10: Types of Dementia Flashcards
Progressive (permanent) or reversible (potentially)?
Multi-infarct
Progressive (permanent)
What percentage of mild cognitive impairment progresses to dementia each year?
10-15%
More profound deficits in self-awareness, self-monitoring, and self-knowledge compared to patients with AD.
Frontotemporal Dementia (Pick’s Disease)
_____ affects people more in middle age.
Pick’s disease
What deficiency causes Wernicke-Korsakoff’s syndrome?
Thiamine
Loss of ability to understand or express speech.
Aphasia
Theories of causation for vascular dementias (6).
- Lacunae
- Multiembolic events
- Vasculitis
- Blood dyscrasias
- Hypoperfusion
- Anoxic episodes
Progressive (permanent) or reversible (potentially)?
Normal Pressure Hydrocephalus (NPH)
Reversible (potentially)
Early, mid, or late stage AD?
Memory loss, poor judgment, perceptual disturbances, withdrawal, and depression.
Early Stage
_____ (intracellular deposits observed in degenerated neurons) distribute in brain regions involved in learning, memory, and language.
Neurofibrillary tangles
People live an average of _____ years after diagnosis of AD.
8-10 years
What is the usual cause of delirium?
Underlying physical illness
Progressive (permanent) or reversible (potentially)?
Delirium
Reversible (potentially)
T/F Alcoholic dementias can coexist with AD and multi-infarct.
True
Inability to interpret sensations and hence to recognize things.
Agnosia
Adult presents with deficits in memory or in other cognitive functions without significant impact on daily functioning.
Mild Cognitive Impairment
50% of those with mental status change, with the etiology of depression, develop dementia over the next _____ years.
5
Progressive (permanent) or reversible (potentially)?
Alcoholic dementias
Progressive (permanent)
Inability to perform particular purposive actions.
Apraxia
Neuropathological hallmarks (_____) are diagnostic of AD.
Amyloid plaques
Early, mid, or late stage AD?
Recent and remote memory loss, restlessness, perseveration, loss of impulse control, and increased aphasia.
Mid Stage
A speech disorder in which a person has trouble saying what he or she wants to say correctly and consistently.
Verbal Apraxia
What deficiency causes alcohol-induced pellagra?
Niacin and/or tryptophan
Patients with _____ are six times more likely to get dementia.
Parkinson’s Disease
What 5 meds can cause reversible dementia?
- H2RAs
- Antidepressants
- Anti-anxiety agents
- Major tranquilizers
- Cardiac meds
What is the #1 etiologic factor in AD?
Genetics
Abnormal processing of _____ is likely central to the pathogenesis of AD.
Amyloid beta protein
_____ accounts for roughly 5-25% of reversible dementias.
Depression
What are the 2 neurotransmitters involved in AD that are targets of medications?
- Acetylcholine
2. Glutamate
Most common progressive dementia.
Alzheimer’s Disease (AD)
Dementia or delirium? Abrupt changes in cognition that occur within hours to days.
Delirium
Mixed dementia is reversible with _____.
Underlying progressive
Progressive (permanent) or reversible (potentially)?
Alzheimer’s
Progressive (permanent)
What is the most important risk factor for vascular dementias like multi-infarct?
HTN
How can you tell the difference between frontotemporal dementia (Pick’s disease) and AD with imaging?
Atrophy is usually symmetrical in AD. It can be symmetrical or asymmetrical in Pick’s disease.
Progressive (permanent) or reversible (potentially)?
Medications
Reversible (potentially)
Occurs with history of gastric bypass surgery, alcohol abuse, advanced age, and PPI use.
B12 Deficiency Dementia
Progressive (permanent) or reversible (potentially)?
Thyroid disease
Reversible (potentially)
Early, mid, or late stage AD?
Incontinence, apraxia, little recognition of family, and loss of most self-care abilities.
Late Stage
Life threatening alteration of consciousness. Also referred to as acute confusional state.
Delirium
Progressive (permanent) or reversible (potentially)?
B12 deficiency
Reversible (potentially)
This type of dementia is fixed, irreversible.
Progressive
How many identified genetic markers are present that precipitate the complex AD process?
1
Progressive (permanent) or reversible (potentially)?
Infections
Reversible (potentially)
Medical emergency treatment for delirium focuses on what 2 things?
- Detecting underlying etiology
2. Protecting/advocating for patient
3 alcohol-induced dementias.
- Wernicke-Korsakoff’s Syndrome
- Alcohol-induced Pellagra
- Hepatic Encephalitis
What factors influence AD (8)?
- Genetics
- Aluminum
- Estrogen
- NSAIDs
- Vitamin E
- Viral agents
- DMT2 (explored)
- Alcohol consumption (explored)
T/F There is currently no treatment to prevent progression of AD.
True
Beta-amyloid protein accumulation leads to an _____ response, causing neuritic injury.
Inflammatory
T/F The chances of social survival are better with multi-infarct dementia than with AD.
True. Essence of person’s personality is more intact than with AD.
Progressive dementias have development of multiple cognitive deficits manifested by both memory impairment and at least one of the following what (4)?
- Aphasia
- Apraxia
- Agnosia
- Disturbance in executive functioning
Major risk factors for all forms of dementia (3).
- HTN
- DM
- Hyperlipidemia
Can mimic PD and has poor response to levodopa or Sinemet.
Progressive Supranuclear Palsy (PSP)
In more advanced stages of AD, _____ problems are enormous.
Behavioral
Pick’s disease is a type of _____ dementia.
Frontotemporal
Associated with triad of dementia, gait disturbance, and urinary incontinence. What is it and how is it treated?
NPH is treated with ventriculoperitoneal (VP) shunt.
In frontotemporal dementia (Pick’s Disease), imaging (CT and MRI) often reveals symmetrical or asymmetrical atrophy of _____ and _____ lobes.
Anterior temporal and frontal lobes
The patho of Alzheimer’s involves neuritic _____ and _____, as well as deposition of amyloid beta protein.
Plaques and tangles
Though UTIs and respiratory infections are the most common causes of infection-related dementia, _____ and _____ are other causes.
Diverticulitis and abscesses
Often experience frequent falls, syncope, sensitivity to neuroleptic drugs, delusions, and hallucinations.
Dementia with Lewy Bodies (DLB) (Parkinson’s patients)
Progressive complex neurological degeneration including loss of neurons, particularly those responsible for memory and cognition.
Alzheimer’s Disease (AD)
Regarding the structure of AD, aggregates of _____ are seen adjacent to and within walls of blood vessels.
Amyloid protein
Risk factors for delirium (6).
- 90+
- Substance abuse hx
- Dementia
- Postsurgery
- Sudden change in environment
- New medications
What scale is helpful in differentiating AD from multi-infarct dementia?
Hachinski Ischemic Rating Scale