Delirium and Dementia Flashcards
what is delerium?
Acute and Potentially Reversible State of Confusion
Disturbance of Consciousness
Sx will Fluctuate
what is there a high risk of during delirium?
suicide
what occurs during Acute Onset/Fluctuating Mental Status?
Fluctuating Levels of Consciousness Cognitive Skills, including Memory, Language, and Organization
what drugs can alter delirium?
Polypharmacy, EtOH, Anticholinergics, Narcotics, Antipsychotics, Sedatives, Hypnotics, Diuretics, Anti-PD Agents, Antihistamines
what kinds of metabolic dysfx cause delirium?
Renal failure, Sodium, Calcium, Fluid Status, BG, Hepatic, Thyroid, Vitamin Deficiencies-B1,B6,B12
how can hypoxia cause delirium?
(Heart, Lungs, Anemia) due to lack of 02 to brain
what kinds of anatomic brain disorders cause delirium?
Stroke, Trauma, Infection, Tumor, Neuro Pressure Hydrocephalitis, Pain, Stress
how does infection cause delirium?
from surgery causing pneumonia, UTI, Respiratory, Cellulitis, AIDS, Encephalitis, Meningitis
what is hyperactive delirium?
Agitated, Disoriented, Delusional, Hallucinations
May be Confused with Schizophrenia, Agitated dementia, or Psychosis
what is hypoactive delirium?
Subdued, Quietly Confused, disoriented, and Apathetic
may Go Unrecognized or Be Confused With Depression or dementia
what is mixed delirium?
Fluctuations Between Hyper and Hypo Active subtypes
what are sxs of delirium?
INATTENTION DISORGANIZED THINKING ALTERED LEVEL OF CONSCIOUSNESS DISORIENTATION MEMORY IMPAIRMENT PERCEPTUAL DISTURBANCES MOTOR DISTURBANCES
what is dementia?
Development of multiple cognitive deficits that include memory impairment and one cognitive disturbance: aphasia, apraxia, agnosia, or Executive dysFx
what % of people over 80 have dementia?
50%
what type of dementia is most prevalent?
alzheimers
what are the risk factors of dementia?
Age, Age, Age Gender- woman Level of education 1st degree relative head injury
what does a higher education level affect?
Protective factor of signs + symptoms of dementia but not disease
what are the cognitive deficits of cortical dementia?
Memory and language difficulties (Aphasia) most pronounced symptoms.
Info processing deficits
what are the repercussions of cortical vs subcortical dementia?
subcortical Memory loss & language difficulties not present or less severe than cortical
what are the cognitive deficits of subcortical dementia?
Changes in personality and attention span
what is the criteria for alzheimers dementia?
- Memory Impairment
- Other Cognitive Impairment
- Gradual Onset And Decline
what is alzheimers dementia?
Severe amnesia
Deficits in language, EF, attention, Visuospatial and constructional abilities
how do you tx alzheimers?
aricept: ACHesterase inhibitor so that ACH stays in synapse longer
what exam is used to test alzheimers dementia?
MMSE = mini mental status exam
shows decline beginning 8 years before diagnosis
what occurs during early stage alzheimers?
2-3 years Begins with forgetfulness Progresses to disorientation and confusion Personality changes Symptoms of depression/manic b
what occurs during middle stage alzheimers?
2-10 years assistance with ADLs Unable to remember names Loss of short-term recall anxious, agitated, delusional, obsessive behavior physically or verbally aggressive Poor hygiene Disturbed sleep Inability to carry conversation use sentence fragments Posture altered Disoriented to time and place ask questions repeatedly
what occurs during late stage alzheimers?
8-12 years Loss of verbal articulation Loss of ambulation Bowel and bladder incontinence Extended sleep patterns Unresponsive to most stimuli
what is the criteria for Vascular Dementia?
- Memory Impairment
- Other Cognitive Disturbances
- short onset
what causes Vascular Dementia?
One or more strokes
what is the clinical manifestation of vascular dementia?
Sudden appearance of Sx
More apraxia, falls, and rapid shuffling steps than in AD
who is vascular dementia more likely to happen to?
More likely in men
what are the 1st sxs of Frontotemporal Dementia aka Pick’s Disease?
emotional changes, disinhibition, deterioration in social skills
what are later sxs of Frontotemporal Dementia aka Pick’s Disease?
become extrovert or withdrawn, rude, impatient, aggressive and make inappropriate remarks in public. Increase in sexual behavior, hyperorality
hallmark feature: Disinhibition & Apathy
what is Dementia with Lewy Bodies often misdiagnosed as?
AD, Delirium, PD
b/c it Has tremors
what are the sxs of Dementia with Lewy Bodies?
Repeated falls Syncope Transient (brief) LOC Delusions Hallucinations* Rapid Eye Movement (REM) sleep disorder Hand Tremors* Cognitive decline*
when does Transient Global Amnesia occur?
after a physical or emotional stressful event
what occurs during Transient Global Amnesia?
Sudden onset of memory loss, verified by a witness
Retention of personal identity despite memory loss
Normal cognition
no more than 24 hours
Gradual return of memory
what are risk factors of Transient Global Amnesia?
Age (56-75 y/o) & Migraines
