Dementia Flashcards
What is the DSM5-TR diagnostic criteria for dementia?
- evidence of significant cognitive decline from a previous level of performance on one or more cognitive domains based on: concern that there has been a decline, substantial impairment of cognitive performance in clinical assessment
- cog defs interfere with independence in everyday activities
- cog defs do not occur exclusively in context of delirium
- cog defs not better explained by another mental disorder
What is the prevalence of dementia?
- 850,000 in UK
- predicted to rise to 1.6 mil by 2040
- 209,600 cases per year
What are the percentages of each dementia type in over 65s?
- 60% Alzheimer’s
- 20% vascular
- 10% mixed
- 6% other
- 4% frontotemporal
How many people have early onset dementia?
42,000 under 65
What extra things must be taken onto consideration for those with early onset dementia?
- working
- dependent children
- financial commitments
- physically fit and behave in a way that people find challenging
- accept and cope with losing skills at young age
- more difficult to access info, support, and services
What are the percentages of each dementia type in early onset dementia?
- 33% Alzheimer’s
- 20% vascular
- 10% Lewy body
- 12% fronto-temporal
- 10% Korsacoffs syndrome
- 15% other types
What are the different dementia classification schemes?
- by disease process
- by primary site of cell damage
- by prognosis
What is DAT?
dementia of Alzheimer’s type
What causes DAT?
- degeneration of neurons
- amyloid beta plaques outside cell - bind to and impair capacity to transmit signals
- tau neurofibrillary tangles - disrupt functioning from inside
- loss of neurotransmitters
What are the triggers of DAT?
unclear but may include:
1. genetics
2. diet
3. lifestyle
4. toxins
How many stages are there of symptom progression in DAT?
3
What are the symptoms of stage 1 DAT?
- WFD
- retrograde and anterograde amnesia
- depression (reactive)
What are the symptoms of stage 2 DAT?
- increased WFD
- vague and generic talk
- comprehension difficulties
- episodic memory impairment which impacts discourse
- WM impairment
- problem solving impairment
- reduced attention span and difficulty switching attention
- misperception/hallucination/delusions
What are the symptoms of stage 3 DAT?
- echolalia
- neologistic speech
- apathy
- aggression
- mute
What causes vascular dementia?
multiple infarcts/strokes
What are the risk factors of vascular dementia?
- high blood pressure
- heart problems
- high cholesterol and diabetes
How does vascular dementia progress?
decline with each new vascular event
How can vascular dementia be treated?
theoretically can stop the decline if you can stop the strokes
What are the symptoms of vascular dementia?
behavioural symptoms and focal neurology signs vary according to site of vascular pathology
What is DLB?
dementia with Lewy bodies
What are Lewy bodies?
spherical protein deposits found in nerve cells in sub-cortex, limbic system, and cortex which interrupt the action of important chemical messengers (e.g. ACh, dopamine)
What are the symptoms of DLB?
- hallucinations
- delusions
- fluctuations in cognitive impairment
- falls/fainting
- disturbed sleep
- hypersensitivity to antipsychotics
What is FTD?
Frontotemporal dementia
What are the statistics for FTD?
- second most common type in under 65s
- 3rd most common neurodegenerative type overall
