Dementia Flashcards
What is dementia?
Progressive and degenerative brain disorder that affects memory, thinking, behavior and ability to carry out daily activities
List the symptoms of dementia?
Reduced ability to carry out daily activity
Memory loss
Personality changes
Difficulty reasoning and communication
List the four types of dementia?
Alzheimer’s disease
Vascular dementia
Dementia with Lewy bodies
Frontotemporal dementia
Tell us about Alzheimer’s disease
- Most common type of dementia
- caused by buildup of amyloid plaques and tau tangles in brain
Alzheimer’s disease leads to…?
Memory loss and cognitive decline
What is vascular dementia
Reduced blood flow to the brain which can be due to stroke or CVD
List stmtuokes of Vascular dementia?
Difficulty planning, organizing and decision making
What is Lewy bodies dementia?
Buildup of abnormal protein deposits (alpha synuclein) in the brain
Lewy body dementia leads to?
Problems with movement, sleep and cognitive function. Causes visual hallucinations
What is frontotemporal dementia?
Progressive damage to frontal or temporal lobes of brain. Linked to genetic mutation
FT dementia affects your..?
Personality
Behavior
And language
List the non modifiable risk factors?
Age
Genetics
Parkinson’s disease
Cerebrovascular disease
List the modifiable risk factors?
Smoking
Diabetes mellitus
Lack of physical activity
Obesity
List other symptoms of dementia
Memory problem - impaired executive function, disorientation, dysphasia
Behavior symptoms- depression, agitation, delusions and sleep disruption
Difficulty with daily living- eating, hygiene, dressing
What are the other conditions similar to dementia?
Depression
Hypothyroidism (mood and cognitive disturbance)
Infections (uti)
Vitamin deficiency
Delirium
What is the aim of treatment?
Does cure but
- helps relieve symptoms
- stop progression of dementia
What is the first line group class treatment?
Acetylcholinesterase inhibitors
List the drugs used to treat mild to moderate Alzheimer’s disease?
Acetylcholinesterase -
Donepazil, rivastigmine and galantamine
(DARG)
List drug used to treat moderate to severe Alzheimer’s disease
Glutamate receptor antagonist-
Memantine ( alone or add with first line)
Which dementia can you not use Acetylcholinesterase and memantine?
Frontotemporal dementia
What are the MHRA warnings in dementia m?
- Do not use antipsychotics in elderly patient with dementia unless you have to. (Risk of stroke- death)
- balance risks and assess if they have previous of stroke, TIA, hypertension, diabetes, smoking and AF (cerebrovascular
When can you give antipsychotic trt in dementia?
- Last option
- high risk of harming themselves or others
- hallucinations, delusions, severely distress
What are the rules of taking antipsychotics drugs?
- Give lowest dose
- review at least every 6 weeks
Antipsychotic can worse motor features of the condition in which dementia?
Lewy bodies
Parkinson’s disease
What is the dose of donepezil?
5mg orally OD at bedtime
List the side effects of acetylcholinesterase?
Parasympathetic side effects (works in that pathway)
Diarrhea, urinary incontinence, muscle weakness, bradycardia
Bronchospasm, emesis, lacrimation(flow of tears), salivation
(Dumb bels)
which acetylcholinesterase is only licensed for dementia with Parkinson’s disease
Rivastigmine
which acetylcholinesterase is only licensed for dementia with Parkinson’s disease
Rivastigmine
