Dementia Flashcards
Key pathophysiological features of Alzheimer’s disease
- amyloid plaques + hyperphosphorylated tau protein deposited in neurons => neuronal cell death
Type of dementia associated with more memory problems
Alzheimer’s disease
Lewy bodies are
a build up of alpha-synuclein proteins
Give 3 examples of Acetylcholinesterase inhibitors
Donepezil,
Rivastigmine,
Galantamine
Outline the effect of Acetylcholinesterase inhibitors on ppl w dementia
can delay worsening of memory, thinking, language + thought processes for 6-12months +
Effect of Memantine on Dementia
it can help with:
memory
reasoning
language
attention
For what kind of behaviours in Alzheimer’s disease is Memantine often used
challenging behaviours e.g. to reduce agitation or aggressive behavioural symptoms
Outline 2 important risk factors for Alzheimer’s disease
Age: >65yrs after 80yrs 1in6 chance
Sex: twice as many women >65yrs than men
List some symptoms of Alzheimer’s disease
- disorientation in time + place
- difficulty with DM, problem solving, planning + sequencing tasks
- difficulty remembering recent events
- difficulty finding words
- repeating words during conversations
- not recognising familiar faces
- reduced ability to perform everyday tasks e.g. cooking/shopping
- changes in ability to process + interpret visual information
Pathophysiology of vascular dementia
ischaemic injury to the brain causing permanent neuronal death
Potential causes of vascular dementia
Atherosclerosis
TIAs
Direct damage from haemorrhagic stroke
2nd most common cause of dementia in ppl >65yrs
Vascular Dementia
Outline some clinical features of Vascular Dementia
- slowness of thought
- difficulty with planning and understanding
- concentration problems
- changes to your mood/personality/behaviour e.g. agitation, depression
- feeling disoriented + confused
- difficulty walking and keeping balance
- urinary frequency, urgency + incontinence
- night wandering
A key risk factor for Vascular Dementia is
FHx of stroke/diabetes/heart disease = 2x increased risk
Pathophysiology of frontotemporal dementia
deposition of ubiquitinated TDP-43 and hyperphosphorylated tau proteins in the frontal and temporal lobes
Clinical features of Pick’s disease
- changes in personality + behaviour
- apathy + withdrawal
- obsessive or repetitive behaviour
- loss of empathy
- changes in appetite + food eaten e.g. more sugary foods
- difficulties w decision making, problem solving + concentration
- ritualised behaviours - hoarding, repeated phrases/gestures
Clinical features of Primary progressive aphasia
- Language difficulties
- Grammar problems
- Reduced comprehension
- loss of understanding of familiar words
- difficulty recognising ppl or objects
Clinical features of Semantic dementia
- lack of understanding of familiar words
- loss of knowledge OR the meaning of words
Clinical features of progressive non-fluent aphasia
- slower hesitant speech
- stutter
- errors in grammar
- impaired understanding of complex sentences
- may mispronounce words
4 main types of frontotemporal dementia
- Behavioural variant frontotemporal dementia - Pick’s disease
Primary progressive aphasia
Semantic dementia
Progressive non-fluent aphasia
5 main types of dementia
Alzheimer’s disease
Vascular dementia
Frontotemporal dementia
Lewy body dementia
Parkinson’s dementia
Type of Dementia more commonly diagnosed in ppl under 65yrs old
Frontotemporal dementia
Pathophysiology of Lewy body dementia
build up of alpha-synuclein protein clumps == disrupts cell communication
Clinical features of Lewy body dementia
- fluctuating cognition i.e patient may seem fine one day or worse the next
- memory problems
- mood changes
- persistent, well-formed hallucinations
- Parkinsonian features - slowed movement, stiffness + tremors
Supportive clinical features of Lewy body dementia
- unsteadiness + increased falls
- delusions
- neuroleptic sensitivity
- may have early problems w visuospatial awareness
- decline in problem solving skills + DM
Pathophysiology of Parkinson’s dementia
cognitive deterioration characterised by Lewy bodies in the substantia nigra
Dementia that develops 10-15 yrs after motor symptoms of PD have presented
Parkinson’s dementia
Signs + symptoms of Parkinson’s dementia
- Changes in memory, concentration and judgment
- Trouble interpreting visual information
- Muffled speech
- Visual hallucinations
- Delusions, especially paranoid ideas
- Depression, irritability and anxiety
- Sleep disturbances, including excessive daytime drowsiness and rapid eye movement (REM) sleep disorder
- motor decline more rapid
Type of dementia commonly diagnosed in ppl under the age of 65
FRONTOTEMPORAL
Slower, stuttery and more hesitant speech would indicate which type of frontotemporal dementia?
Progressive non-fluent aphasia
