Dementia

Question 1

What does the ‘A’ in the ABCD of Dementia stand for?

Answer 1

Activities of Daily Living (ADLs)

Question 2

What does the ‘B’ in the ABCD of Dementia refer to?

Answer 2

Behavioural and Psychiatric Symptoms of Dementia (BPSD)

Question 3

What does the ‘C’ in the ABCD of Dementia represent?

Answer 3

Cognitive Impairment

Question 4

What does the ‘D’ in the ABCD of Dementia indicate?

Answer 4

Decline

Question 5

What are the cognitive presentations of dementia?

Answer 5

Memory (Dysmensia) plus one or more of:
* Dysphasia
* Dyspraxia
* Dysgnosia
* Dysexecutive functioning

Question 6

What are some behavioural presentations of dementia?

Answer 6

Agitation, Psychosis, Affective symptoms, Disinhibition, Behavioural issues

Question 7

What characterizes the early presentation of Alzheimer’s dementia?

Answer 7

Early impairment of memory and executive function

Question 8

What is the typical progression of Vascular dementia?

Answer 8

Step-wise decline with sudden changes

Question 9

What are common symptoms of Lewy body dementia?

Answer 9

Visual hallucinations, fluctuations, Parkinsonism, increased sensitivity to antipsychotics

Question 10

What are the key features of Frontotemporal dementia?

Answer 10

Personality change, emotional blunting, speech disorder, neuropsychology changes

Question 11

What are the pathogenesis features of Alzheimer’s dementia?

Answer 11

Amyloid plaques, tau tangles, neuron death, reduction in Acetylcholine

Question 12

What is the most common cause of dementia?

Answer 12

Alzheimer’s dementia (62%)

Question 13

What are some uncommon causes of dementia?

Answer 13

Frontotemporal dementia, Alcohol-related brain damage, Subcortical causes, Prion protein diseases

Question 14

What are reversible causes of dementia?

Answer 14

Delirium, Normal pressure hydrocephalus, Subdural haemorrhage, Tumours, Vitamin B12 deficiency

Question 15

What is the typical duration of dementia onset?

Answer 15

6 months duration and usually progressive

Question 16

What are the differential diagnoses of dementia?

Answer 16

Delirium, Depression, Other causes of dementia

Question 17

What should be included in the diagnosis of dementia?

Answer 17

History, Cognitive testing, Physical examination, Brain imaging

Question 18

What type of brain imaging is used for Alzheimer’s and Frontotemporal dementia?

Answer 18

SPECT imaging

Question 19

What is the purpose of a DATscan?

Answer 19

To show reduced dopamine uptake in Lewy Body dementia

Question 20

What is the Mini-Mental State Examination (MMSE) used for?

Answer 20

To score dementia severity

Question 21

What are the five questions for assessing capacity?

Answer 21

1. Understand information?
2. Retain information?
3. Communicate decision?
4. Weigh up information?
5. Believe information?

Question 22

What are the 6 C’s of Capacity?

Answer 22

Capacity, Consent, Compliance, Coercion, Certification, Common sense

Question 23

Who can make decisions in cases of loss of capacity?

Answer 23

Power of Attorney (POA) or Guardianship

Question 24

What is the systematic approach to managing Alzheimer’s Disease in primary care?

Answer 24

Case-finding, Clinical assessment, Differential diagnosis exclusion, Specialist referral

Question 25

What are some agents used for symptomatic control in dementia?

Answer 25

Antipsychotics, Antidepressants, Anxiolytics, Hypnotics, Anticonvulsants

Question 26

What is the treatment for Mild-Moderate Alzheimer’s dementia?

Answer 26

Acetylcholinesterase inhibitors

Question 27

What is a treatment option for Severe Alzheimer’s dementia?

Answer 27

Glutamate receptor antagonist (e.g., Memantine)

Question 28

What is an important non-pharmacological approach to managing dementia distress?

Answer 28

Communication and distraction

Question 29

What should be done regarding driving fitness in dementia patients?

Answer 29

Notify DVLA at diagnosis