Dementia

Question 1

How many people live with dementia worldwide?

Answer 1

46 million people

Question 2

What is the cost of dementia to the global economy?

Answer 2

$818 billion/year

Question 3

What is the commonest cause of dementia?

Answer 3

Alzheimer’s disease

Question 4

What is Dementia characterised by?

Answer 4

Progressive, cognitive, social and functional impairment

Question 5

Is there a cure for dementia?

Answer 5

There is no current cure, with acetylcholinesterase inhibitors having
modest symptomatic benefit in early stages.

Question 6

What are the 4 common types of dementia?

Answer 6

Alzheimer’s disease
Vascular dementia
Frontotemporal dementia
Dementia with Lewy bodies

Question 7

What are the potentially reversible causes of dementia?

Answer 7

Depression
Alcohol related brain damage
Endocrine (hypothyroidism, Cushing’s, Addison’s)
B1/B12/B6 Deficiency
Benign tumours
Normal pressure hydrocephalus
Infections - HIV/syphilis, Whipple’s disease
Limbic encephalitis (paraneoplastic/autoimmune)
Inflammatory (vasculitis , MS, sarcoid)

Question 8

Why is it hard to accurately diagnose dementia in the clinic?

Answer 8

The disease follows a heterogenous
course.
In old age the disease presentation is of
multiple co-morbidities.
Lots of mixed and uncertain pictures.
Younger patients are more typical.
Clinical history, the function of the patient
and how they change is paramount.

Question 9

In what part of the clinical process does diagnosis of dementia mostly lie?

Answer 9

History taking

Question 10

List the steps in the clinical process.

Answer 10

Referral > History > Examination > Investigation > Diagnosis > Management

Question 11

List the checklist to interview patients if you suspect they have dementia.

Answer 11

Memory
Language
Numerical Skills
Executive skills
Visuospatial skills
Neglect phenomena
Visual perception
Route finding and landmark
identification
Personality and social conduct
Sexual behaviour
Eating
Mood
Motivation/Apathy
Anxiety/Agitation
Delusions/Hallucinations
ADLs

Question 12

What is Dementia?

Answer 12

Severe loss of memory and other cognitive abilities which

leads to impaired daily function (regardless of the underlying cause)

Question 13

What is the MMSE test?

Answer 13

The Mini-Mental State Exam (MMSE) is a widely used test of cognitive function among the elderly; it includes tests of orientation, attention, memory, language and visual-spatial skills.

Question 14

List the blood investigations you can take to see if a patient has dementia.

Answer 14

Full blood count
Inflammatory Markers
Thyroid Function
Biochemistry and renal function
Glucose
B12 and folate
Clotting
Syphilis serology
HIV
Caeruloplasmin