dementia

Question 1

define dementia

Answer 1

results from an acquired brain disease; characterized by a progressive decline in memory and other cognitive domains that interferes with daily living and independent functioning

Question 2

what are some symptoms associated with dementia?

Answer 2

1. memory loss
2. behavioral
3. personality changes
4. problems w/ executive functioning
5. attention and processing speed impairment
6. disorientation
7. perceptual changes
8. language

Question 3

dementia is also known as…

Answer 3

major cognitive disorder

Question 4

what are the requirements for dementia?

Answer 4

significant decline from previous levels of performance in one or more of the cognitive domains

Question 5

what are the requirements for dementia? pt. 2

Answer 5

cognitive deficits interfere w/ independence in everyday activities

cognitive deficits do not occur exclusively in the context of delirium

cognitive deficits are not better explained by other mental disorders

Question 6

what are some examples of activities of daily living?

Answer 6

bathing
dressing
grooming
eating
toileting
transferring

Question 7

what are examples of instrumental activities of daily living

Answer 7

cooking
cleaning
managing finances
grocery shopping
managing medications

Question 8

true or false: dementia may also include behavioral problems

Answer 8

true

Question 9

dementia is not…

Answer 9

depression
delirium
age related memory decline

other conditions that have inconsistent symptoms (+ are temporary or treatable)

Question 10

what are modifiable risk factors for dementia?

Answer 10

less education
hypertension
hearing impairment
smoking
obesity
depression
low social contact
TBI
physical inactivity

Question 11

what are some causes of dementia?

Answer 11

Alzheimer’s disease
lewybody disease
vascular pathology
FTD
huntingtons
parkinsons
TBI
MS
HIV

Question 12

what is the leading cause of dementia?

Answer 12

alzheimer’s

Question 13

true or false: dementia is an umbrella term used to describe a range of symptoms associated with cognitive impairment

Answer 13

true

Question 14

what are the 3 levels of dementia characterization

Answer 14

1. clinical: the symptoms
2. neuroanatomical: the location in the brain
3. neuropathological: the disease

Question 15

what are symptoms of Alzheimer’s

Answer 15

early stage deficits in episodic and working memory

later stage impairments in semantic memory

relatively spared procedural memory in early to middle stages of disease

Question 16

what are symptoms of vascular dementia

Answer 16

cognitive symptoms are heterogenous depending on the lesion distribution

cortical lesions are associated with amnesia, visuospatial deficits, and aphasia

subcortical lesions are associated w/ impairments of memory, executive functions, attention, and motor function

Question 17

what are symptoms of Lewy body?

Answer 17

fluctuating presentation of cognitive symptoms

procedural memory and learning deficits may occur with subcortical pathology

declarative memory systems may be impaired w/ cortical pathology

frequently overlaps w/ Parkinson’s

Question 18

what are symptoms of frontotemporal dementia

Answer 18

extreme changes in behavior

some subtypes have…
-language problems and motor disorders

usually at a younger age than Alzheimer’s

Question 19

do SLP’s diagnose alzheimers, mild cognitive impairment, and or dementia

Answer 19

no

Question 20

what are screening tools for evaluation of dementia

Answer 20

MOCA
Mini-mental
SLUMS

Question 21

what is the evaluation process for dementia?

Answer 21

interview
questionnaire or rating scales
standardized evaluation tools

Question 22

what does the interview look like for dementia?

Answer 22

1. find out sensory information
2. use principles of ethnographic interviewing
   -build relationship, hear their story, be curious
3. be solution focused

Question 23

who can we give the questionnaires or rating scales when evaluating dementia?

Answer 23

client
family member
caregiver

Question 24

what are some examples of questionnaires or rating scales that we can use for a dementia eval

Answer 24

functional activities questionnaire
AD8
IQCODE

Question 25

standardized assessment tools for dementia include...

Answer 25

screeners comprehensive evaluation

Question 26

what scale is used to measure stages of dementia?

Answer 26

global deterioration scale/reisberg's scale

Question 27

what is GD level 1

Answer 27

no cognitive decline no complaints of memory problems no evidence of cognitive deficits

Question 28

what is GD level 2

Answer 28

very mild cognitive decline reports of memory problems -forgetting names, misplacing objects no evidence of issues w/ work or social relationships

Question 29

what is GD level 3

Answer 29

mild cognitive decline impaired concentration difficulty w/ work tasks some denial and anxiety about deficits

Question 30

what is GD level 4

Answer 30

moderate cognitive decline trouble... -remembering personal history -traveling or handling finances reduced expression of emotions withdrawal from situations that are challenging

Question 31

what is GD level 5

Answer 31

moderately severe cognitive decline some assistance needed evidence of short term memory loss lack of orientation to time, place, date may need assistance w/ choosing what to wear

Question 32

what is GD level 6

Answer 32

severe cognitive decline lack of awareness ADL may need assistance incontinence and bowel issues sleep disturbances personality + behavior changes

Question 33

what is GD level 7

Answer 33

very severe cognitive decline significant personality + behavior changes loss of speech and ability to hold conversation difficulty moving, eating, and swallowing unable to do daily activities w/o assistance

Question 34

treatment for dementia may include...

Answer 34

medication therapy -counseling -caregiver training -external aids -errorless learning -montessori approach -spaced retrieval

Question 35

how can SLP's educate on healthy brain habits

Answer 35

disease management activity nutrition cognitive stimulation engagement with others socially relaxation sleep hygiene

Question 36

true or false: you can slow the progression of disease changes

Answer 36

true

Question 37

what are strategies the family can use to help someone with dementia

Answer 37

repeating key info speaking slowly + clearly giving choices (not opened ended) keeping info and Q's short using written words + pictures reminding about appointments + medicine

Question 38

what is the FOCUSED caregiver training program?

Answer 38

face to face communication orient to topic continue w/ concrete topics resolve any communication blocks structure w/ y/n and choice Q's encourage exchange convos direct, simple, short sentences

Question 39

what are some examples of external aids for orientation?

Answer 39

calendar or written schedule

Question 40

what are some examples of external aids for prospective memory?

Answer 40

alarms to-do lists

Question 41

what is spaced retrieval training

Answer 41

client is told a piece of info and asked to recall repeatedly and systematically overtime designed to decrease demands on working memory and episodic memory

Question 42

define errorless learning

Answer 42

procedure structured to reduce the opportunity for errors during learning

Question 43

what are the errorless learning procedures

Answer 43

1. break the task into small discrete steps 2. model before the client is asked to perform the task 3. encourage the client to avoid guessing 4. correct errors immediately 5. gradually fade prompts

Question 44

what is a Montessori approach?

Answer 44

provide a prepared environment to promote independence for doing activities

Question 45

what is reminiscence therapy

Answer 45

recalling the past drawing on semantic + episodic memory decreases demands on working memory + recent episodic stimulates positive emotion and action