Dementia Flashcards
List 7 ways to prevent dementia
Be less sednetary Lose weight Don't smoke Don't drink Don't eat shit foods Eat good foods Control HTN Control lipids
**Cognitive training
-Memory and reasoning
Increased IADLs at 5 and 10 year follow up
How do we screen for dementia
we don’t
ONly test if concerning symptoms
DSM criteria
Decline from previous function one or more cognitive domains (complex attention, learning and memory, language, perceptural motor, social cognition and executive function
Impacting ADLs and IADLs
DEATH SHAFT
One or more domans for MCI, two or more domaines for dementia
MCI vs Dementias
MCI doesn’t impact IADLS
Dementia does
Dementia requires at least two domains to be impacted
Types of dementias and how to tell them apart
Alzheimers (Gradual onset, normal neuro, initial short term memory loss)
Frontotemporal (behavioral problems and social awareness)
Vascular (stepwise decline, risk factors)
Lewy body (Visual hallucinations and flucuating congnition)
DDX of 10 reversible causes
Delerium Depression Epilepsy Eyes and Ears Migraine Medications Ethanol TIA Trauma TUmor Infection
When and what do you image
3T MRI
if abrupt onset (<2 years) unexpected decline, focal neuro findings, previous malignancy or trauma, use of anticoagulants, Significant vascular risk factors
Or if last imaging was more than 2 years ago…
Not great guidelines for this
Tests to do
CBC TSH Lytes Creat VITB12 Ca Allbumin FBG Lipids ECG
How to diagnose
History and questionaires
MMSE
MOCA
Quick screens:
Clock drawing
Short portable mental status questionaire
mini-cog
Memory impairment screen
General practioner assessment of cognition
Spell WORLD backwards (working memory-good for delerium differentiation)
What is one thing not to forget about dianosing someone with dementia
Do a driving assessment
Pharmacotherapy for Dementia. List two categories and one medication in each
Cholinesterage inhibotrs
Donepazil
2nd line is Glutamatergic medication
Memantine
Consider SSRI for seconary symptoms
List one medication category to avoid in dementia patients
Antipsychotics
