Dementia

Question 1

Give examples of potential causes of dementia?

Answer 1

Degenerative disease - Alzheimer's levy body dementia, frontotemporal dementia, Huntington's, progressive sypranuclear palsy, spin-cerebellar degeneration
Vascular dementia
Creutzfeldt Jacob disease
Normal pressure hydrocephalus
Wilson's disease
Porphoria
Neurosyphilis
Brain tumours
Heavy metals

Question 2

What are the potential complications of dementia?

Answer 2

Risk of delirium
Risk of falls
Risk of institutionalisation
Risk of elder abuse
UTI
Pneumonia (including aspiration)
Frailty
Depression
Insomnia

Question 3

What pharmacotherapy can be used in the management of Alzheimer’s disease?

Answer 3

Cholineresterase inhibitors e.g. donezepil, rivastigmine, galantamine
Memantine

Question 4

What cognitive functions are initially decreased in Alzheimer’s disease?

Answer 4

Memory
Executive function
Word finding

Question 5

As Alzheimer’s disease progresses what cognitive function become impaired?

Answer 5

Visuo-spatial
Language - i.e., dysarthria
Mood and affect

Question 6

What are the classical intimal findings in Lewy body dementia?

Answer 6

• Cognitive fluctuations
• Recurrent visual hallucinations
• REM sleep behavioural disorder (RBD)
• Spontaneous motor signs.

Question 7

What is the pharmacological management of leeway body dementia?

Answer 7

Memantine and anticholinergics (donapezil, rivastigmine)

Question 8

What specific complications can occur in frontotemporal dementia?

Answer 8

Financial or legal crises
Parenting issues
Dangerous driving

Question 9

As well as behavioural changes, what cognitive functions are initially affected in frontotemporal dementia?

Answer 9

Language fluency

Question 10

In what age group does frontotemporal dementia typically present?

Answer 10

<65 years