Dementia Flashcards
Describe the clinical features of Alzheimer’s disease.
Alzheimer’s disease is the most common form dementia characterized by cerebral cortex atrophy, formation of amyloid ‘plaques’ and neurofillary ‘tangles’, decreased ACh production, and progressive damage to the brain over time.
What are the risk factors associated with dementia?
Risk factors for dementia include age, mild cognitive impairment, genetics, cardiovascular disease risk factors like diabetes and hypertension, Parkinson’s disease, stroke, depression, heavy alcohol consumption, and low educational attainment.
Define mild cognitive impairment (MCI) how it differs from dementia.
MCI does not meet the diagnostic criteria for dementia as it may only affect one cognitive domain or not significantly impact daily activities, unlike dementia which involves deteriorating mental function interfering with daily living.
How does vascular dementia differ from Alzheimer’s disease in terms of its cause?
Vascular dementia is caused by problems in blood supply to the brain, often due to strokes, while Alzheimer’s disease is a physical disease resulting from changes in brain structure and chemical shortages affecting message transmission.
Describe the subtypes of dementia other than Alzheimer’s disease and vascular dementia.
Other subtypes include mixed dementia (both Alzheimer’s and vascular), dementia with Lewy bodies (irregular brain cell function), and rarer causes like Corticobasal degeneration and Creutzfeldt-Jakob disease.
How do the clinical features of dementia typically progress over time?
Dementia symptoms progress with time, starting with insidious onset and non-specific signs, advancing through early, middle, and late stages, with symptoms varying from person to person and becoming more severe as damage to the brain increases.
Describe the progression of symptoms in the early stage of dementia.
In the early stage of dementia, individuals may become forgetful, have difficulty with communication, get lost in familiar places, lose track of time struggle with decision-making and handling finances, experience mood changes like depression and anxiety, and show interest in hobbies.
What are some common symptoms in the middle stage of dementia?
In the middle stage of dementia, individuals may exhibit very forgetful behavior, have trouble comprehending time and events, struggle with communication and personal care, be unable to prepare food or live alone safely, and may display behavioral changes like wandering, repeated questioning, and hallucinations.
How does dementia typically progress in the late stage?
In the late stage of dementia, individuals are usually unaware of time and place, have difficulty understanding their surroundings, cannot recognize relatives or familiar objects, struggle to eat without assistance, experience incontinence, changes in mobility, and may exhibit aggression or non-verbal agitation.
Define the prognosis of dementia as a life-limiting condition.
Dementia is a life-limiting condition with no cure, where the length of time between diagnosis and death varies. Factors like age at onset, gender, and dementia subtype can influence median survival, which is typically 3-9 years after diagnosis.
What are the key steps involved in diagnosing dementia?
Diagnosing dementia involves obtaining a history from the patient and informant, assessing cognitive, behavioral, and psychological symptoms, evaluating the impact on daily life, reviewing comorbidities and risk factors, conducting physical examinations, blood and urine tests, cognitive testing, and referring to specialist dementia diagnostic services.
Describe the behavioral changes that may occur in individuals with dementia.
Individuals with dementia may exhibit behavioral changes such as mood swings, aggression, disinhibition, wandering, disturbed sleep, hallucinations, inappropriate behavior in the home or community, and aggression towards caregivers as the condition progresses through its stages.
Describe the Mini-Cog assessment process for dementia. What are the steps involved and what is the purpose each step?
The Mini-Cog assessment for dementia involves three steps: 1) Three-word recognition to test immediate memory, 2) Clock drawing to assess visuospatial abilities, and 3) Word recall to evaluate delayed memory. The purpose is to screen for cognitive impairment.
How can cognitive symptoms in patients with mild-to-moderate dementia be managed non-pharmacologically? Provide examples of interventions.
Cognitive symptoms in mild-to-moderate dementia can be managed non-pharmacologically through structured group cognitive stimulation programs, group reminiscence therapy, and cognitive rehabilitation or occupational therapy. These interventions aim to improve cognition and overall well-being.
Define acetylcholinesterase inhibitors (AChIs) in the context of dementia treatment. What benefits do they offer and what are some common cautions associated with their use?
Acetylcholinesterase inhibitors (AChIs) are drugs that block the degradation of acetylcholine, providing modest benefits in cognition, function, and behavior in patients with mild-to-moderate Alzheimer’s disease. Common cautions include issues like COPD, asthma, and cardiac abnormalities.
