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