4th Year Dementia Flashcards
what are the dementias?
group of neurodegenerative diseases that lead to global cognitive decline and impairment in individual’s ability to carry out ADLs
cognitive deficits in dementia
memory aphasia agnosia apraxia abulia apathy orientation personality/ behaviour distractibility lack of insight
secondary dementias are reversible, their causes?
alcohol drugs depression tumours normal pressure hydrocephalus metabolic (B12) hypothyroidism infections
RF for development of dementia
age genetics FH smoking alcohol atherosclerosis elevated LDL diabetes high levels of homocysteine mild cognitive impairment
patients presenting <65
YOD
patients presenting >65
LOD
what is Alzheimer’s disease?
beta-amyloid protein and tau protein neurofibrillary tangles cause death of neurones, reduction in ACh
presentation of Alzheimer’s disease
4A's amnesia aphasia agnosia (recognising people/ objects) apraxia (learned movements)
management of Alzheimer’s disease
AChEI
memantine
what does vascular dementia present with?
step-wise deterioration
difficulties with problem solving, planning , communication and emotional lability
insight preserved
management of vascular dementia
reduce cardiovascular RF
what is dementia with Lewy bodies?
deposits of alpha-synuclein protein causes decreased ACh and DA
presentation of DLB
parkinsonism
visual hallucinations
fluctuations
REM sleep disorder
management of DLB
AChEI
memantine
what is FTD?
neuronal cell death in frontal and temporal lobe
who does FTD present in?
YOD
45-65 year olds
three types of FTD
- behavioural variant (Pick’s disease)
- progressive non-fluent aphasia
- semantic dementia
presentation of Pick’s disease
personality change (impulsive), lack of empathy, apathy, OCD, fatty/sugary foods
presentation of semantic dementia
language
comprehension
recognising people and objects
management of FTD
antipsychotics for behaviour
SALT
how often do you review mild cognitive impairment?
every 6 months to a year
when is power of attorney granted?
when the patient is well
when is guardianship granted?
by a sheriff when the patient is unwell as they have not granted someone prior
what to rule out in the diagnosis of dementia
constipation
infection
medications (anticholinergic burden)
