9 Elderly - Dementia

Question 1

What is the single point of referral for all people with suspected diagnosis of dementia

Answer 1

memory assessment clinics

Question 2

How do we make a diagnosis of dementia

Answer 2

pt and carer history
cognitive testing

rule out other causes: blood tests, medication, delirium, depression

Question 3

MMSE levels

Answer 3

normal 26-30
mild 21-25
moderate 10-20
severe 0-9

Question 4

4 dementia assessment tools

Answer 4

MMSE
ACE-R (Addenbrooke’s cognitive examination - revised)
MOCA (Motreal cognative assessment)
Clock drawing

Question 5

Reversible types of dementia

Answer 5

Depression
Delirium
Drugs
Subdural haemorrhage
Tumout
Syphilis
Vit B12 & folate deficiency
Hypothyroidism
Hypoglycemaia
Low Na
High Ca

Question 6

Drugs that contribute to cognitive impairment

Answer 6

Antihistamines
Bz

Oxybutanin
PD drugs
Antidepresants
Li

Steroids
Opiates
Anti psychotics
Phenytoin (antiepileptics)

Question 7

Treatments for AZ

Answer 7

mild-moderate: anticholinesterases

miderate-severe: memantine

Question 8

side-effects of anticholinesterases

Answer 8

g

Question 9

side-effects of anticholinesterases

Answer 9

nausea vom diarrhoea - transient or consider rivastigmine patch
weight loss
muscle weakness
syncope
urinary retention

Question 10

AChEi are contraindicated with

Answer 10

glaucoma
uncontrolled COPD
severe hepatic and renal impairment

sick sinus syndrome
unexplained syncope

Question 11

AChEi for vascular dementia?

Answer 11

no significant benifit proven?

Question 12

What is memantine

Answer 12

NMDA receptor agonist

Question 13

future treatments for AD

Answer 13

Vaccines
MABs against Beta amyloid
vit E

Identifying biomarkers