Dementia

Question 1

What is the most common type of dementia?

Answer 1

Alzheimer’s Disease

Question 2

What is Alzheimer’s Disease?

Answer 2

Progressive degenerative disease of the brain

Question 3

What does Alzheimer’s Disease cause in the brain?

Answer 3

Widespread cerebral atrophy esp. cortex and hippocampus

Question 4

What neuropathological features do you get with Alzheimer’s Disease?

Answer 4

Amyloid plaques
Tau proteins
Neurofibrillary tangles

Question 5

What happens to the levels of acetylcholine in Alzheimer’s Disease?

Answer 5

It decreases

Question 6

What is the non-pharmacological management of Alzheimer’s Disease?

Answer 6

Wellbeing activities and cognitive stimulation therapy

Question 7

What is the pharmacological management of Alzheimer’s Disease?

Answer 7

Acetylcholinesterase inhibitors

Question 8

What is an example of an acetylcholinesterase inhibitor?

Answer 8

Donepezil

Question 9

What is an alternative to acetylcholinesterase inhibitors for the management of Alzheimer’s Disease?

Answer 9

NMDA receptor antagonist

Question 10

What is an example of an NMDA receptor antagonist?

Answer 10

Memantine

Question 11

When would Donepezil be contraindicated?

Answer 11

If the patient has Bradycardia

Question 12

What is an adverse effect of Donepezil?

Answer 12

Insomnia

Question 13

What is the cause of Lewy Body dementia?

Answer 13

Alpha-synuclein cytoplasmic inclusions (Lewy bodies) in the substantia nigra, paralimbic and neocortical areas.

Question 14

How would Lewy body dementia present?

Answer 14

• Parkinsonism
• Visual hallucinations
• Fluctuations in cognition

Question 15

How would Lewy body dementia present?

Answer 15

• Parkinsonism
• Visual hallucinations
• Fluctuations in cognition

Question 16

How is Lewy body dementia diagnosed?

Answer 16

Clinically (main)

SPECT

Question 17

What is used in the management of Lewy body dementia?

Answer 17

• Acetylcholinesterase inhibitors: Donepezil

* NMDA receptor antagonist: Memantine

Question 18

What is another name for frontotemporal dementia?

Answer 18

Pick’s Disease

Question 19

How is the onset of Pick’s described?

Answer 19

Early onset- before 65

Question 20

What tends to be preserved with Pick’s disease?

Answer 20

Memory

Visuospatial Skills

Question 21

What tends to occur with Pick’s disease?

Answer 21

Personality change

Social conduct problems

Question 22

What changes occur in the brain of someone with Pick’s disease?

Answer 22

Atrophy of the frontal and temporal lobes

Question 23

What are pick’s bodies?

Answer 23

Spherical aggregations of tau protein, gliosis, neurofibrillary tangles, senile plaques

Question 24

What isn’t used in the management of Pick’s disease?

Answer 24

Acetylcholinesterase inhibitors

NMDA receptor antagonist

Question 25

What is vascular dementia due to?

Answer 25

Multiple infarcts in the brain

Question 26

What are the characteristics of vascular dementia?

Answer 26

Sudden onset cognitive decline

Stepwise deterioration

Question 27

Who does vascular dementia tend to occur in?

Answer 27

Someone with a previous cardiovascular illness or events

Question 28

What are the main RF for vascular dementia?

Answer 28

History of Stroke or TIA

Question 29

What are the different types of vascular dementia?

Answer 29

Stoke-related
Sub-cortical
Mixed

Question 30

What does stepwise progression mean?

Answer 30

No apparent change for months

Then sudden drop in function

Question 31

How does vascular dementia present?

Answer 31

• Focal neurological abnormalities e.g. visual disturbance, sensory or motor symptoms
• Difficulty with attention and concentration
• Seizures
• Memory, Gait, Speech, Emotional disturbance

Question 32

What is used in the management of vascular dementia?

Answer 32

Cognitive stimulation programmes