Dementia Flashcards
What factors are included in the cognition?
Memory executive function language visuospatial personality
Define dementia
someone can’t do things they used to do due to new progressive cognitive impairment which can not be explained by something else
What are the causes of dementia?
Alzheimers vascular dementia Lewy body dementia Parkinson's dementia Frontotemporal dementia
What is a good way to differentiate dementias?
What symptom presents first: Alzheimers - memory loss Lewy body - Hallucinations Frontotemporal - Language or behavioural changes Vascular - stroke
What are the pathological abnormalities seen in dementia?
- accumulation of protein
- brain matter loss
Which dementia is cause by accumulation of amyloid plaques and Tau?
Alzheimers
alpha synuclein accumulation is associated with what dementia?
Lewy body
What are the differential diagnosis for dementia?
- tumours
- hydrocephalus
- subdural haematoma
- over treated diabetes
- Thyroid disease
- HIV
- encephalitus
- temporal lobe epilepsy
What are the other contributors to cognitive impairment?
- delirium, depression and anxiety
- fibromyalgia, peri menopause and long covid
- drugs e.g. anticholinergics
- sleep disturbance
- pain
What questions should be asked in presenting complaint of memory loss?
- Onset - (progressive?)
- Ask about normal day
also ask relative or someone who see’s them often - repet themselves
- can they remember someone visiting
- recognition of family
What are the associated symptoms of memory loss?
Executive function - can they cook - can they use remote controller Visuospatial - can they navigate places they often visit Behavioural - short-tempered - apathetic - loss of empathy Language - word-finding difficulties - loss of fluency Psychiatric - agitated - depressed/anxious - euphoria - delusions/hallucinations - sleep disorders
What social history questions should be asked if dementia is suspected?
function impairment - personal care - cooking - money - transport Safety - do they wander - can they take medication - do they leave oven on or leave cigarettes to burn
What examinations should be performed in Dementia presentation?
- CV and resp
- Weight
- focal neurological
- extrapyramidal signs
- primitive reflexes
- cognitive assessment
What are the types of cognitive assessment?
- mini mental state examination
- montreal cognitive examination
- Addenbrooke cognitive exam
What bloods should be taken when dementia is suspected?
Bloods rule out other conditions:
- FBC
- ESR
- U&E
- LFTs
- calcium
- CRP
- glucose
- Thyroid functioning
- B12 and folate
- HbA1c
