Dementia Flashcards
What age does WHO define as old age?
- 65years old
What are some tasks that old people struggle with?
Mobility - Stairs and getting to shops
Dexterity - Making cup of tea, brushing teeth
Communication - Sight and hearing - Socialising
What are some medical disease associated with old age?
- Arthritis
- Osteoporosis
- Gout
- Fractures
- Diabetes and hormonal dysfunction
- Cognitive impairment
- Visual and hearing conditions
- GI condition
- Cardiovascular conditions
- Malignancy
What do older people value?
- Company and relationships
- Time
- Desire to contribute to society
- Someone listening
What is Dementia?
- Is a chronic syndrome that is progressive in nature
- Deterioration in cognitive function beyond what might be expected from normal ageing
It affects
- Memory
- Thinking
- Orientation (of the day or where they are)
- Comprehension
- Calculation
-Learning capacity
- Language (hard to follow conversation)
- Judgement (spacial judgment of stairs)
Characterised by
- Amnesia (esp recent events)
- Inability to concentrate
- Disorientation in time, place or person
- Intellectual impairment
What is Alzheimer’s?
- Most common dementia (60%)
- Reduction in size of Cortex, sever in hippocampus
What are some distinctive features of Alzheimers?
- Aphasia
- STML
- Communication difficulties
- Muddled over everyday activities
- Mood swings
- Withdrawn
- Loss of confidence
What are some predisposing factors of Alzheimers?
- Age
- Women> Men
- Head injury in past
- Smoking, hypertension, low folate and high blood cholesterol
- Genetic abnormalities on chromosome 1, 14 or 21
What is Vascular dementia?
- Caused by reduced blood flow to brain
- Damages and eventually kills the brain cells
- Can result from small vessel disease/ Stroke/ lots of mini strokes
What are some distinctive factors for Vascular dementia?
- Memory problem of sudden onset’
- Visuospatial difficulties
- Anxiety
- Delusions
- Seizures
What is dementia with Lewy Bodies?
- Abnormal protein called Lewy bodies deposits in brain cells
- Found in people with Parkinson’s and build up in brain repsonsible for memory or muscle movement
What are some distinctive features of Dementia with Lewy bodies?
- STML
- Cognitive ability fluctuates
- Visuospatial difficulties
- Speech and swallowing problems
- Sleep disorders
- Delusions
What is Frontotemporal dementia?
- Frontal lobes deal with behaviour, problem solving, planning and control of emotions
- Changes in personality and behaviour and difficulties to lamguage
- Younger age of onset
What are some distinctive features of Frontotemporal dementia?
- Uncontrollable repetition of words
- Mutism
- Personality change
- Decline in personal and social conduct
What are some rarer forms of dementia?
- HIV - related genitive impairment
- Parkinsons disease
- Corticobasal degeneration
- Multiple Sclerosis
- Niemann-Pick disease
- Creutzfeldt-Jakob disease
What are some rarer forms of dementia?
- HIV - related genitive impairment
- Parkinson’s disease
- Corticobasal degeneration
- Multiple Sclerosis
- Niemann-Pick disease
- Creutzfeldt-Jakob disease
Why is early diagnosis and treatment beneficial for Dementia?
- Helping family or other caregivers
- Cost saves money long term as less home health aid etc
- Patient benefit to delay progression and give them life goals
- Planning for future to appoint POA and living arrangements etc..
- Improve quality of life not prolong it
What are some early stage symptoms of Dementia?
- Loss of short-term memory
- Confusion, poor judgement, unwilling to make decision
- Anxiety, distress over change
- Inability to manage everyday tasks
- Communication problems (decline in ability or interest in talking, reading and writing)
What are some middle stage symptoms of dementia?
- More support required like reminder to eat and dress
- Fail to recognise people
- Wandering and getting lost
- Behave inappropriately like going out in nightclubs
What are some late stage symptoms of dementia?
- Can’t recognise familiar object or people
- Increasing physical frailty eventually bedbound
- Difficulty eating and swallowing - weight loss
- Incontinence and loss of speech
- Symptoms are progressive and irreversible
What cognitive tests can be done to diagnose dementia?
- Mini-mental state examination (MMSE)
- Blessed demnentia scale
- Single neuropsychological tests
What are some pros of MMSE?
- Well known
- Easy to administer
- Samples range of cognitive functions
- Test-re-test and inter rater availability
What are some cons of MMSE?
- Only three words are to be remembered on recall so not insensitive to mild impairment
- Quite old
- Non standardises time between registration and recall
- Not sensitive to testing frontal lobe
What is the treatment for Dementia?
- No pharmalogical, surgical or behavipoural cure
What is the treatment for Dementia?
- No pharmalogical, surgical or behavioural cure
- Counselling may delay care by up to 1 year
- Aspirin and reducing cardiac risk may halt deterioration of vascular type dementia
- NSAIDS may slow progression
What can be included in dementia friendly care home?
- Different colours for wall and skirting boards etc
- Labels and images on drawers
- Bedroom WC should be visible on bed sitting and lying down
- Personal pictures in sight
- Easy furniture
- Radiators not too hot
What can be included in Dementia friendly healthcare environments?
- Reception desk visible from entrance door
- Floors, ceilings and furniture different colours
- Avoid non essential signs
- Any signage at eye level
- Ensure good natural light instead of artificial
- If any staff rooms or rooms you don’t want patients to enter then paint them as same colour as walls
