DDD-Shumaker Flashcards
65+ patients with cognitive impairment of some degree?
dementia in >65 yo?
dementia in >85?
59%
>65 yo: 8%
>85 yo: 40% (not including MCI)
65+ patients with cognitive impairment of some degree?
59%
What is the biggest barrier to dementia detection in the clinic?
Health care team processes are poorly designed to detect or manage dementia
Barriers to dementia recognition?
Lack of support for caregiver or PCP Time constraints Financial constraints Stigma Diagnostic Uncertainty Disclosure of Diagnosis
Medical Home principles?
Partnerships with patients
Access to care using diverse methods
Coordinated care among team members
Team-based care with Patients at the center of their Team
What is dementia?
Dementia is a progressive decline in memory and at least one other cognitive area in an alert person. These include language, orientation, judgment, abstract thinking and personality.
Diagnosis of dementia?
Memory loss plus one or more of the following:
aphasia – language problems
apraxia – functional, organizational problems
agnosia – unable to recognize objects or tell their purpose
disturbed executive function – planning, sequencing
changes in personality
DSM5 definition of dementia?
A condition involving impairments in thinking, remembering, and reasoning, which affects a person’s function and safety
Irreversible and progressive dementias include Alzheimer’s Disease, Vascular dementia, Lewy Body dementia, and Frontotemporal dementias (FTD)
NCD of Alzheimer’s disease presents with impairments in memory, language and executive function; other NCDs may present with personality/behavior changes or with neurological deficit
Individuals with major neurocognitive disorders exhibit cognitive deficits that interfere with independence, while persons with mild neurocognitive disorders may retain the ability to be independent
What are some subtypes of neurocognitive disorders?
Alzheimer’s Disease (most common) Vascular dementia Lewy body dementia Frontotemporal dementias Parkinson’s disease Huntington’s disease Downs Syndrome Prion diseases AIDS, alcoholism, and other neurodegenerations
Why should we identify dementia?
see if it is treatable: sleep disorders, nutritional deficiencies, med toxicity, major depression, thyroid disease
treat comorbidities: depression, delirium, delusions, hallucinations
help the caregivers w/ their responsibilities
What are some domains that dementia will functionally impair?
- memory
- reasoning & problem-solving
- planning & sequencing everyday tasks
T/F Dementia is NOT delirium or a psychiatric disorder.
True.
T/F Screening for dementia is routinely recommended.
False. But you should keep your eyes/hears open for signs of dementia.
Note: We don’t have curative therapy, so screening isn’t recommended.
Warning signs for dementia?
Fail to keep appointments, or appears at the wrong day or wrong time for an appointment?
A “poor historian” or seem “odd”?
Inattentive to appearance or appear unkempt, inappropriately dressed for weather, or disheveled?
Repeatedly and apparently unintentionally fail to follow directions?
Have unexplained weight loss, “failure to thrive” or vague symptoms?
Seem unable to adapt or experiences functional difficulties under stress?
Defer to a caregiver or family member to answer questions?
What is the SET test?
name 10 animals, fruits, colors, places