Dementia Flashcards
What is the most common type of dementia?
Alzheimer’s Disease
What is Alzheimer’s Disease?
Progressive degenerative disease of the brain
What does Alzheimer’s Disease cause in the brain?
Widespread cerebral atrophy esp. cortex and hippocampus
What neuropathological features do you get with Alzheimer’s Disease?
Amyloid plaques
Tau proteins
Neurofibrillary tangles
What happens to the levels of acetylcholine in Alzheimer’s Disease?
It decreases
What is the non-pharmacological management of Alzheimer’s Disease?
Wellbeing activities and cognitive stimulation therapy
What is the pharmacological management of Alzheimer’s Disease?
Acetylcholinesterase inhibitors
What is an example of an acetylcholinesterase inhibitor?
Donepezil
What is an alternative to acetylcholinesterase inhibitors for the management of Alzheimer’s Disease?
NMDA receptor antagonist
What is an example of an NMDA receptor antagonist?
Memantine
When would Donepezil be contraindicated?
If the patient has Bradycardia
What is an adverse effect of Donepezil?
Insomnia
What is the cause of Lewy Body dementia?
Alpha-synuclein cytoplasmic inclusions (Lewy bodies) in the substantia nigra, paralimbic and neocortical areas.
How would Lewy body dementia present?
- Parkinsonism
- Visual hallucinations
- Fluctuations in cognition
How would Lewy body dementia present?
- Parkinsonism
- Visual hallucinations
- Fluctuations in cognition
How is Lewy body dementia diagnosed?
Clinically (main)
SPECT
What is used in the management of Lewy body dementia?
- Acetylcholinesterase inhibitors: Donepezil
* NMDA receptor antagonist: Memantine
What is another name for frontotemporal dementia?
Pick’s Disease
How is the onset of Pick’s described?
Early onset- before 65
What tends to be preserved with Pick’s disease?
Memory
Visuospatial Skills
What tends to occur with Pick’s disease?
Personality change
Social conduct problems
What changes occur in the brain of someone with Pick’s disease?
Atrophy of the frontal and temporal lobes
What are pick’s bodies?
Spherical aggregations of tau protein, gliosis, neurofibrillary tangles, senile plaques
What isn’t used in the management of Pick’s disease?
Acetylcholinesterase inhibitors
NMDA receptor antagonist
What is vascular dementia due to?
Multiple infarcts in the brain
What are the characteristics of vascular dementia?
Sudden onset cognitive decline
Stepwise deterioration
Who does vascular dementia tend to occur in?
Someone with a previous cardiovascular illness or events
What are the main RF for vascular dementia?
History of Stroke or TIA
What are the different types of vascular dementia?
Stoke-related
Sub-cortical
Mixed
What does stepwise progression mean?
No apparent change for months
Then sudden drop in function
How does vascular dementia present?
- Focal neurological abnormalities e.g. visual disturbance, sensory or motor symptoms
- Difficulty with attention and concentration
- Seizures
- Memory, Gait, Speech, Emotional disturbance
What is used in the management of vascular dementia?
Cognitive stimulation programmes
