Dementia Flashcards
What are the Rx for dementia?
- Smoking
- DM
- Lack of exercise
- Obesity
What are the reversible causes of dementia?
- Hypothyroidism
- Addison’s
- B12/folate/thiamine deficiency
- syphilis
- depression
- Subdural haematoma
- normal pressure hydrocephalus
- brain tumour
What are the characteristics of Alzheimer’s disease?
Difficulty with executive function and/or nominal dysphasia
Loss of episodic memory – recent events, repeated questioning, difficulty learning new information
What are the characteristics of vascular dementia?
Insidious, stepwise presentation
Focal neurological signs
What are the characteristics of demential with Lewy bodies?
Fluctuating cognition
Recurrent visual hallucinations
REM SBD
+ 1 or more symptoms of parkinsonism: bradykinesia, rest tremor rigidity
What are the characteristics of frontotemporal dementia?
Personality changes and behavioural disturbance (apathy or social/sexual disinhibition)
Other cognitive functions (such as memory and perception may be relatively preserved
How do you manage Alzheimer’s disease?
Group cognition stimulation therapy
mild-mod
- Acetylcholinesterase inhibitors (Donepezil, galantamine and rivastigmine)
mod-severe
- Add on memantine (NMDA antagonist)
severe
- Memantine Monotherapy
What are the risk factors for vascular dementia?
- Hx of stroke/TIA
- AF
- HTN
- DM
- Hyperlipidaemia
- Smoking
- Obesity
- CHD
How do you manage vascular dementia?
Manage CV risk factors
What is avoided in Lewy body dementia and why?
Neuroleptics/antipsychotic (block dopamine receptors)
may develop irreversible parkinsonism
When are acetylcholinesterase inhibitors CI?
- Bradycardia
- LBBB
- Prolonged QTc interval
What can you give for RLS?
Clonazepam
