Dementia Flashcards
dementia prevalence
-Alzheimer’s is most common form
-1 in 9 people have AD
impact of dementia
-health care costs
->900 billion in 2022
symptoms of dementia
-cognitive decline
-functional decline
Early stage dementia symptoms
-manage finances
-medications
house keeping
-driving
-shopping
-meal prep
Middle to later stages of dementia
-trouble:
-bathing
-toileting
-dressing
-grooming
-walking
-eating meals
MiniCog Test
-3 item repeat
-clock draw test
-3 item recall
SLUMS
-dementia test uses scoring system
-many questions
differential diagnosis
-untreated depression
-untreated insomnia
-untreated pain
-sleep apnea
-hypothyroidism
-uncontrolled diabetes
-delirium
medications that can contribute to cognitive changes
-benzos
-sedatives
-anticholinergic
-corticosteroids
-opioids
-muscle relaxants
-NSAIDs
-hypoglycemic agents
-antihypertensives
Use of anticholinergics
-increased risk of dementia and AD
-high risk with antidepressants, antihistamines, and bladder antimuscarinics
DSM 5 Neurocognitive Disorder
-mild neurocognitive disorder: mild cognitive impairment
-major neurocognitive disorder: dementia
Alzheimer’s Disease
-accumulation of amyloid beta plaques and tau
-neuro degeneration
-loss of memory, function
-begins 20 years before symptoms show
AT(N) Framework
-aggregated amyloid
-aggregated tau
-Neurodegeneration or neuronal injury
type 3 diabetes
- insulin resistance in the brain impacts neurocognition
-memory deficits
lifestyle modifications-AD
-supplements
-exercise
-mental activity
-social engagement
-music therapy
vascular dementia
-stroke/TIA
-cognitive function reduces with time
-affects executive function and complex attention
-caused by: uncontrolled BP, diabetes, high cholesterol, ischemic stroke
Lewy Body Dementia(DLB)
–fluctuating cognition(good and bad days)
-visual hallucinations
-parkinsonism features
-lewy bodies in cortex and midbrain
-affects learning/memory, and executive function
Frontotemporal dementia (FTLD)
-absensce of plaques and tangles
-behavioral disinhibition
-apathy or inertia
-compulsive behavior
-preservative behavior
-affects social cognition and executive function
Prevention strategies
-control cardio risks
-depression management
-social engagement
-early detection
resources for medication management
-nursing agency
-pill box
-alarmed pill box
-cell phone reminders
-bubble packs
-higher level of care
FDA approved treatments for dementia
-acetylcholinesterase inhibitors
-NMDA receptor antagonist
-monoclonal antibodies
cholinergic hypothesis
-increased levels of acetylcholine leads to better cognition
-use cholinesterase inhibitors to prevent breakdown in the brain
Glutamatergic hypothesis
mild to moderate AD treatments
-donepezil
-galantamine
-Rivastigmine
Moderate to severe AD
-donepezil
-rivastigmine transdermal patch
-memantine
