Dementia

Question 1

What is dementia?

Answer 1

loss of cognitive ability, resulting in loss of functional independence

Question 2

What areas can dementia affect?

Answer 2

Memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement.

Question 3

What is the most common cause of dementia?

Answer 3

Alzheimer’s disease

Question 4

What are two atypical types of Alzheimer’s disease?

Answer 4

1) Posterior Cortical Atrophy (PCA) - predominant visual disturbance
2) Logopenic AD - predominant language difficulties

Question 5

What are some diagnostic tools for Alzheimer’s disease?

Answer 5

Lumbar puncture to examine cerebrospinal fluid (CSF) for levels of amyloid and tau; MRI-B; PET; Amyloid PET

Question 6

What is the difference between dementia and mild cognitive impairment?

Answer 6

Mild cognitive impairment involves modest cognitive decline without interfering with independence and minimal effect on daily functioning, while dementia significantly impairs daily activities.

Question 7

What are the five main cognitive-linguistic domains affected in dementia?

Answer 7

1) Language
2) Memory
3) Executive function
4) Visuospatial skills
5) Attention

Question 8

What are some early communication changes in Alzheimer’s disease?

Answer 8

Initially very fluent, no articulation/phonological/syntax issues

• Word-finding difficulties
• Lexical-semantic problems
• Reduced verbal fluency

Question 9

How is hearing loss related to dementia risk?

Answer 9

People with mild hearing loss at age 50 are twice as likely to develop dementia, increasing to a five times greater risk for those with severe hearing loss.

Question 10

What are the types of dementia?

Answer 10

Alzheimer’s
Vascular dementia
Frontotemporal dementia
Lewy Body dementia
Dementia’s related to PD, Huntington’s etc.

Question 11

Alzheimer’s disease dementia

Answer 11

Characterised by: amyloid plaques and beta tangles
Symptoms: impairments in memory, language and visuospatial skills

Question 12

Vascular dementia

Answer 12

Characterised by: disease or injury to blood vessels leading to brain
Symptoms: impaired motor skills and judgement

Question 12

Frontotemporal dementia

Answer 12

Characterised by: deterioration of frontal and temporal lobes of brain
Symptoms: personality changes and language - umbrella term for PPA

Question 13

Lewy Body dementia

Answer 13

Characterised by: LB protein deposits on nerve cells
Symptoms: hallucinations, disordered sleep, impaired thinking, and motor skills

Question 14

Parkinson’s Disease dementia

Answer 14

Changes in memory, concentration and judgment.
Trouble interpreting visual information.
Muffled speech.
Visual hallucinations.
Delusions, especially paranoid ideas.
Depression, irritability and anxiety.
Sleep disturbances, including excessive daytime drowsiness and rapid eye movement (REM) sleep disorder.

Question 15

Dysphagia in Alzheimer’s

Answer 15

• Mild: Longer oral transit duration (OTD) for solid boluses; Longer pharyngeal response durations (PRD) and total swallow durations (TSD) for liquids [7]; Reduced hyolaryngeal movement
• Moderate: Inadequate pharyngeal clearance, reduced upper esophageal opening, penetration/aspiration

Question 16

Dysphagia in vascular dementia

Answer 16

Difficulty with formation and mastication of semi-solid boluses; reduced hyolaryngeal movement;
decreased epiglottic inversion

Question 17

Dysphagia in LB/PD

Answer 17

Delayed pharyngeal initiation, residue, penetration/aspiration

Question 18

Dysphagia in FTD

Answer 18

Rapid and compulsive eating; inappropriate choices for eating; larger bolus sizes; Early leakage of food into pharynx during mastication; pharyngeal residue

Question 19

Dysphagia in mixed dementia

Answer 19

Aspiration of liquids, incomplete laryngeal closure, and impaired inversion of the epiglottis