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Neuropsych > Dementia > Flashcards

Dementia Flashcards

1
Q

What is dementia

A

brain disorder causing progressive change and deterioration in cognitive ability, behavior, emotion and personality

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2
Q

Why can diagnosing dementia be difficult?

A

shares similarities with normal age and other diseases/conditions (ie MDD).

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3
Q

What needs to be established before diagnosing dementia

A

Evidence of decline in function

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4
Q

What are 4 types of demetia

A

Alzheimer’s disease (AD)
Vascular Dementia
Lewy-Body Disease (LBD)
Frontotemporal dementia (FTD)

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5
Q

What is the most common form of dementia

A

Alzheimer’s disease (AD)

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6
Q

What are the key features of AD

A
  1. Insidious onset
  2. Early memory impairment (rapid forgetting)
  3. Gradual decline leading to the loss of more
    cognitive functions
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7
Q

What are three diagnoses of AD

A
  1. Definite – clinical diagnosis with histology
  2. Probably – clinical syndrome without histology
  3. Possible – atypical clinical features but no alternative diagnosis
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8
Q

What 4 cognitive areas does AD efffect

A
  1. Memory
  2. Language & semantics
  3. Executive function
  4. Spatial abilities
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9
Q

What structures are effected early during AD

A

Medial temporal lobe / hippocampus

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10
Q

How is memory affected by AD

A

The ability to learn and remember information is compromised.

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11
Q

What kind of memory is particularly affected by AD

A

Episodic memory tests are sensitive to AD, even in the early stages (long-term memory for specific event and experiences)

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12
Q

impairment of recall and recognition suggest deficits in what?

A

consolidation and rapid forgetting rather than

difficulties with retrieval.

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13
Q

What language impairments are there with AS

A

object naming

Verbal Fluency and semantic categorization

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14
Q

What does categorization problems mean?

A

knowledge of concepts and associations between them appears to be compromised

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15
Q

What area does categorisation problems suggest is affected

A

Temporal lobe

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16
Q

What is a test of object naming for AD

A

Boston Naming Task

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17
Q

What is a test of verbal fluency for AD

A

FAS

18
Q

What visio-spatial deficits are common in AD

A

problems with visual orientation and visuoperception

19
Q

What are 3 tests for visio-spatial deficits in AD

A
  • Clock drawing task
  • Ray complex figure
  • Clock Drawing task
20
Q

What particular areas of executive function are impaired in AD

A

Set shifting

self-monitoring

21
Q

What executive functions become impaired later in the disease

A

Working memory

sustained attention

22
Q

What are 4 tests of executive function in AD

A
  • Tower of London
  • Wisconsin card sort
  • Porteus maze
  • Trail Making part B
23
Q

What are some tests of memory in AD

A
  • Free recall
  • Recognition
  • Paired-associate learning
24
Q

Crystallized intellect is preserved in AD - what does this mean

A

can remember facts

25
Q

How is LTM effected in AD

A

can still recall information about their life

26
Q

What is the main differentiator between AD and Lew’s Body Disease

A

LBD has Recurrent visual hallucinations – well formed and detailed

27
Q

How is memory effected in Lewy-Body Disease (LBD)

A

Memory not early feature but hippocampus is

affected late in the disease

28
Q

How is movement effected by LBD and give examples

A

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

29
Q

How do AD and LBD differ in terms of spatial deficits

A

DLB more impaired on visual-perceptual and visuoconstructional tasks than AD
eg Clock Drawing

30
Q

What is Frontotemporal dementia (FTD)

A

spectrum of disorders involving degeneration of the frontal and temporal lobes.

31
Q

What are the 3 subclasses of FTD

A
  1. FTD affecting behaviour (behavioural variant)
  2. Semantic dementia (SD) affecting meaningful speech
  3. Progressive nonfluent aphasia (PNFA) affecting speech production.
32
Q

What is the most common variant of FTD

A

FTD affecting behaviour (behavioural variant)

33
Q

How is the behavioural variant of FTD described

A

includes changes in personality, behaviour, insight and social awareness
may display a range of inappropriate
behaviours (ie aggression or inappropriate sexual behaviour).

34
Q

What brain area is most effected in the behavioural variant of FTD

A

orbitofrontal PFC

35
Q

The semantic variant of FTD has what features

A

can speak fluently but experience word finding problems, loss of semantic knowledge

36
Q

What brain area is most effected in the semantic variant of FTD

A

Temporal lobe

37
Q

What are 2 crucial differentials to exclude when diagnosing dementia

A

Depression

Delerium

38
Q

What is the goal of the neuropsych in relation to dementia

A 
• 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?)
39
Q

What important factor must neuropsych take into account when monitoring dementia

A

what changes are normally expected with age.

40
Q

What 4 cognitive domains should be tested for dementia

A

executive/attention
memory
language
visuospatial functions

41
Q

What effect does Vascular disease have on AD

A

can contribute to AD and exacerbate disease progression and deficits

Neuropsych (7 decks)

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