Dementia Flashcards
What is dementia?
Progressive decline in higher cortical function leading to global impairment of memory, intellect, and personality, which affects the ability to cope with activities of daily living
What are the causes of pernament dementia?
- Alzheimer’s diesase
- Fronto-temporal dementia
- Dementia with Lewy-Bodies
- Vascular dementia
- Creutzfeldt-Jacob disease - rare
What are the reversible causes of dementia?
- Depression
- Trauma
- Vitamin deficiency
- Alcohol
- Thyroid disorders
How does dementia present?
- Memory deficit
- Behavioural
- Physical
- Language disorder
- Visuospatial disorder
- Apraxia
What memory deficits are present in dementia?
Struggle to learn new information and have short term memory loss initially, which progresses to long term memories
What are the behavioural symptoms of dementia?
- Altered personality
- Disinhibition
- Labile emotions
- Wandering
What are the physical presentations of dementia?
- Incontinence
- Reduced oral intake
- Difficulty swallowing
What language disorders might dementia present with?
- Anomic aphasia
- Difficulty understanding language
What visuospatial symptoms might dementia present with?
Unable to identify visual and spatial relationships between objects
What is apraxia?
Difficulty with motor planning, resulting in inability to perform leaned purposeful movements
What investigations should be done when a patient presents with suspected dementia?
- Full history and mini-mental state examination
- Full neurological examination
- Blood tests
- CT/MRI of the head
- Memory clinic follow up
What might be required when obtaining a full history from a patient with dementia?
Collateral history from family, as patient might be trying to hide it or not remeber
Why is a full neurological examination required in dementia?
As focal neurological signs might show different diagnoses
What is the use of CT/MRI scans in dementia?
Sometimes not that helpful, but show other causes, e.g. tumour or RICP
Why do blood tests need to be done in suspected dementia?
To check for reversible causes
What needs to be looked for in the blood tests of suspected dementia?
- TFTs to check for thyroid disorders
- Vitamin B12
Why is memory clinic follow up important in dementia?
Need someone to care for the patient after, e.g. home visits, social care
How is it decided if a patient has delirium or dementia?
CAM (confusion assessment method) score