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CCD > 5.3 - Diagnosing Dementia > Flashcards

5.3 - Diagnosing Dementia Flashcards

1
Q

How do Physicians diagnose dementia?

4

A

Taking and extensive history from the patient and his/her family

Closely observing the patient

Performing a physical exam

Performing mental status and psychological tests

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2
Q

What 4 things are included in a Patient History in patients with Dementia?

A

ADL’s

IADL’s

Independent family functioning – community affairs

Other

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3
Q

What are 2 examples of IADL’s?

A

Everyday problem solving

Business and financial affairs

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4
Q

What are 4 examples of Independent Family Functioning – Community Affairs?

A

Job responsibilities

Shopping

Volunteer

Social groups

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5
Q

What are 2 Other Subjects that we might patients during a patient history for dementia?

A

Hobbies

Personal care

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6
Q

What 5 things are included in an Exam when diagnosing dementia?

A

Cognitive domains

Aphasia

Apraxia

Agnosia

Executive functioning

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7
Q

What are 2 Diagnostic Approaches to Dementia?

A

Neuroradiologic Studies

Clinical Neurobehavioral Exams (Primary data for diagnosis)

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8
Q

Who can assist in Differentiation of Dementias?

5

A

Clinicians

Neuroradiologists

Neuropathologists

Geneticisits

Microbiologists

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9
Q

How do Clinicians assist in differentiation of dementias?

A

Clinical signs and symptoms

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10
Q

How do Neuroradiologists assist in differentiation of dementias?

A

Static images of brain structure and dynamic images of brain metabolism

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11
Q

How do Neuropathologists assist in differentiation of dementias?

A

Postmortem analysis of brain tissue

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12
Q

How do Geneticisits assist in differentiation of dementias?

A

Families where disease or disease cluster appear

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13
Q

How do Microbiologists assist in differentiation of dementias?

A

Chromosomes to mutations in specific genes

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14
Q

What are 5 categories of symptoms that are used to evaluate Dementia?

A

Impaired cognition

Impaired function

Mood/mental Phenomena

Behaviors

Drives

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15
Q

What kinds of items are included in the Impaired Cognition category when evaluating dementia?

(12)

A

Memory

Language

Orientation

Writing + Reading

Calculating

Recognizing

Attention

Concentration

Planning + Organizing

Personality Change

Executing

Social Rules

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16
Q

What kinds of items are included in the Impaired Function category when evaluating dementia?

(11)

A

Cooking

Finances

Housekeeping

Shopping

Driving

Hearing + Sight

Dressing

Mobility (Falls)

Bathing + Grooming

Feeding

Continence

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17
Q

What kinds of items are included in the Mood/Mental Phenomena category when evaluating dementia?

(21)

A

Depression

Self-Deprecation

Somatic Complaints

Crying Spells

Diurnal Variation

Withdrawn

Anxiety

Fatigues Easily

Death/Suicidal

Disinterest

Anhedonic (unable to find pleasure in activities)

Low Energy Level

Apathy

Panic

Lability

Irritable

Euphoria

Delusions

Illusions

Rapid Speech

Hallucinations

Acute Confusion

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18
Q

What kinds of items are included in the Behaviors category when evaluating dementia?

(12)

A

Verbal Abuse

Uncooperation

Physically Aggressive

“Sundowning” (confusion seen late in the day)

Demands Interaction

Outbursts

Catastrophic

Noisy

Wandering

Hoarding + Rummaging

Sexual Aggression

Intrusive

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19
Q

What kinds of items are included in the Drives category when evaluating dementia?

(8)

A

Poor Appetite

Weight Loss

Excessive Appetite

Hypersexuality

Hyposexuality

Sleeping Poorly

Excessive Sleep

Out of Bed at Night

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20
Q

What are 4 Standardized Screening Tools for Dementia?

A

Mini Mental Status Exam (MMSE)

Clinical Dementia Rating Scale

Blessed Dementia Scale

Global Deterioration Scale

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21
Q

What is the Gold Standard for screening dementia?

A

Mini Mental Status Exam (MMSE)

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22
Q

What is the Mini Mental Status Exam (MMSE)?

A

Brief, standardized exam of cognitive status

23
Q

How long does it take to administer the Mini Mental Status Exam (MMSE)?

A

~ 10 minutes

24
Q

What does the Mini Mental Status Exam (MMSE) assess?

5

A

Orientation

Attention

Immediate and short term recall

Language

Ability to follow simple verbal + written commands

25
Q

What score on the Mini Mental Status Exam (MMSE) indicates cognitive impairment?

A

Less than 24

26
Q

What is the Clinical Dementia Rating Scale?

A

A 5-point scale used to characterize six domains of cognitive + functional performance

27
Q

What are the 6 domains examined in the Clinical Dementia Rating Scale?

A

Memory

Orientation

Judgement + Problem Solving

Community Affairs

Home + Hobbies

Personal Care

28
Q

How are the 6 domains rated in the Clinical Dementia Rating Scale?

A

By the clinician based on a patient interview

29
Q

What are the final scores that can be given on the Clinical Dementia Rating Scale?

A 
0   = Normal
0.5 = Very Mild Dementia
1     = Mild Dementia
2    = Moderate Dementia
3    = Severe Dementia
30
Q

What is the Blessed Dementia Scale?

2

A

Family member report

Estimation of ADL ability in 8 areas

31
Q

How is the Blessed Dementia Scale scored?

A

Behavior + personality ratings

32
Q

What is the maximum score on the Blessed Dementia Scale?

A

28

33
Q

What is an unimpaired rating on the Blessed Dementia Scale?

Mild impairment?

Moderate to severe impairment?

A

<4=unimpaired

4-9= mild

10 or greater = mod - severe
used

34
Q

What is the Global Deterioration Scale?

A

A rating of 7 levels of dementia

35
Q

How is the Global Deterioration Scale scored?

2

A

Rating completed by a clinician after patient interview

Ratings based on general descriptions

36
Q

What 3 assessments can be used to evaluate dementia?

A

Arizona Battery for Communication Disorders of Dementia (ABCD)

Cognitive-Linguistic Quick Test

Functional Linguistic Communication Inventory

37
Q

How many Screening Subtests are in the Arizona Battery for Communication Disorders of Dementia (ABCD)?

A

4

38
Q

What are the 4 Screening Subtests in the Arizona Battery for Communication Disorders of Dementia (ABCD)?

A

Speech Discrimination

Visual Perception and Literacy

Visual Field

Visual Agnosia

39
Q

How many Subtests are in the Arizona Battery for Communication Disorders of Dementia (ABCD)?

A

14

40
Q

Can the Subtests in the Arizona Battery for Communication Disorders of Dementia (ABCD) be administered in isolation?

A

Yes

41
Q

How does the Arizona Battery for Communication Disorders of Dementia (ABCD) need to be administered when the whole test is given?

A

In the order presented in

manual

42
Q

How long does the Arizona Battery for Communication Disorders of Dementia (ABCD) take to administer?

A

45-90 minutes

43
Q

Who is the Arizona Battery for Communication Disorders of Dementia (ABCD) recommended for?

A

Individuals with mild dementia

44
Q

What is the Cognitive-Linguistic Quick Test used for?

A

To quickly I.D. strengths and weaknesses in five cognitive domains

45
Q

What 5 cognitive domains are assessed in the Cognitive-Linguistic Quick Test?

A

Attention

Memory

Executive functions

Language

Visuospatial skills

46
Q

How long does the Cognitive-Linguistic Quick Test take to administer?

A

5 to 30 minutes

47
Q

Where can the Cognitive-Linguistic Quick Test be administered?

A

At a table or bedside

48
Q

What is one benefit of the Cognitive-Linguistic Quick Test?

A

It is available in both English and Spanish

49
Q

What was the Functional Linguistic Communication Inventory designed to quantify?

A

Functional linguistic communication skills in moderately and severely demented individuals

50
Q

How many areas are targeted in the Functional Linguistic Communication Inventory?

A

10

51
Q

How long does it take to administer the Functional Linguistic Communication Inventory?

A

~30 minutes

52
Q

What tests can we use to test Language Ability in patients with Dementia?

A

BDAE (Boston Diagnostic Aphasia Examination)

BNT (Boston Naming Test)

PPVT (Peabody Picture Vocabulary Test)

TACL (Test for Auditory Comprehension of Language)

DCT (Discourse Completion Test)

53
Q

Do we use language tests to diagnose dementia?

A

No. Only to test specific language domains.

CCD (16 decks)

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