dementia Flashcards
define dementia
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
what are some symptoms associated with dementia?
- memory loss
- behavioral
- personality changes
- problems w/ executive functioning
- attention and processing speed impairment
- disorientation
- perceptual changes
- language
dementia is also known as…
major cognitive disorder
what are the requirements for dementia?
significant decline from previous levels of performance in one or more of the cognitive domains
what are the requirements for dementia? pt. 2
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
what are some examples of activities of daily living?
bathing
dressing
grooming
eating
toileting
transferring
what are examples of instrumental activities of daily living
cooking
cleaning
managing finances
grocery shopping
managing medications
true or false: dementia may also include behavioral problems
true
dementia is not…
depression
delirium
age related memory decline
other conditions that have inconsistent symptoms (+ are temporary or treatable)
what are modifiable risk factors for dementia?
less education
hypertension
hearing impairment
smoking
obesity
depression
low social contact
TBI
physical inactivity
what are some causes of dementia?
Alzheimer’s disease
lewybody disease
vascular pathology
FTD
huntingtons
parkinsons
TBI
MS
HIV
what is the leading cause of dementia?
alzheimer’s
true or false: dementia is an umbrella term used to describe a range of symptoms associated with cognitive impairment
true
what are the 3 levels of dementia characterization
- clinical: the symptoms
- neuroanatomical: the location in the brain
- neuropathological: the disease
what are symptoms of Alzheimer’s
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
what are symptoms of vascular dementia
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
what are symptoms of Lewy body?
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
what are symptoms of frontotemporal dementia
extreme changes in behavior
some subtypes have…
-language problems and motor disorders
usually at a younger age than Alzheimer’s
do SLP’s diagnose alzheimers, mild cognitive impairment, and or dementia
no
what are screening tools for evaluation of dementia
MOCA
Mini-mental
SLUMS
what is the evaluation process for dementia?
interview
questionnaire or rating scales
standardized evaluation tools
what does the interview look like for dementia?
- find out sensory information
- use principles of ethnographic interviewing
-build relationship, hear their story, be curious - be solution focused
who can we give the questionnaires or rating scales when evaluating dementia?
client
family member
caregiver
what are some examples of questionnaires or rating scales that we can use for a dementia eval
functional activities questionnaire
AD8
IQCODE
standardized assessment tools for dementia include…
screeners
comprehensive evaluation
what scale is used to measure stages of dementia?
global deterioration scale/reisberg’s scale
what is GD level 1
no cognitive decline
no complaints of memory problems
no evidence of cognitive deficits
what is GD level 2
very mild cognitive decline
reports of memory problems
-forgetting names, misplacing objects
no evidence of issues w/ work or social relationships
what is GD level 3
mild cognitive decline
impaired concentration
difficulty w/ work tasks
some denial and anxiety about deficits
what is GD level 4
moderate cognitive decline
trouble…
-remembering personal history
-traveling or handling finances
reduced expression of emotions
withdrawal from situations that are challenging
what is GD level 5
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
what is GD level 6
severe cognitive decline
lack of awareness
ADL may need assistance
incontinence and bowel issues
sleep disturbances
personality + behavior changes
what is GD level 7
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
treatment for dementia may include…
medication
therapy
-counseling
-caregiver training
-external aids
-errorless learning
-montessori approach
-spaced retrieval
how can SLP’s educate on healthy brain habits
disease management
activity
nutrition
cognitive stimulation
engagement with others socially
relaxation
sleep hygiene
true or false: you can slow the progression of disease changes
true
what are strategies the family can use to help someone with dementia
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
what is the FOCUSED caregiver training program?
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
what are some examples of external aids for orientation?
calendar or written schedule
what are some examples of external aids for prospective memory?
alarms
to-do lists
what is spaced retrieval training
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
define errorless learning
procedure structured to reduce the opportunity for errors during learning
what are the errorless learning procedures
- break the task into small discrete steps
- model before the client is asked to perform the task
- encourage the client to avoid guessing
- correct errors immediately
- gradually fade prompts
what is a Montessori approach?
provide a prepared environment to promote independence for doing activities
what is reminiscence therapy
recalling the past
drawing on semantic + episodic memory
decreases demands on working memory + recent episodic
stimulates positive emotion and action
