignity (1)
5. Balanc ing the need for {cllnit.g!f!;,ff~{~~IJ!}:4t_ff
.~,,, \ ..... ~ •'-'

childhood relates to
21. Using informa tion from the article, explain how cognitive function in
cognitive performance in later life (paragraph 16 & 17). (3)
years later (1.)
1. Childho od cognitiv e functio n can predict {cognitive perform ance} (60)
2. Some aspects of cognitio n remain stable through out life (1)
3. Cogniti ve functio n shapes {quality of life} and {longev ity} (1)

r 2024 14
CHSE/ Depart ment of Biology /Grade12- Semester 4 I Unit 5-Artic le/ Octobe
r

22. Explain how midlife education and occupation influence brain health later in life (Paragraphs
16). (3)
1. Education and occupation increase {cognitive reserve}, delaying the onset of cognitive
decline (1)
2. They provide {mental stimulation}, which strengthens brain health (1)
3. This effect is independent of {childhood cognitive ability} (l)

23. Paragraph 19 suggests that there is,qJelationship between high blood pressure and brain
' ,. .......... ~ ~

volume. ~. . . ,.....
.. • , ·, - \:

(a) Describe how t~i~ ref~tionship could be regarded as a corr~lation. (1) _

1. As blood pressur:,,ittcreases, brain volume seems fo dec(easeY,th,re,{s a-negative
correlatio9:6'et~een blood press'!re qnd brain volumt. .{l} ;• J
. ~ ' ,
(b) Suggest how midlife hyperten'sion· increases the risk of dementia. (4).

1. Highr blodd pressure causes endotheJ}at damage to {blood vessels_' in the brain} 71)
, i ·1 t ,1 <) •

2. Corlect' reference to atherosclerosis/formation of atheroma. :

3. ld~aioi redu~ed blood flow'to ce{ebrbm, so brain cells/tissues rec'eive less {oxygen/glucose}
4. ~/dp~ed q~~o!,ic respir6tlqn/redf.ceq ATP production in brain c_el{s . .
5. Reference to •necrosis of brain tissue/neurones/nerve cells/ neural connections leadmg to
. ·' ~

,' brain shr(nkage/atrophy · , ~ ,

6. increasing ;isk of stroke leading to l~ss offunction in the cerebrJm of the brain and causing
1 1
decline-in cogn(tive function. ... .
1
.- -

' 'I/ , \ l ,\,:~ ;.

; : (: -.1 - ( ; • < ~ A J I ~
1

(c) Suggest why people with high blood pressure believe they are·_a t an increased risk of
d~veloping CVD but nof rie,urodegenerative disorder such as ~lzh~imer's? (3)
1 ? .. t
•

l. Risk describea as the likelihood of developing Alzheimer's.

'
• ~t
~ .. :
2. P.roportion.of people in population with CVD is f?igher than ~ine
Alzheimer's
3. L~ss•;eseartfla~ailable'iinkfng high blood pressure to bJvelopmeht of Alzheimer's
-, t~., l .I ' l -,, f,

4. Mo,:e ,awareriefs-~rouni:J high blood pressure linked;to .QID comppred to Alzheimer's.

5. (there/o~~) peoj,le_ are fore likely to underestimate, th~ /ink bet"fieen high blood pressure 0

and dev_efo'pment ~oj'Al~h~imer's. ,,,1 _,

. ,, '\ •. • {
t I ..'._ "<1.

• < •
•\ '.' • \ • Jt
J\',-' •• •~ ... L•I .. • • \ ,, 0 ,, ' • J j

(d) Describe how s~~~it1g ~ctn

l
lead tcf·Ji~i~ogoitlJe functiok (5)···· • ~\~•l<-:
V';
.__.
""..it. ' \l'.... ...." .
1
l. Nicotine in the cigarette~~o~~ £?U~~,.(vaso~onstricti9n) inc1ee,.~g (blood pressure} (l)
2. High blood pressure causes"endot~e./ial damage.to {blo(!d vessels in the brain} (1)
3. Correct reference to atherosclerosisl/o'tmation of ath'eroma.
4. Idea of reduced blood flow to cerebrum, so brain cells/tissues receive less {oxygen/glucose}
5. Reduced aerobic respiration/reduced ATP production In brain cells
6. Reference to necrosis of brain tissue/neurones/nerve cells/ neural connections leading to
brain shrinkage/atrophy
7. increasing risk of stroke leading to loss offunction in the cerebrum of the brain and causing
decline in cognitive function.

CHSE/ Department of Biology /Grade12- Semester 4 / Unit 5-Article/ October 2024 15

 24• Paragraphs 19-22 highlights the importance of early
heart health checks in relation to
Alzheimer's.

(a) Summarize the key findings about the relationship between midlife cardiovascular health
and brain volume later in life (paragraph19-22). (3)
1
• {High blood pressure} and poor {heart health} in midlife predict smaller {brain volume} in
later life (1)
2• {High blood
pressure} causes (small blood vessel damage) in the brain {1) •
3

• These brain changes in_cre(ij~'.the ;isk -~~ {·strokJ}.· ;'/ii~'lilintia}i· and I cognitive decline} (1)
..? ,'' .t-' : • • 'J , l' . 1 f .., ' \"I ' )., .... '
,t· •.. '•' ! • t.
. ');
.t ) t ''!~ _1;\ ~~}S,t :, .,,... .. t •,
(b) Based on th1'~~i~1:: atcuss the P.Ublic h~alth impli~atibn's of thesd'tiridip gi for the prevention
of Alzheimer's1dis'ease. (4) . -~ I • ,, 1 t( ~t~ .•-._. '
1. Early i,:;p i;J:~ar ( card}~va~cula~ ;~1cks}, especially before tie of 40,·ar~~c~ucial {1}
2. Conit~!lf1g {hif!.,h\•41ood_pressure} and maintaining {heart healthicou ld reduce'the risk of
t~~
{Atihllmer 'sJ1l{ l ' 1 /' ... l
3. {~~:~(fc·
healt~}fi~t egles} s~ould{~cJs on early detection and pfdvention of {risk factors} (1)
4. lmpprtanc.~_,of~{lifestyle mocliflccitidn$} such as {diet}, {exercise}, and {smoking cessation} {1}
l \.'- ,'_.·\~ir '
,, • J • • .}'1 ..,.1 '
'l ' ' ' :\, l -~. • ',;; I
l t
I
\ t.;

··,.._,'4
\;t'
.,, ..
.',._:J
•,I
,•t' , 1 •
.' ") I
• •
't,•·J • ,I: l

25. (a) Expla,ln,row blood test~:fan be used to detect amyloid pla~uesiand compare their
advantage_~ffi·rf.~E-Tscans (paragrap.l;, 24) (4) - ?'"'" •• • -·~-~~ .-
1. ~ !JIpod t~St$ ~'ml~t~~1o h.f,l(frs associated with {amy/o,icJ.faccu~u/atioh},(.1.j,
2. ·,Allow e?rly detection b~f'!.~~ {symptoms} appear {1~ ~ { _ :l
3. '. f~ese tef,t~ a,re cheape1~f1.ar {PET scans} (1) ; 1.,;, ! j i
4. ·{!JJ~od te.s[~}'_~an be pelf.~!'fed more frequently an1:°C!n' ~ larqer ~cale (1)
5. '{f.E!.scans_} ~tquire spe~la/fqui pment while blood ff$~S\does,not~{1}
I'.
~
I• \
,...,• ~ • 1,l
' 1·• - • ~s '' I •
"( 1
\, ' • ,, ', ·, ·, •\1. ~: •," ' : . ! ~ .
. _. . '>\, -1} ,: J: . ,l ,. ,.• ;.( \ '
·•l 6
··? •• ~· :•.
' I'·•: ,_;~~! th,-~•-i!
' \
~
J / '

26. "Why ca~'-~?me"S~ople ~tti~ate through or escape tre~~ probl~r:1-~ altogether ~ven though
they are apparently at risR!tfrom genes or certain disa,dvantages:in life?" (Paragraph' 28)
(a) Describ~· ~~at this st~~~ent ~u~g~sts regarding H$i2&t Alzhe\riler's disease .• (2)
1. Idea that botf,;}J~q,ei and enviro~i,i~~f~tlt1.~i;"'rii~•l1'.!,~rdct to~et~er_.in''t~e d~c/ine of
cognitive functU;~i/ji,\';... ··"•· j,..~. ·,,,..,,. ,,.~ • •. ' .. _,, • •

2. Reference to 0$ namedexQmdl~·.91 e
nv_i~!?,~~":~'!~':'I {9£t'¥1
-~~ch q[Jife~tyle factors:

{diet/exerc ise/smokin g/ eatJcatiC?~f?~P~.':ens~~1{~f,&HPJ1tion} . .

3. It also indicates that further research is needed to understand why people with seemmgly
increased risk factors do not get the disease.

CHSE/ Departmen t of Biology /Grade12- Semester 4 / Unit 5-Article/ October 2024 16

ARTICLE 2: New Alzheimer's drugs don't deserve the hype - here's why
27. Article two focuses on new drugs for the treatment for Alzheimer's.
There are many ongoing clinical trials for new drugs and treatments for Alzheimer's disease.
These trials are both randomized and double-blinded with the use of placebo.
What is meant by these terms and why are they important? (3)
1. randomized - patients are assigned into treatment or placebo groups on a random basis.
2. double-blind - neither thf!:l?,ff(ent·nor the doctor knows wha~tr.eptment the patient is
getting. This remove.S'any q{as in or recording the results .: • " .
3. placebo - this a/1~.f;s
i!?:,F....
cJ,s.
i1
iee if the,:e is. qnf
.....~ • ~;;, .
improve_ment
"1il~ • , ~.; t'!',t.,._
to
even without a,n active drug 4~- ...

being take~l~f!.n;~e•'due t~,,_the plf1/!!S"il/t.e'ttl-..:Yj.,~~cebio is a:e.ff!,or inje~tlon without any

active ingredient e.g. a ,wbite sugar pill or tablet, or a'saline/wat'er injection
i-. , -.. I , .-.
'
'Ii .l • _;z. • \

28. Clinic~·! .tr,als~re.,{perfor~~a\n druisi\hat successfully pass the ani'mal testing stages.
drugs stated in article
Desc'ribe.three-ph~sed
~ ... ,
testing ' cciuld be used to test anti-amyloid
'* that
> ,.
.,.~.... ' ; , ..
2. 'f1
(4)
1~
' ,,,~.\ft-
.r
~ iiU
,. ·•'
.., 't
1 ,
•' -,
•
,\
t

1. (f~~$k I) dr~gl~sted o(({ir,all numb~r of) healthy {people I v.qlu~teers}

2. (ph.a'se II) " -.~ ,,.~ tested on• sMall
, ,r-f\ . , I
a,'.ug
number of patients (with dise&se}i
} ,
3. t;(phase 11/)'<;ltug tested dn ldrge nurri/Jer of patients (with disef'!se}1
4. ,~ re/erence ti/{placebo /~ouble bllnµ trial} (during phase II I /i!_IJIS~ Ill);
I .I • . { ' '

2~;-~~tjree-Rr~i~-~~~tJ"o:s.-c,n:~~- psed ~nd ~.fnew Alzheimer's lei~~eo~f?~;~t~~t~!Y ei~~~i!~,~~\~S~

Z.,\d,~ugs ~.en·~ro.oect.io.qr!i~le .2. Des~~J.tl,"e t!ro.r.oJ,~s,.pl_p_hase I and~p~a~~,:!.I'. (3) ;. :
l.{ io test for.side-effects (1) ·; •1
2.\ t'!-:~ete(;;,(rie {safe/ mi~lm~m /effective} {dosage /concentrq~ion} (l}
3. , to}leterinine if it is more effective than existing tredtments (1)
~: ,, .. \ ';' ')\<:\ ' ,.. • i I I

,, I· " \ \}/ \ 1 : '.: : · -~ ;

t ,1 t~!~ ,\ 11
'.' I • .
30. AhJ~J~:2 out'1iijffl~sues 1wit~ anti-amyloid drugs and fon~erns.'reg~rding the clinical triats··used
,. ~ .., . ,, jl .• I

to test.t~ese drugs. Suggesehow clinical trials should'be designed' ~o◄

that the effectiveness of
o,),":lll ~ " • ,'", """
r 1
',1:: '\. '1 "

-t··.,;:i\ ~ < ... .. • 11

•

these thfee,drugs (aducar:iumab, lecanemab and don,anemab) qm be compared. (4)

# • ~ '\ :-- ·, • •

~,( Jo... ►\ I ,,,_, i \ ~•,

1. 3 (large) gH,upJ:9f peopie•(J) ;s_{,1-p_-:;m.~-- ~•· -,,:,,, ·• tf•tt· ·~ ::· -~;1 ~ 1

•
~. t . ' • '" ,,. h :1;\;, :N>r,•,,;;;~ "· / 11 • \· < '

2. Reference to lisf'?{P,!19,.cebo/ dou'bl~~fllJjjJJ~-: ,i.,,J:.i~-·-:, e:if• \' ~'-~._·_ ; •

3. {Sample size is largrnt~r:r.~produclbility {l} ACCEPT repeatable°X·'feliqble IGNORE accurate/
. . '"'elr,·1 .,h;.'" ;~ .....'!· . l \!' .• '
Prec,se I valid
-i•

,,~.,.':'-·::·'.;,;:, ,,_ ·· • ., ~· • . . . ,...

.,.r;;J).<· < - . ' •
,, ,1 ,-,. . ."~-
.
4. people in all groups consurri~'tffe.same~{m_ass I volume] concentration}
fl.•
of drug {1} IGNORE
" ' ~ ~ \ . . , , .. ~.·.. ..

amount
5. Reference to other appropriate named control variable e.g. sex, age, diet, level of activity,
alcohol intake IGNORE same number of people in each group I amount
6. Variables controlled for validity (1) IGNORE accurate I precise /reproducible/ repeatable I
reliable

CHSE/ Department of Biology /Grade12- Semester 4 / Unit 5-Artic/e/ October 2024 17

31 - (a) list three new Alzheim
er's drugs mentioned in the article in paragraph 31 (l)

1. {Aduc anuma b}, {lecanemab}, and {donan emab} (1)

(b) Describe the inform ation that needs to be collected by scientis

ts before these drugs could be
approv ed. (3)

1. wheth er it caused side effects (in humans)· ..., ,r ,..,, ...

2. wheth er or not it reduced the size of the p/aqu 0~1~. )
· ..
3. {(an effective) conc~n~ration / the half-life} of the d;';;g:
'ACC£P~.ifci"fV_ ~he drug is
metab olized in the body. , f· ~~J:, _;; : •·
4. the (best) n:1etho~,to admlJ /ster !he drug • ·-. • ::·: ~ 1,~:_,1 • ''°\;'-' i , •.,.
S. how long t" admmlster qr~~ (for amyloid to be destroyed)
'. .. ,.j
(c) Desc~i~e)lO'Cv a dpubh?-Jtin~ clinic~·I 't:iial would be performed
to te'st one of th~sid rugs. (4)
1. {Sei~itib~ of) p~\,in ts with the A'lzhjimer's/ amyloid positiv
} 'p~tients and rand~f1JIY •
divf<;fing into t~o groups {1~ / :
2. {h~lf I one' grqup} given {drug} dnd {~al// one group} given
{pla~ebo} (1)
3. ,'neith er doctor nor patien t knows which treatm ent has been
, •I given (1)
4. analysis of data to see if drug is more •
effective than the {placebo} {1}
I I I
r
'
32. T~e three drugs ad~canumab, lecanemab~and donanem~b are
ex~mples-of whole.monoclonal
• -antiboq,ies \JSed•in·the~treatment 10f Alzheimer's·(paragraph 3i}...
• :· •
Monoc lona\ antibodies are, made in a laboratory specific to one
ty~e of antigen
(glycoprotein). ' . !
•(a.) Suggest how these antibodies help the immune sy~ter\, to d~sttoy
amyloid proteins
~c~umulat·~d in the brain: (2) :. , ". • 1
1. Antlb~ diei carried throug~ blood crossing blood brain• b,arrier
2. thJ antibodies will {bind·to the amyloid proteins I form an
. ,, l
an'tig'en antibody complex}'{1)
ACC:EPT.'agglutination and opsonization.
3. (therefore), destroyed fas.ter by the {macrophages} phagoc
i •:; 1 L• .
ytes} (1) ACCEPT engulfed by
macro phage s/aste r
'r~ \t
\\'
rr,.tf~• ' ~ l'"1
'' I I ..
(b) Describe'three.limitati'6'hs as{9ciated with of these drugs based I'- '
,• 1 I

..
in article 2. (3) •
, ,J:... J •• ,,
l on, th~~·~inform
,~
y
ation given
··,"i. • '· ~· , , ·,
~ - ,i.. •~;?•~.. "'.
1. Drug trials show o~ly-a,Jffa}f.red~ctio..,'! in.c~gnitive decline
COmlJ.Ored to placebo (1)
2. Side effects such brain sweillhg,.q~d bleeding were reported
(1)
3. The high cost of treatm ent " ••
4. Highly selective trials limit their real-world use (1)

CHSE/ Depar tment of Biolog y /Grade12- Semester 4 I Unit 5-Artic 18

le/ October 2024
33. In the donanemab trial, the people taking the drug declined on average by ten points on a
144-point cognitive scale. The placebo group declined by 13 points (paragraph 33).
Suggest how it can be determined whether there is a significant difference between the
results for the placebo group and the test group in this trial. (2)
1. Carry out (student) t-test
2. Compare critical value and calculated t- value
3. If calculated value is greater than critical value, there is a significant difference In the results.

34. Discuss the implications of using expensive drugs like aducanumab for Alzheimer's treatment
when their cognitive- benefits are marginal (par,agraph
(•._;' •,• ~ •
38). (2)
') , , > •l't ,, 'J • ,'. I

... patients
limits access to r'ealthy {1) - • --.-
1. High (cost} of. treatment
(,, . .

2. Marglnal_impt9vement,may not justify the financial burden on h~althcar,_s_yst~ms {1}

3. Ethical dlte_mma of offering {expensive treatments} with uncertain long-ternfoJ,ttcomes (1)
,,,._ ' .
. '. -· . ' ,:. .
35. Aduca'numab
' ~
was marketed
, ,,
in the US'
for US$45,000 (£35,000) per
\
patient per yea.t~ri~
~:t.;r,:" ~
later
reduced to U5$20,000 to increase demand. Calculate the percentage decrease in CO$!;:l>tir
year per pati~nt.(paragraph 38). (2) l. 45000-20000/45000 x iOO~ 55.6 ;/.
0

\~·:. \
• ~ . ·J
t-. ! J

36. Suggest two ethical concerns associated with excluding a large portion of patients from
~!inical tfiafs due to strict eligibility.criteria (paragraph 42) (3) •
1.i EJ/cludirig patients with brain pathologies other than amyloid accumulation makes the trial
.r'esults (~s~·gp~licable to real-world settings,{1) • • • - . :.. ,~·.:. • :;: ·~ :·: . ~:.
2. : E~hical co;~~'!!'Et-!Jbou_r fairness and repre~entation Jn trials (1) .:. ? , .~:.. ~ L. ~- ; : .- _,' ~h • ,

3.. Li,:nited access for those who could potentially benefit from the {treatment} (1)

37; Compare·and ~ontrast Alzheimer's and Parkinson's disease (article 1 and 2). (3)
~
' ".I ,,
- •
•

Similarities: • ,
1. Both are neuro'degenerative disorders/ brain disorders (1) ,::
Diff~rences '-. ,. . .. , -~ _·/
2. Alzheimer's Disease is a disorder linked to memory (9ss, language, and cognitive i~ues
while 1.'ar~lnson's is a brain disorder that affects the. motor syst~m, leads to tr,erifQrs, and
< \• ' .J
'- l ' "'' ,•

causes p~oblems with "?ovement. OR The symptoms of Parkinso~'s are tre"fC~li>Jlhstability,

anxiety, de~re~ion, sleep issues, and bra~ykinesia, w_hlle those-JJ Alzh~l1'~1,s'&re memory
loss, speech iss~!S, iu,dgment, feeling disoriented, mood and pe~sp,,,_alitY;_chllnges,
depression, and·agitation {1) •, , ~~ ,.
3. Parkinson's results frorr, _the loss of c!opamine-producing neurons_.wh~~e as Alzheimer's is
associated with accumulation of amylold and tau proteins/ loss of neurones producing
acetylcholine. (1) •

NOTE: The above questions are compiled by biology teachers of CHSE and biology
students of B2024.

CHSE/ Department of Biology /Grade12- Semester 4 / Unit 5-Article/ O<.'tober 2024 19