Dementia

Question 1

Dementia onset

Answer 1

Takes a longer time gradual development of multiple cognitive deficits

Question 2

Dementia symptoms (6)

Answer 2

impaired executive functioning
impaired global intellect
impaired problem solving
impaired organizational skills
altered memory is the FIRST SIGN

Question 3

Subcortical dementia (8)

Answer 3

motor symptoms: gait and balance issues, tremors, ataxia, dystonia
emotional changes, mood changes, depression and apathy,
Parkinson’s, Huntington’s, vascular dementia

Question 4

Cortical dementia affects what part of the brain?

Answer 4

cerebral cortex
the outer layer of the brain responsible for higher cognitive functions

Question 5

Hallmark of cortical dementia

Answer 5

memory loss and language difficulties

Question 6

Aphasia (cortical dementia)

Answer 6

language impairment is common in cortical dementia, leading to problems of communication

Question 7

Visuospatial issues

Answer 7

Cortical dementia
individuals may experience impairment affecting their ability to navigate and recognize objects

Question 8

Apraxia

Answer 8

cortical dementia- difficulties in performing purposeful movement

Question 9

Personality change in cortical dementia

Answer 9

increased impulsivity

Question 10

Hallucinations and delusions

Answer 10

cortical dementia- agitation and distress

Question 11

common types of cortical dementia (3)

Answer 11

alzheimer’s disease, frontotemporal, primary progressive aphasia

Question 12

Subcortical Dementia

Answer 12

affects the brains subcortical structures located beneath the cerebral cortex

Question 13

Cognitive & motor symptoms of Subcortical Dementia

Answer 13

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

Question 14

Emotional changes from subcortical dementia

Answer 14

mood changes, depression, and apathy

Question 15

Slower processing speed usually comes with

Answer 15

subcortical dementia

Question 16

Common causes of subcortical dementia (3)

Answer 16

Parkinson’s disease
Huntington’s
Vascular dementia

Question 17

Differentiate subcortical dementia from cortical dementia:

Answer 17

slowness in movement, tremors, difficulty with fine motor skills

Question 18

What is the most common type of dementia?

Answer 18

Dementia of Alzheimer’s type (DAT)

Question 19

Dementia of Alzheimer’s type is classified as (2)

Answer 19

cortical dementia

gradual onset and progressive decline without focal neurological deficits

Question 20

Early signs of HIV dementia (3) p. 277

Answer 20

cognitive decline, motor abnormalities, and behavioral abnormalities

Question 21

Clinical signs of late-stage HIV related dementia p. 277 (7)

Answer 21

global cognitive impairment, mutism, seizures, hallucinations, delusions, apathy, mania

Question 22

Lewy Body Disease
is what type of dementia p. 279

Answer 22

subcortical and cortical

Question 23

symptoms of lewy body disease

Answer 23

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

Question 24

What type of dementia adversely reacts to antipsychotics especially atypical antipsychotics

Answer 24

Lewy Body Disease

Question 25

Second most common type of dementia

Answer 25

vascular

Question 26

vascular dementia is usually caused by

Answer 26

cardiovascular disease

Question 27

What dementia is most common in preexisting BP and CV risk

Answer 27

vascular

Question 28

Hallmarks of Vascular dementia p278

Answer 28

carotid bruits, fundoycopic abnormalities, enlarged cardiac chambers

Question 29

name for frontotemporal dementia and frontal lobe dementia

Answer 29

Picks disease

Question 30

What dementia disease shows personality behavioral and language changes (slurred) in early stage

Answer 30

Pick’s disease

Question 31

Picks disease is more common in?

Answer 31

men

Question 32

Picks disease, cognitive changes occurs in

Answer 32

later stages

Question 33

Huntington’s disease is what type of dementia p.278

Answer 33

subcortical

Question 34

Huntington’s disease has a high incidence of

Answer 34

depression and psychosis

Question 35

people with Huntington’s disease have difficulty with

Answer 35

complex tasks- very slow

Question 36

Etiology of DAT

Answer 36

diffuse cerebral atrophy and enlarged ventricles

Question 37

What happens to ACH and NE with DAT

Answer 37

decreased

Question 38

Genetic loading of DAT p278

Answer 38

family hx of dementia in first order relative

Question 39

Tx for psychosis and agitation in dementia Pg 284 (3)

Answer 39

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

Question 40

What should be avoided when treating psychosis and agitation in dementia?

Answer 40

Benzodiazepines should be avoided if possible the patients are already vulnerable to their adverse effects such as sedation, falls, delirium

Question 41

How to differentiate Delirium vs dementia?

Answer 41

In delirium you see ALOC, dementia you see behavioral disturbances, cognitive deficits, language difficulties

Question 42

Best tx for AIDS dementia complex

Answer 42

HIV aids is responsible so the target is tx for HIV aids,
Antiviral therapy (refer to PCP)

Question 43

Cognition and memory symptoms of MDD in the older adult population is often called () and confused with ()

Answer 43

pseudodementia
dementia-related symptoms

Question 44

Difference between pseudodementia and MDD

Answer 44

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

Question 45

How to differentiate dementia from pseudodementia

Answer 45

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

Question 46

Personality, behavioral, language change in early stage is from

Answer 46

Picks disease (frontotemporal and frontal lobe dementia) **

Question 47

patient presents with personality changes, social behavior changes, aggression, inappropriate social behavior, what lobe of the brain can be affected?

Answer 47

frontal lobe dementia

Question 48

subcortical dementia often show up as

Answer 48

motor abnormalities

Question 49

Huntingtons disease usually begins between ages

Answer 49

30-45 but can occur as early as 2 and as late as 70

Question 50

Does HD affect any demographic more

Answer 50

no effects males and females equally and all ethnic and racial groups

Question 51

how to accurately and effectively test for HD

Answer 51

direct genetic test

Question 52

each child of a person with HD has a ___ percent chance of inheriting the HD causing gene mutation

Answer 52

50 percent

Question 53

Medication tx for Parkinson disease dementia (3)

Answer 53

donzepezil or rivastigmine, galantamine helps improve cognitive an behavioral symptoms

Question 54

what medication types should be avoided for those with parkinsons disease dementia

Answer 54

Antipsychotics are especially typical so no HALDOL or chlorpromazine if must give an antipsychotic make sure it is atypical

Question 55

DAT can see what changes in neurotransmitters

Answer 55

decrease ACH and NE

Question 56

Genetic loading, family hx, and first order relative can increase risk. of what type of dementia

Answer 56

DAT

Question 57

tx for psychosis and agitation in dementia

Answer 57

try non pharmacological treatments first then try atypical antipsychotics