Dementia

Question 1

what is dementia?

Answer 1

A syndrome due to disease of the brain
Usually of a chronic or progressive nature

A disturbance of multiple, higher cortical functions: memory, thinking, orientation, comprehension, calculation, learning capability, language and judgement

Consciousness is not impaired

Impairments of cognitive function are commonly
accompanied (or occasionally preceeded), by a deterioration in emotional control, social behaviour or motivation

Question 2

what are the symptoms of dementia?

Answer 2

memory loss
disorientation of time
difficult with day to day tasks
confusion
difficulty speaking and writing
repetitive questioning
decreased social interaction and withdrawal
hallucinations and paranoia

Question 3

what are the different types of dementia?

Answer 3

1. alzheimer’s disease
2. vascular disease
3. dementia with Lewy bodies
4. mixed dementia
5. frontotemporal demential /picks disease
6. others
   -alcohol
   -HIV
   -huntingtons

Question 3

what is Alzheimers disease?

Answer 3

amyloid plaques and tau tangles = abnormal protein build up around the brain = loss of neurotransmitters sending messages

mainly affecting ACh

Question 4

what is vascular disease?

Answer 4

blood vessels in the brain are damaged = reducing blood flow to the brain

linked with stroke and TIA

Question 5

what is a risk factor to vascular disease?

Answer 5

atherosclerosis
alcohol
smoking
hypertension
obesity
raised cholesterol
poor diabetes control
vitamin b12/folate deficient

Question 6

what is dementia with Lewy bodies?

Answer 6

small clumps of protein inside nerve cells - clumps are called Lewy bodies

damage the nerve cells
cause movement problems within Parkinson’s

Question 7

what is frontotemporal demential /picks disease?

Answer 7

uncommon type of dementia
affects front and side of the brain
causes behaviour and language problems
affects young people 45-65 years old

Question 8

how do you diagnose dementia?

Answer 8

• rule out other causes of change/decline in memory e.g.drugs/infection
• timescale of symptom progression
• other conditions e.g. stroke
• MRI/CT scan
• cognitive assessments]

Question 9

what are the symptoms for each type of dementia?

Answer 9

Alzheimers- memory loss/ language defect/ rapid forgetfulness/gait

vascular = focal neurological/ vascular disease

Lewy body = visual hallucination/gait/ tone/ falls

frontotemporal = poor judgement / socially withdrawn

Question 10

what is the treatment for alzhemiers disease?

Answer 10

1. AChE inhibitor - donepezil/ rivastigmine
2. NMDA receptor antagonists - memantine

Question 11

what is the treatment for vascular disease?

Answer 11

1. treat underlying issues
2. adopt healthy lifestyle
3. rehab support: OT, speech therapy, physio

Question 12

what is behavioural and physiological symptoms of dementia (BPSD)?

Answer 12

1. psychosis - delusions/hallucinations
2. agitation - aggression/ wandering/ abnormal vocalisation/ disinhibition
3. mood disorders - depression/ anxiety/ apathy hypomania

Question 13

how do you treat behavioural and physiological symptoms of dementia (BPSD)?

Answer 13

CBT
antipsychotics - risperidone only licensed in the UK