Dementia Flashcards
What is dementia, specifically Alzheimer’s and Parkinsons dementia, characterised by?
Aggregation of misfolded proteins and cerebrovascular disease.
Alzheimer’s dementia - amyloid-beta plaques and neurofibrillary tangles.
Parkinson’s dementia - alpha-synuclein clumps aka Lewys bodies.
What are the common symptoms of dementia?
Memory loss
Difficulty concentrating
Mood swings
What is first-line treatment for Alzheimer’s dementia?
Acetylcholinesterase inhibitors.
Name 3 acetylcholinesterase inhibitors for dementia.
Donepezil, Galantamine, Rivastigmine.
How do acetylcholinesterase inhibitors work?
Acetylcholine is a neurotransmitter involved in transduction related to memory and learning ability. Acetylcholinesterase terminates this neuronal transmission by breaking down acetylcholine into acetic acid and choline.
What are some common side effects of acetylcholinesterase inhibitors?
GI discomfort
Hallucinations
Urinary incontinence
Agitation.
What is second-line treatment of Alzheimer’s dementia?
NMDA receptor antagonists such as Memantine.
How do NMDA receptor antagonists or Memantine work?
Inhibit calcium influx into cells normally caused by chronic N-methyl-d-aspartate receptor activation by its substrate, glutamate. Overactivity of glutamate at NMDA receptors in the CNS contributes to neurotoxicity in Alzheimer’s.
What is first line treatment of Parkinson’s dementia?
Acetylcholinesterase inhibitors.
What is lasting power of attorney?
A legal agreement which allows a patient to appoint one or more people to make decisions on their behalf.
What makes a person lack capacity?
The inability to make a decision due to disturbance in the functioning of the mind or brain.
During a mental health assessment, what will prove a person has capacity?
Understand information relevant to the decision, retain the information, and be able to consider it as part of the decision making process.
What is an advanced care plan?
A plan created by a patient which plans for their future care and support needs.
What is the difference between advance statements and advanced decisions?
Advanced statement (aka joint crisis plan) - non-legally binding agreements between a patient and their HCPs in the case of a crisis covering treatment, support, and practical help (e.g., childcare arrangements).
Advanced decision - a legally binding decision to refuse certain types of health care in the future.
What are the 4 things that need to be done before a medicine can be given covertly?
- Mental capacity assessment.
- Best interests meeting.
- Record keeping.
- Formal plan.
