6 - Dementia Flashcards
What does WHO define as old age?
65
What is dementia?
- syndrome of chronic/progressive nature
- deterioration in cognitive function that affects memory, orientation, comprehension, language and judgement
What are common signs of dementia?
- day-to-day memory problems
- issues with concentrating, planning or organising
- struggle to follow conversation
- problems judging distances or seeing objects in 3D
- confusion around the date or where they are
What is Alzheimers?
- most common type of dementia
- reduction in size of cortex, severe dementia affects the hippocampus
- plaque deposits build up between nerve cells
What are the common features of Alzheimers?
- STML
- aphasia
- communication difficulties
- muddled over everyday activities
- mood swings
- withdrawn
- loss of confidence
Who is more at risk for developing Alzheimers?
- older
- more women than men
- head injury
- smoking, hypertension, low folate or high cholesterol
- abnormalities on chromosomes 1, 14 or 21
What is vascular dementia?
- reduced blood flow to the brain damages and kills cells
- caused by blockage of small vessels, stroke, multiple TIAs
What are the common features of a vascular stroke?
- memory loss of sudden onset
- visuospatial difficulties
- anxiety
- delusions
- seizures
Who is more at risk for developing vascular dementia?
- hypertension
- diabetes
- smoking
- obesity
What is dementia with Lewy Bodies?
Deposits of abnormal protein called Lewy bodies inside brain cells
What are common features of dementia with Lewy bodies?
- STML
- cognitive ability fluctuates
- visuospatial difficulties
- attentional difficulties
- overlapping motor disorders
- speech and swallowing problems
- sleep disorders
- delusions
What is frontotemporal dementia?
- younger age of onset
- affects frontal lobes of brain which control behaviour, problem solving and emotions
- caused by ubiqitin clumps of protein
What are common features of frontotemporal dementia?
- STML (not always present)
- uncontrollable repetition of words
- mutism
- repetition of words from other people
- personality change
- decline in personal and social conduct
What are other, rarer forms of dementia?
- HIV
- Parkinson’s disease
- corticobasal degeneration
- MS
How do you test for dementia?
- MMSE (mini mental state exam)
- Blessed dementia test
- FBC, U&Es, kidney, liver and thyroid should be assessed to eliminate treatable causes
What are other cognitive tests?
- MMSE
- blessed dementia scale
- Montreal cognitive assessment
- neuropsychological tests (clock draw, delayed word recall, category fluency)
What treatment options are there for dementia?
- no pharmacological, surgical or behavioural cure
- counselling can delay residential care
- aspirin/reducing cardiac risks can halt progression of vascular dementia
- NSAIDs and vit E can slow progression
- anticholinesterases (donepezil) for Alzheimers
What makes a dementia friendly healthcare environment?
- ceilings, floors, doors etc different colours
- avoid non essential signage
- good natural light
- staff or locked rooms doors coloured the same as walls
- use pictures on signs to aid understanding
