Dementia Flashcards
what is dementia?
Progressive decline in cognitive function:
language, executive function, memory and social cognition
What can cause reversible dementia?
Normal pressure hydropcephalus
vit b12 def
subdural haemorrhage
wernicke’s encephalopathy
hypothyroidism
hypoglycemia
What are the most common causes of dementia?
Alzheimer
vascular
lewy body
frontal-temporal
Whats the pathology of alzhiemers
P:
Extracellular deposition of beta amyloid plaques
Tau neurofibrillary tangles
Damaged synapses
Cortical atrophy (hippocampus)
RF Downs Syndriome, ApoE4 allele
what are the cardinal signs of AD
Present classically with: 3A
Agnosia - cant recognize face
Apraxia - no basic motor functions
Aphasia - cant talk as well
+ cogntive changes (memory/psych)
What the pathology of vascular dementia
Reduced blood flow to the brain, secondary to small or large vessel disease (small infaractions)
What the pathology of lewy body demnetia
Accumulation of alpha synuclein depostion (lewy bodies) in brainstem and cortex
what the pathology of frontal-temporal dementia?
group of conditions that lead to neurological degeneration of frontal and temporal lob;
Presents w/: Behavioural and personality changes
memory impairment and language impairment
impulsivity
loss of empath
What are the risk factors for dementia?
Age
Obesity
Smoking
T2DM
HTN
Depression
education
social isolation an loneliness
How is dementia investigated?
Consists of excluding possible causes + observing cognitive decline over time
MMSE - Mini mental state exam score/30
Brain MRI - Cortical atrophy
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What non pharmacological therapies are offered to dementia patients?
Access to memory service
Education
Advanced care plan
Cognitive stimulation therapy
How do you teat dementia?
1st line: AChE (Acetylcholinesterase) inhibitor:
Donepezil or Rivastigmine
and/or NMDA antagonist Memantine
Adjunct:
Anti-physcotics - holoperidol
Frontal/temporal- therpautic
What complications might you get with dementia
Wt loss and malnutrition
diasbility
abuse
