12 - Psychiatry of the Elderly Flashcards
What is transient global amnesia?
Neurological condition characterised by a temporary but total disruption of both short and long term memory. Other cognitive functions are preserved.
It can present with patients being found wandering the street far away from their home.
The episode may last for several hours before spontaneously resolving
How can you remember the 4 features of dementia?
4 A’s
- Amnesia (recent memories lost first)
- Aphasia (word-finding problems, speech muddled and disjointed)
- Agnosia (recognition problems)
- Apraxia (inability to carry out skilled tasks despite normal motor function)
What is the epidemiology and aetiology of delirium?
30% of elderly inpatients
What are some risk factors for delirium?
How is delirium treated in general terms?
- Treat underlying cause
- Good lighting and orientating environment
- PRN Haloperidol or Olanzapine if extremely agitated
What are some complications with delirium?
- Longer hospital stay
- Dementia
What are some differentials for delirium?
- Withdrawal from alcohol/drugs
- Mania
- Post-ictal
- Psychosis or anxiety
- Dementia
What is the ICD-10 criteria for delirium?
What is the difference between dementia and delirium in the following categories?
What are some cognitive tests you can do on delirious patients?
- AMT
- CAM (Do after AMT)
- MMSE
What are some reversible causes of dementia?
DEMENTIA
Drugs
Eyes and Ears (visual/hearing impairment)
Metabolic (Cushing’s, Hypothyroidism)
Emotional (Depression)
Normal pressure Hydrocephalus/Nutritional deficiencies
Tumours/Trauma
Infections
Alcoholism
How can you remember the areas of impairment in dementia?
My Cat Loves Eating Pigeons
Memory, Cognition, Language, Executive Functioning, Personality
How can you distinguish dementia from depression in the elderly?
In depression low mood starts first then memory issues
What are some frontal lobe tests?
- Similarities (conceptualization)
- Lexical fluency (mental flexibility)
- Motor series ‘Luria’ test (programming)
- Conflicting instructions (sensitivity to interference)
- Go–No-Go (inhibitory control)
- Prehension behaviour (environmental autonomy)
What is advocacy?
An impartial person who can help you understand and stand up for your rights in the aged care system
What is an encapsulated delusion?
Well-organised delusions that are fixed, continuous, and defended in an intelligent way
Delusion is only in one area of life so does not interfere with everyday life and executive functioning
