Dementia Flashcards
How is normal pressure hydrocephalus (NPH) characterised?
By early onset of gait abnormality with little or no cortical atrophy on neuroimaging studies
Diagnosis and Statistical Manual of mental disorders (DSM)
- 4 A’s of impairment of at least one higher cortical function
Aphasia
Agnosia
Apraxia
Abstraction of judgement
Associated issues with dementia
- Depression
- Cognitive training
- Mobility
- Behaviour/aggression
- Advocacy
- Hospitalisation and residential care
- Continence
- Pain
Depression is common to co-exist with dementia. What would the benefits of resolving this issue have for the paitent?
Resolution of depression can improve cognitive function.
What type of treatment can be used for mild to moderate dementia?
CST- cognitive stimulation therapy
Benefits of exercise for dementia?
Can delay onset/progession of dementia
Decrease risk of falls or strength loss
Improve function in ADL’s (active daily living)
The exact cause of NPH is unknown, but it is correlated with the following:
- meningitis,
- head trauma,
- subarachnoid hemorrhage,
- Paget’s disease of the skull,
- Mucopolysaccharidosis of the meninges.
- Systemic hypertension.
What was the first sign of normal pressure hydrocephalus (NPH) when discovered in 1965, and is also typically the earliest feature noted, and considered to be the most reponsive to treatment?
gait abnormalites
Cardinal signs required for a diagnosis of parkinsons disease
distal resting tremor of 3-6 Hz
rigidity
bradykinesia
asymmetrical onset
What is a common symptom of parkinson’s disease?
Reversal of sleep cycle
The most common cause of dementia
Alzheimer’s Disease
What are some common risk factors that increase the risk for developing alzheimers disease?
Positive Family History
Down Syndrome
Finish this sentence. “Paitents with Alzheimer’s disease commonly present with…”
An insideous onset of memory loss which slowly progresses over many years
Clinical History of Alzheimers disease
- Episodic memory +/- difficult learning new information
- Communication
- Mobility
- Other symptoms throughout
Risk Factors for dementia
- Age
- Genetics
- Smoking
- Alcohol use
- Atherosclerosis
- Diabetes
- Mild cognitive impairment
- Down syndrome
Types of dementia
- Alzheimer’s disease – MC, of all dementias.
- Vascular dementia
- Combination of which is called “mixed dementias”.
- Parkinson’s Disease
What type of dementia can occur with AD?
Vascular dementia
Steps for differential diagnosis for dementia
- Clinical Presentation- Carer feedback can be important
- Cognitive assessment *-> MMSE, MiniCog, CDT *
- Diagnosis by exclusion
Signs of early dementia
Anomia - Difficulty find words to say
Agnosia - cannot recognise objects/people
Apraxia - inability to execute voluntary motor movement
Forgetting names, appt, done task, loosing things
Difficult performing familiar tasks
personality changes
Anomia
Difficulty find words to say
Agnosia
Cannot recognise objects or people despite previous knowledge
Apraxia
inability to execute voluntary motor movement
Signs of early dementia
- Anomia - words
- Agnosia - objects
- Apraxia - mobilty
- Forgetting names, tasks etc
- Personality changes
Signs of Intermediate dementia
Worsening of early signs
need help with ADL’s
disrupted sleep
difficulty learning new things
confusion/disorientation familiar surroundings
increased risk of falls from poor judgement
