Dementia Flashcards
most common cause of dementia?
Alzheimers
differences in aetiology between early onset and late onset dementia?
vascular dementia more common in early onset than late, AD still most common in both
most useful tool for diagnosis?
History taking
Focuses on memory, language, executive skills, neglect phenomena, personality and social conduct, sexual behaviour, mood, eating etc.
chronology of each
clinical course of dementia?
gradual decline over years (more exaggerated than natural decline with old age) with pre-clinical, mild cognitive impairment and dementia phases.
possible definition of dementia?
severe loss of memory and other cognitive abilities which leads to impaired daily function
what is examined in dementia patients?
Neurological /mental state
what is an MMSE?
mini mental state examination
involves recall, attention, language, calculation and orientation assessment
What might MMSS be supplemented with
ACE III (Addenbrooke’s Cognitive Examination) → longer and more memory focused
what blood tests might be relevant?
FBC, inflammatory markers, thyroid/renal function, glucose, B12 and folate, clotting factors
also syphilis, HIV, ceruloplasmin (copper transport)
18F florbetapir PET scans → usefulness?
higher scan presence indicates more beta-amyloid (associated with AD pathology)
main causes of dementia
alzheimer’s (subtle,insidious amnestic/non amnestic presentation)
vascular (relates to cerebro vascular disease with multiple infarcts and gets worse progressively)
Lewy body (cognitive impairment within 1 year of parkinsonian symptoms,visual hallucinations and fluctuating cognition)
frontotemporal (behavior variant FTD,semantic dementia,non fluent aphasia)
depression
delirium
signs of dementia with Lewy bodies?
cognitive impairment before/within a year of Parkinsonian symptoms, visual hallucination, fluctuating cognition
signs of FTD?
behavioural variance, semantic dementia, progressive non-fluent aphasia (productive
what is head turning sign?
look at whoever’s accompanying you for support when asked a question
two factors involved in the pathophysiology of AD?
beta-amyloid and tau