Dementia Flashcards
1
Q
who diagnoses dementia
A
- GP
- consult geriatrician, nuerologist, psychiatrist
- memory clinics
2
Q
how is dementia diagnosed
A
- subjective reports
- brain imaging
- blood tests (biomarkers)
- cognitive screening
3
Q
clinical consensus meeting
A
- working diagnostic formulation between MDT
- referrals likely (OT, SLT, neuropsychology)
- CSF biomarkers for AD
- further neuroimaging
- cases are rediscussed once neuroimaging results are available
- medical review is booked
4
Q
role of SLT in communication assessment
A
- assess body functions and structures that contribute to communication disorders
- informal and formal assessment of communication to develop of a profile of skills and difficulties (may include psychological and social)
- contribute to MDT
- engage in assessment of the capacity for decision-making when there are language difficulties
- functional assessment (ICF)
5
Q
MDT
A
- client and family
- geriatrician, neurologist, psychiatrist, GP
- nurse, nurse specialist, ANP
- OT, PT
- dietician
- neuropsychologist
- medical social worker
- pharmacist
- radiologist
6
Q
pre-diagnostic assessment considerations
A
- ask their view on cognition
- co-occurring conditions
- predisposition
- emotions around a possible diagnosis
7
Q
post-diagnostic assessment considerations
A
- coping ability
- supports available
- fear for the future
8
Q
assessment considerations
A
- environment, time of day, hearing aids/glass, family present, dentures
- sight and hearing
- fatigue
- medication
- education
- first language
9
Q
modifiable risk factor (promotes brain health)
A
hearing loss
10
Q
hearing enables ?
A
- cognition
- facilitates social interaction
- enhances communication
11
Q
different purposes of assessment
A
- communication screening
- functional communication assessment
- comprehensive cognitive communication assessment
12
Q
assessment components
A
- case history
- conversational skills
- collateral (e.g. “can’t get the words out, lose concentration when watching tv, going off topic”)
- language assessment
- assessment of cognitive domains
13
Q
case history includes ?
A
- medical history
- social history
- communication history
- environmental evaluation
- hearing/vision
- progression of language vs. memory difficulties
- fatigue
- first language
- education
- life and work experience
- physical activity
- medications and interventions
- coping with diagnosis
- support systems
14
Q
formal vs. informal assessment
A
- both valid
- consider if the person with dementia can engage with formal testing
- use many different tools to elicit a complete picture
15
Q
cognitive linguistic domains
A
- language
- memory
- executive function
- visuospatial skills
- attention
16
Q
receptive language skills to assess
A
- auditory comprehension (single word, sentence, paragraph)
- follow commands (level of breakdown)
- yes/no questions
- semantic knowledge
- reading and writing
17
Q
expressive language skills to assess
A
- confrontational naming
- generative naming (verbal fluency)
- repetition (single word, sentence, complex sentence) and level of breakdown
- picture description
- narrative discourse
18
Q
conversation analysis
A
- focuses on interactions between 2 people
- areas of conversation breakdown and repair, turn taking, and topic maintenance
- video conversation analyzed by SLT for successes, breakdowns, barriers
19
Q
conversational skills
A
- turn taking
- greeting/closing
- topic maintenance
- conversation breakdown/repair
- tangential speech
- social skills
20
Q
assessment considerations in acute care
A
- limited time
- medically unwell
- informal screens with family, general conversations usually most appropriate
- be aware of onward referral
- ensure person with dementia stays connected
21
Q
assessment in PPA
A
- assess cognitive-linguistic ability (formal and informal methods, aphasia battery)
- motor speech assessment
- develop a profile of linguistic abilities and difficulties
22
Q
specific PPA assessments
A
- sydney language battery (SYDBAT)
- repeat and point test
- progressive aphasia severity scale (PASS)
23
Q
how to assess single word, sentence, and paragraph comprehension
A
- word/sentence to picture matching
- word-to-definition matching
- synonym matching
- answering personally relevant questions
- answering yes/no questions (simple and abstract), answering questions to a read paragraph
- familiarity, frequency, grammatical complexity, word length
- object knowledge
24
Q
assessing semantics
A
- word meanings and concepts
- extensive network of associations and concepts form our knowledge (when one is activated, related concepts, events, words are activated)
- attach meaning onto word form, making it able to be spoken
25
Q
assessing naming
A
- confrontational naming
- single word-retrieval in response to pictures and objects
- error rates and types
- delay in naming
- factors that affect naming (familiar vs unfamiliar, nouns vs verbs, semantic category)
26
Q
assessing picture description
A
- spontaneous speech
- fluency
- articulation
- word-finding, naming difficulties
- effortfulness
- hesitations
- grammatical structure
- accuracy of content
- melody, prosody
- specific error types
- mean length of utterance
- speech rate
27
Q
assessing verbal fluency
A
- generative naming
- prominent role in neuropsychology testing
- not just assessing whether can retrieve a word or not, tap into cognitive-linguistic skill (verbal functioning)
28
Q
semantic fluency
A
- resembles everyday production taks
- exploit existing links between related concepts to retrieve responses
29
Q
phonemic fluency
A
- rarely done in everyday speech production
- more cognitively demanding than semantic fluency
- suppress the activation of semantically related or associated words
30
Q
how to assess repetition
A
- single words
- multisyllabic words
- phrases
- sentences
- non words
