Alzheimer-Dementia Flashcards
What is Dementia?
Characterized by loss of function in multiple cognitive domains
Has 1 or more of the following clinical manifestations
-General decrease in cognition
-Behavioral Disturbance
-Interference with daily function/independence
What is the prevalence of Dementia?
5% under 65
35-50% over 85%
What else comes with dementia?
Aphasia-A language disorder that affects a person’s ability to communicate
Apraxia- difficulty with motor planning
Agnosia- inability to process sensory information
Disturbance of executive functions
What are some things pt with dementia will have?
Difficulty learning & retaining new info (remembering events)
Handling complex tasks (balancing a checkbook)
Reasoning (unable to cope with unexpected events)
Spatial ability and orientation (Getting lost in familiar places)
Language
Behavior
What are some different versions of dementia?
Alzheimers-60-80% Vascular (multi-infarct)-10-20% Parkinsons disease and related demtias - 5% Frontal Lobe dementia Reversible dementia's
What is delirium?
Disturbance of consciousness
-reduced clarity of awareness of environment
-w/ reduce ability to focus, sustain or shift attention
Change in cognition
-memor deficit, disorientation, language disturbance
How does delirium work?
The disturbance develops over short period of time and fluctuates during the course of the day.
Differentiated by etiology (due to general medical condition, substance induced, multiple etiology, not otherwise specified)
What is the prevalence of Delirium?
10-30% in hospitalized medically ill
10-40% of hospitalized elderly
Up to 51% of post-operative patients
How can you differentiate between delirium and dementia?
Delirium fluctuates with time of day, differentiated by variations in alertness/orientation.
Dementia residents usually are alert, and mental status does not change during the day
How many pt with delirium fully recover?
40%
What’s the most common form of dementia?
Alzheimers-60-70%
What is Alzheimers?
Acquired syndrome of decline in memory and at least one other cognitive domain sufficient to interfere with social or occupational functioning in an alert person
What are some risk factors for Alzheimers?
Age History of depression Femaile Low education level Family history Diabetes Hypercholesterolemia Blood Pressure Genetics
How can Alzheimers disease be diagnosed
only at an autopsy
What are some signs and symptoms of Alzheimers?
memory loss personality change global cognitive dysfunction, functional impairments Loss of short term memory
What is the 1st Stage of Alzheimers?
Stage 1-Mild
-Defective memory difficulty learning new info, language and visuospacial skills decline
-Personality changes occur, but motor abilities remain intact
First 1-3 years
What is the 2nd stage of Alzheimers?
Moderate
- recent and remote memory severely impaired, recall of previously learned info difficult
- language, visuospatial skills and personality changes worsen
- Psychiatric features and acalculia are noted
- Neuroimaging and EEG changes begin
- Lasts 2-10 years
What is the 3rd stage of Alzheimers?
Severe
- Intellectual function markedly worsens
- Echolalia, palilalia, aphasia, loss of motor function, falls, loss of sphincter control, personality changes
- Bedridden
- Neuroimaging studies demonstrate atrophy
- EEG shows diffuse slowing
- Lasts 1-3 years
What is Vascular dementia?
Clinical presentation varies with location of infarcts.
- Lacunar Dementia-no stroke history; progressive dementia, focal deficits, frontal lobe-like syndrome
- Binswanger’s disease-Apathy, agitation, bilateral corticospinal or bulbar signs
What is Post-stroke Dementia?
New dementia at 3 months after acute stroke
6-32% prevalence
What’s mixed dementia?
Features vascular (lacunar) and Alzheimer
What are some examples of reversible dementias?
Medication-induced
Alcohol-related (Withdrawal, intoxication)
Metabolic disorders
Depression
What is the 1-minute mental status exam?
Category fluency-name as many animals as they can
Phonemic fluency test-Name as many words as possible in a minute
Test of recall-3 unrelated objects and see if the pt can remember
What is sundowning?
Occurs late in day, and extends into the night Etiology unknown May be aggravated by -fatigue -low lighting -increased shadows -disruption of internal clock Sleep disturbance
