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Disorders of the Nervous System > Dementia > Flashcards

Dementia Flashcards

1
Q

what is CFAS

A

cognitive function and ageing study

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2
Q

what did the CFAS show

A

comparison of dementia cases from 1989 - 2011
prevalence increasing rapidly but people in 70s are now at lower risk than 30yrs ago
level of education rising and changes in way CVD has been treated (improving brain health) means cases should drop but its not outweighed by no. of people living older

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3
Q

what is the diagnostic criteria for dementia cognitive/behavioural symptoms?

A

intefere with ability to function
represent decline from previous functioning
impariment in memory, visuospatial function, language, personality, behaviour
not explained by delirium psychiatric disorder

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4
Q

how should you assess dementia when asking patients family

A

ask about things they have noticed such as ability to do normal tasks like washing, dressing, housework, finances

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5
Q

what is a way of measuring executive function

A

the instrumental activities of daily living scale (IADL)
assesses ability to use telephone, shopping, food prep, housekeeping, laundry, transport, medication and finances

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6
Q

what is cognition

A

the localisation of function
important for rather than responsible for

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7
Q

what type of memory is affected in alzheimers

A

episodic memory
hippocampal tissue shrinkage
e.g what you had for breakfast in the morning or what you did last summer - long term memory

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8
Q

what are some frontal lobe functions

A

sequencing and planning e.g putting on shoes before socks
personality
decision making
temporal-order judgments
planing
problem solving
abstract conception

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9
Q

what is the dorsolateral streams function

A

executive abilities and adaptive behaviours like anticipating, planning, evaluating

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10
Q

what are the functions of the orbitomesial stream

A

social and emotional behaviours

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11
Q

what is a test that shows frontal lobe and executive function

A

dot to dot of numbers randomly scattered on paper in order
people who have dysfunction do this slowly or make errors e.g forget there is numbers there

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12
Q

what are some non-cognitive symptoms of dementia

A

can be a cause of disability by causing physical and motor symptoms, autonomic symptoms
personality/behaviour changes
occur later in alzheimers

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13
Q

what can the non-cognitive symptoms of dementia help identify

A

the type of dementia for diagnosis

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14
Q

what are some autonomic and motor symptoms of dementia

A

incontinence
constipation
postural hypotension
falls
parkinsonism

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15
Q

what are some neuropsychiatric symptoms of dementia

A

apathy (lack of interest/drive)
depression
sleep disturbance
agitation
aggression
psychosis

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16
Q

what 4 criteria can help diagnose the sub-type of dementia

A

pattern of onset and progression of decline
pattern of cognitive impairment
pattern of symptoms
imaging and biomarker findings

17
Q

outline alzheimer symptoms that could aid diagnoses

A
  • insidious onset and gradual progression
  • anterograde memory (ability to remember/learn new info)
    -initially deficit in memory language visuospatial executive function, not behaviour or personality
18
Q

how can we assess amyloid and tau deposition in patients now

A

extraction of CSF from spine
sample taken when alive but categorised based on postmortem finding

19
Q

how would a PET scan show alzheimers

A

purple colour = low signal
warm colours = high signal
so would be warm colours which show tau deposition

20
Q

outline the symptoms of dementia with lewy bodies which could aid diagnoses

A

insidious onset and gradual progression with episodes of delirium and fluctuation
predominant executive and visuospatial deficits
cognitive fluctuation
visual hallucinations, parkinsonism, REM sleep disorder
loss of sense of smell and autonomic symptoms

21
Q

what is different about dementia with lewy bodies aetiology

A

alpha synuclein deposition instead of amyloid beta

22
Q

what are indicative biomarkers of dementia with lewy bodies

A

look at nerve cells associated with movement (SPECT)
PSG (polysomnography) - electrode on skull and muscle which measure REM sleep - muscles in sleep should be paralysed but for dementia patients they move

23
Q

outline symptoms which could aid in frontotemporal dementia diagnoses

A

gradual progressive decline
frontal executive cognition impaired
apathy, loss of sympathy/empathy
repetitive, obsessive behaviours
hyperorality/dietary changes

24
Q

using a PET scan and administering sugar can aid in diagnoses of frontotemporal dementia - what would the scan look like?

A

low uptake if brain is not functioning, so less warmer colours in the brain - more purple

24
Q

outline the symptoms which could aid in the diagnoses of vascular dementia

A

abrupt/step-wise decline - following a stroke
focal neurological signs, early gait disturbance and falls
early incontinence
use imaging to find decrease in blood flow to brain

25
Q

what are biological treatments for dementia

A

drugs
optimising physical health

26
Q

what are psychological treatments for dementia

A

cognitive stimulation therapy
carer support

27
Q

what are social treatments for dementia

A

housing and care needs - activities

28
Q

what receptor is associated with cognitive symptoms for alzheimers and dementia with lewy bodies?
what treatment can be used to help this?

A

acetylcholine deficit
implicated in attention, memory function
cholinesterase inhibitors - boost ACH in brian by inhibiting acetylcholine esterase to keep more ACH in synapse - helps cognitive function and activities of daily living

29
Q

what is an example of a cholinesterase inhibitor

A

donepezil
rivastigmine

30
Q

what drug is memantine and why does it help alleviate the symptoms of alzheimers disease

A

blocks NMDA receptors which decreases excitation - as it is thought glutaminergic excitotoxicity occurs in alzheimers
moderate improvement in cognitive function

31
Q

what is the future of dementia treatment

A

disease modifying treatments
newest - lecanemab and donanemab
work with immune system to clear amyloid in brain to slow progression
but side effects like oedema and need intravenous infusion

32
Q

what is the most promising alzheimers biomarker

A

p-tau

Disorders of the Nervous System (19 decks)

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