Dementia Flashcards

1
Q

What age does WHO define as old age?

A
  • 65years old
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2
Q

What are some tasks that old people struggle with?

A

Mobility - Stairs and getting to shops
Dexterity - Making cup of tea, brushing teeth
Communication - Sight and hearing - Socialising

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3
Q

What are some medical disease associated with old age?

A
  • Arthritis
  • Osteoporosis
  • Gout
  • Fractures
  • Diabetes and hormonal dysfunction
  • Cognitive impairment
  • Visual and hearing conditions
  • GI condition
  • Cardiovascular conditions
  • Malignancy
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4
Q

What do older people value?

A
  • Company and relationships
  • Time
  • Desire to contribute to society
  • Someone listening
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5
Q

What is Dementia?

A
  • 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

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6
Q

What is Alzheimer’s?

A
  • Most common dementia (60%)
  • Reduction in size of Cortex, sever in hippocampus
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7
Q

What are some distinctive features of Alzheimers?

A
  • Aphasia
  • STML
  • Communication difficulties
  • Muddled over everyday activities
  • Mood swings
  • Withdrawn
  • Loss of confidence
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8
Q

What are some predisposing factors of Alzheimers?

A
  • Age
  • Women> Men
  • Head injury in past
  • Smoking, hypertension, low folate and high blood cholesterol
  • Genetic abnormalities on chromosome 1, 14 or 21
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9
Q

What is Vascular dementia?

A
  • 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
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10
Q

What are some distinctive factors for Vascular dementia?

A
  • Memory problem of sudden onset’
  • Visuospatial difficulties
  • Anxiety
  • Delusions
  • Seizures
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11
Q

What is dementia with Lewy Bodies?

A
  • 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
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12
Q

What are some distinctive features of Dementia with Lewy bodies?

A
  • STML
  • Cognitive ability fluctuates
  • Visuospatial difficulties
  • Speech and swallowing problems
  • Sleep disorders
  • Delusions
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13
Q

What is Frontotemporal dementia?

A
  • 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
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14
Q

What are some distinctive features of Frontotemporal dementia?

A
  • Uncontrollable repetition of words
  • Mutism
  • Personality change
  • Decline in personal and social conduct
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15
Q

What are some rarer forms of dementia?

A
  • HIV - related genitive impairment
  • Parkinsons disease
  • Corticobasal degeneration
  • Multiple Sclerosis
  • Niemann-Pick disease
  • Creutzfeldt-Jakob disease
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16
Q

What are some rarer forms of dementia?

A
  • HIV - related genitive impairment
  • Parkinson’s disease
  • Corticobasal degeneration
  • Multiple Sclerosis
  • Niemann-Pick disease
  • Creutzfeldt-Jakob disease
17
Q

Why is early diagnosis and treatment beneficial for Dementia?

A
  • 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
18
Q

What are some early stage symptoms of Dementia?

A
  • 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)
19
Q

What are some middle stage symptoms of dementia?

A
  • More support required like reminder to eat and dress
  • Fail to recognise people
  • Wandering and getting lost
  • Behave inappropriately like going out in nightclubs
20
Q

What are some late stage symptoms of dementia?

A
  • 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
21
Q

What cognitive tests can be done to diagnose dementia?

A
  • Mini-mental state examination (MMSE)
  • Blessed demnentia scale
  • Single neuropsychological tests
22
Q

What are some pros of MMSE?

A
  • Well known
  • Easy to administer
  • Samples range of cognitive functions
  • Test-re-test and inter rater availability
23
Q

What are some cons of MMSE?

A
  • 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
24
Q

What is the treatment for Dementia?

A
  • No pharmalogical, surgical or behavipoural cure
25
Q

What is the treatment for Dementia?

A
  • 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
26
Q

What can be included in dementia friendly care home?

A
  • 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
27
Q

What can be included in Dementia friendly healthcare environments?

A
  • 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
28
Q

What elements of psychosis can be present in a patient with dementia?

A

Visual, auditory, and tactile.

They are diagnostic criteria in patients with Lewy body dementia.

29
Q

What are some steps you can take to manage a patient with dementia?

A

Avoid misconceptions
Avoid long explanations
Stay general but assertive
Try not to correct patient
Be non-confrontational
Distraction

30
Q

What aspects of treatment planning are impacted by a dementia diagnosis?

A

Progressive nature of dementia
Maintaining OH
Retaining key teeth
Establish preventative regime

31
Q
A
32
Q

Why are older people more at risk from GA?

A

Weaker organs and tissues
Limited physiological reserve upon stressor application.