Alzhiemers - Dementia Flashcards
What is dementia?
Dementia is characterised by forgetfulness, difficulty finding words and other cognitive impairments and it is not a normal part of ageing
What are the different types of dementia?
Alzheimer’s disease
vascular dementia and frontotemporal dementia. AD is the most prevalent type of dementia and there are two types of AD: early onset (develops before the age of 65) and late onset (develops after the age of 65)
What are the signs and symptoms of Alzheimer’s?
A person with Alzheimer’s disease may display a variety of signs and symptoms throughout
the progressive stages of the condition which are referred to as early, middle, and late
Noticeable memory loss will gradually worsen as will the person’s
communicative abilities and their capabilities to undertake everyday activities
What are the stages of Alzheimer’s?
Early stage (can last for 2-3 years)
Middle stage (2-10 years)
Late stage
What occurs in the early stage of alzhiemers?
- new learning becomes difficult as short-term memory is significantly affected, and long-term memory begins to deteriorate
- difficulties with language in this stage including paraphasia
(substituting an incorrect word for a forgotten a word) and forgetting words - Visuospatial Skills start to decline which may result in a person getting lost in a familiar environment and putting items in the wrong place.
- difficulty with Executive Functions, causing problems with planning, organizing, sequencing and abstracting
What occurs in the middle stage of Alzheimer’s?
- Short- and long-term memory continue to worsen
- May lose ability to speak fluently
- May become disoriented in time and place
- Difficulty organising thoughts and thinking logically
- Visuospatial skills decline further – losing ability to judge distance and depth
- Wandering, agitation, loss of impulse control, loss of inhibition
- Psychiatric symptoms of depression, anxiety, hallucinations and loss of control over emotions resulting in outbursts of fear and/or anger worsen in this stage
What occurs in the late stage of Alzheimer’s?
- Will not be able to create any new memories
- Speech limited to few words
- Motor skills continue to decline – loss of postural control – may be bedridden
- May have complications of seizures, contractures, pressure ulcers, UTIs, pneumonia and incontinence.
- AD progresses until death
What is the aetiology of AD?
beta-amyloid plaques and neurofibrillary tangles are involved in the process and that they play a role in the structural changes to the brain, including damage to neurons and affect neuro transmission.
There is also some evidence that acetylcholine, a neurotransmitter is involved in the progression of the disease
What are the risk factors for AD?
Down syndrome
Female
Older age
Low educational level
History of head trauma with loss of consciousness
Hisotr of depression
Late maternal age
Alcohol abuse
Prolonged physical inactivity
Type 2 diabetes
How is AD diagnosed?
Must meet 3 criteria: AND rule out other causes and types of dementia
- The person needs to develop multiple cognitive deficits which include memory impairment and one other deficit which could be: aphasia, apraxia, agnosia or a disturbance in executive function (problems with planning, organizing, sequencing and abstracting).
- The multiple cognitive deficits should cause significant impairment in social or occupational functioning, which is a significant decline from their prior level of functioning.
- The course of the disease should be characterised by a gradual onset and continuing cognitive decline
What is the medical management of AD?
4 pillars of care:
- Supportive care for the patient
- Supportive care for the family/caregiver
- Disease treatment
- Symptom treatment, including cognitive, mental and behavioural symptoms
What are the complications of AD?
- Infections
- Constipation
- Delirium
- medication or substance intoxication can exacerbate
- symptoms
Complications in the last stage of AD include: - Seizures
- Contractures
- pressure ulcers
- urinary tract infections
- pneumonia
- incontinence
What is the impact on the person and their OP in early stage AD?
ADLs - The person may not experience difficulty with ADLs.
IADLs-
- Community mobility and driving may be impacted due to the person’s difficulty with orientation. The person may also become easily disorientated when mobilising or driving in the community. The person’s ability to drive safely may also be affected by poor coordination, difficulty with judging distances and difficulty with multi-tasking. Memory loss, difficulty processing information and with making decisions may also affect driving.
- Meal preparation may be difficult due to memory loss and the person may forget that they are preparing a meal.
- health management, the person may forget about medical appointments or to take medication.
- Social participation - individuals may experience difficultly with social participation with friends and family as well as with sexual expression due to depression, deteriorating language, memory loss and embarrassment of their condition. They may also experience difficulty with clearly articulating thoughts and needs.
What is the impact on the person and their OP in middle stage AD?
ADLs - May experience difficulty with showering, dressing and grooming due to forgetting steps in the occupations, experiencing difficulty with problem solving and decision making and misplacing items needed to conduct these occupations. They may forget to clean certain body areas, affecting their hygiene. Due to the difficulty with judging depth and distance, the person is at risk of falling.
IADLs - Individuals may become dependent on others for help with community mobility, financial management and shopping. In regards to shopping, the person may become lost even in the familiar shopping centre. They may forget the process for buying items, specific items needed and how to handle money and change.
What is the impact on the person and their OP in late-stage AD?
All occupations - The person is fully dependent on others for all ADLs and IADLs due to the impairment of all cognitive functions and of neuromusculoskeletal and movement-related functions.
