Dementia Flashcards
What is dementia
brain disorder causing progressive change and deterioration in cognitive ability, behavior, emotion and personality
Why can diagnosing dementia be difficult?
shares similarities with normal age and other diseases/conditions (ie MDD).
What needs to be established before diagnosing dementia
Evidence of decline in function
What are 4 types of demetia
Alzheimer’s disease (AD)
Vascular Dementia
Lewy-Body Disease (LBD)
Frontotemporal dementia (FTD)
What is the most common form of dementia
Alzheimer’s disease (AD)
What are the key features of AD
- Insidious onset
- Early memory impairment (rapid forgetting)
- Gradual decline leading to the loss of more
cognitive functions
What are three diagnoses of AD
- Definite – clinical diagnosis with histology
- Probably – clinical syndrome without histology
- Possible – atypical clinical features but no alternative diagnosis
What 4 cognitive areas does AD efffect
- Memory
- Language & semantics
- Executive function
- Spatial abilities
What structures are effected early during AD
Medial temporal lobe / hippocampus
How is memory affected by AD
The ability to learn and remember information is compromised.
What kind of memory is particularly affected by AD
Episodic memory tests are sensitive to AD, even in the early stages (long-term memory for specific event and experiences)
impairment of recall and recognition suggest deficits in what?
consolidation and rapid forgetting rather than
difficulties with retrieval.
What language impairments are there with AS
object naming
Verbal Fluency and semantic categorization
What does categorization problems mean?
knowledge of concepts and associations between them appears to be compromised
What area does categorisation problems suggest is affected
Temporal lobe
What is a test of object naming for AD
Boston Naming Task
What is a test of verbal fluency for AD
FAS
What visio-spatial deficits are common in AD
problems with visual orientation and visuoperception
What are 3 tests for visio-spatial deficits in AD
- Clock drawing task
- Ray complex figure
- Clock Drawing task
What particular areas of executive function are impaired in AD
Set shifting
self-monitoring
What executive functions become impaired later in the disease
Working memory
sustained attention
What are 4 tests of executive function in AD
- Tower of London
- Wisconsin card sort
- Porteus maze
- Trail Making part B
What are some tests of memory in AD
- Free recall
- Recognition
- Paired-associate learning
Crystallized intellect is preserved in AD - what does this mean
can remember facts
How is LTM effected in AD
can still recall information about their life
What is the main differentiator between AD and Lew’s Body Disease
LBD has Recurrent visual hallucinations – well formed and detailed
How is memory effected in Lewy-Body Disease (LBD)
Memory not early feature but hippocampus is
affected late in the disease
How is movement effected by LBD and give examples
Spontaneous motor features of Parkinsonism later in the disease
- Rigidity
– Hypophonic speech (weak voice due to incoordination of vocal muscles)
– Masked facies (persons face is not expressive)
– Stooped posture
– Slow shuffling gait
How do AD and LBD differ in terms of spatial deficits
DLB more impaired on visual-perceptual and visuoconstructional tasks than AD
eg Clock Drawing
What is Frontotemporal dementia (FTD)
spectrum of disorders involving degeneration of the frontal and temporal lobes.
What are the 3 subclasses of FTD
- FTD affecting behaviour (behavioural variant)
- Semantic dementia (SD) affecting meaningful speech
- Progressive nonfluent aphasia (PNFA) affecting speech production.
What is the most common variant of FTD
FTD affecting behaviour (behavioural variant)
How is the behavioural variant of FTD described
includes changes in personality, behaviour, insight and social awareness
may display a range of inappropriate
behaviours (ie aggression or inappropriate sexual behaviour).
What brain area is most effected in the behavioural variant of FTD
orbitofrontal PFC
The semantic variant of FTD has what features
can speak fluently but experience word finding problems, loss of semantic knowledge
What brain area is most effected in the semantic variant of FTD
Temporal lobe
What are 2 crucial differentials to exclude when diagnosing dementia
Depression
Delerium
What is the goal of the neuropsych in relation to dementia
• Assessment of cognitive strengths and weaknesses • Establish a baseline for later assessment of decline • Diagnosis • Treatment options • Assessment of treatment efficacy (ie has the medication improved symptoms?)
What important factor must neuropsych take into account when monitoring dementia
what changes are normally expected with age.
What 4 cognitive domains should be tested for dementia
executive/attention
memory
language
visuospatial functions
What effect does Vascular disease have on AD
can contribute to AD and exacerbate disease progression and deficits
