Dementia Flashcards
Dementia onset
Takes a longer time gradual development of multiple cognitive deficits
Dementia symptoms (6)
impaired executive functioning
impaired global intellect
impaired problem solving
impaired organizational skills
altered memory is the FIRST SIGN
Subcortical dementia (8)
motor symptoms: gait and balance issues, tremors, ataxia, dystonia
emotional changes, mood changes, depression and apathy,
Parkinson’s, Huntington’s, vascular dementia
Cortical dementia affects what part of the brain?
cerebral cortex
the outer layer of the brain responsible for higher cognitive functions
Hallmark of cortical dementia
memory loss and language difficulties
Aphasia (cortical dementia)
language impairment is common in cortical dementia, leading to problems of communication
Visuospatial issues
Cortical dementia
individuals may experience impairment affecting their ability to navigate and recognize objects
Apraxia
cortical dementia- difficulties in performing purposeful movement
Personality change in cortical dementia
increased impulsivity
Hallucinations and delusions
cortical dementia- agitation and distress
common types of cortical dementia (3)
alzheimer’s disease, frontotemporal, primary progressive aphasia
Subcortical Dementia
affects the brains subcortical structures located beneath the cerebral cortex
Cognitive & motor symptoms of Subcortical Dementia
Combination of cognitive and motor symptoms, including memory problems and movement difficulties
tremors, stiffness, bradykinesia
Gait and balance issues- walking and balance are common due to the involvement of motor pathways
Emotional changes from subcortical dementia
mood changes, depression, and apathy
Slower processing speed usually comes with
subcortical dementia
Common causes of subcortical dementia (3)
Parkinson’s disease
Huntington’s
Vascular dementia
Differentiate subcortical dementia from cortical dementia:
slowness in movement, tremors, difficulty with fine motor skills
What is the most common type of dementia?
Dementia of Alzheimer’s type (DAT)
Dementia of Alzheimer’s type is classified as (2)
cortical dementia
gradual onset and progressive decline without focal neurological deficits
Early signs of HIV dementia (3) p. 277
cognitive decline, motor abnormalities, and behavioral abnormalities
Clinical signs of late-stage HIV related dementia p. 277 (7)
global cognitive impairment, mutism, seizures, hallucinations, delusions, apathy, mania
Lewy Body Disease
is what type of dementia p. 279
subcortical and cortical
symptoms of lewy body disease
recurrent visual hallucinations
fluctuating cognitive impairment
Parkinson’s features bradykinesia and tremor
Often exhibits deficits in executive function, including difficulties with learning, planning, organization problem solving, and decision making
What type of dementia adversely reacts to antipsychotics especially atypical antipsychotics
Lewy Body Disease
Second most common type of dementia
vascular
vascular dementia is usually caused by
cardiovascular disease
What dementia is most common in preexisting BP and CV risk
vascular
Hallmarks of Vascular dementia p278
carotid bruits, fundoycopic abnormalities, enlarged cardiac chambers
name for frontotemporal dementia and frontal lobe dementia
Picks disease
What dementia disease shows personality behavioral and language changes (slurred) in early stage
Pick’s disease
Picks disease is more common in?
men
Picks disease, cognitive changes occurs in
later stages
Huntington’s disease is what type of dementia p.278
subcortical
Huntington’s disease has a high incidence of
depression and psychosis
people with Huntington’s disease have difficulty with
complex tasks- very slow
Etiology of DAT
diffuse cerebral atrophy and enlarged ventricles
What happens to ACH and NE with DAT
decreased
Genetic loading of DAT p278
family hx of dementia in first order relative
Tx for psychosis and agitation in dementia Pg 284 (3)
Try non-pharmacological interventions first
Atypical antipsychotics should be used as first-line agents in patients with psychotic symptoms of dementia
use lowest effective dose and attempt to wean periodically
What should be avoided when treating psychosis and agitation in dementia?
Benzodiazepines should be avoided if possible the patients are already vulnerable to their adverse effects such as sedation, falls, delirium
How to differentiate Delirium vs dementia?
In delirium you see ALOC, dementia you see behavioral disturbances, cognitive deficits, language difficulties
Best tx for AIDS dementia complex
HIV aids is responsible so the target is tx for HIV aids,
Antiviral therapy (refer to PCP)
Cognition and memory symptoms of MDD in the older adult population is often called () and confused with ()
pseudodementia
dementia-related symptoms
Difference between pseudodementia and MDD
Clients with dementia usually have a premorbid hx of slowly declining cognition whereas in MDD cognitive changes have a relatively acute onset and are significant when compared to premorbid functioning
How to differentiate dementia from pseudodementia
Pseudodementia “I don’t know” and are frustrated by the sudden memory changes versus dementia patients will try to answer but lacks answer or confabulation
Personality, behavioral, language change in early stage is from
Picks disease (frontotemporal and frontal lobe dementia) **
patient presents with personality changes, social behavior changes, aggression, inappropriate social behavior, what lobe of the brain can be affected?
frontal lobe dementia
subcortical dementia often show up as
motor abnormalities
Huntingtons disease usually begins between ages
30-45 but can occur as early as 2 and as late as 70
Does HD affect any demographic more
no effects males and females equally and all ethnic and racial groups
how to accurately and effectively test for HD
direct genetic test
each child of a person with HD has a ___ percent chance of inheriting the HD causing gene mutation
50 percent
Medication tx for Parkinson disease dementia (3)
donzepezil or rivastigmine, galantamine helps improve cognitive an behavioral symptoms
what medication types should be avoided for those with parkinsons disease dementia
Antipsychotics are especially typical so no HALDOL or chlorpromazine if must give an antipsychotic make sure it is atypical
DAT can see what changes in neurotransmitters
decrease ACH and NE
Genetic loading, family hx, and first order relative can increase risk. of what type of dementia
DAT
tx for psychosis and agitation in dementia
try non pharmacological treatments first then try atypical antipsychotics
