Dementia

Question 1

What is Dementia?

Answer 1

A chronic/progressive syndrome involving impairment of multiple higher cortical functions e.g. memory, thinking, orientation, comprehension and language.

Question 2

Important Types of Dementia (3).

Answer 2

1. Alzheimer’s disease.
2. Vascular Dementia.
3. Lewy Body Dementia.
4. Fronto-Temporal Dementia.

Question 3

Common Causes of Dementia (3).

Answer 3

1. Alzheimer’s disease.
2. Cerebrovascular Disease - Multi-Infarct.
3. Lewy body Dementia.

Question 4

Rarer Causes of Dementia (4).

Answer 4

1. Huntington’s.
2. CJD.
3. Pick’s Disease (Atrophy of Frontal and Temporal Lobes).
4. HIV.

Question 5

Differentials of Dementia (8).

Answer 5

1. Hypothyroidism, Addison’s.
2. B12, Folate, Thiamine Deficiency.
3. Syphilis.
4. Brain Tumour.
5. Normal Pressure Hydrocephalus.
6. Subdural Haematoma.
7. Depression.
8. Chronic Drug Use e.g. Alcohol, Barbiturates.

Question 6

Delirium vs. Dementia (5).

Answer 6

Delirium :

1. Impairment of Consciousness.
2. Fluctuation of Symptoms (Worse at Night).
3. Abnormal Perceptions e.g. Illusions and Hallucinations.
4. Agitation and Fear.
5. Delusions.

Question 7

Depression vs. Dementia (6).

Answer 7

Depression :

1. Short History and Rapid onset.
2. Biological Symptoms e.g .Weight Loss, Sleep Disturbance.
3. Worry Over Poor Memory.
4. Reluctance to Take Tests.
5. Variable MMTS.
6. Global Memory Loss - Dementia : Recent Memory Loss.

Question 8

Investigations of Dementia.

Answer 8

1. Blood Screen (Exclude Reversible Causes).

2. Neuroimaging (Secondary Care - exclude reversible causes and help provide information on aetiology).

Question 9

Assessment Tools Recommended by NICE in Non-Specialist Setting (2).

Answer 9

1. 10 Point Cognitive Screener (10-CS).

2. 6 Item Cognitive Impairment Test (6CIT).

Question 10

Assessment Tools NOT Recommended by NICE in Specialist Setting (3).

Answer 10

1. AMTS.
2. GPCOG.
3. MMSE (24/30).