Dementia Flashcards
What does the ‘A’ in the ABCD of Dementia stand for?
Activities of Daily Living (ADLs)
What does the ‘B’ in the ABCD of Dementia refer to?
Behavioural and Psychiatric Symptoms of Dementia (BPSD)
What does the ‘C’ in the ABCD of Dementia represent?
Cognitive Impairment
What does the ‘D’ in the ABCD of Dementia indicate?
Decline
What are the cognitive presentations of dementia?
Memory (Dysmensia) plus one or more of:
* Dysphasia
* Dyspraxia
* Dysgnosia
* Dysexecutive functioning
What are some behavioural presentations of dementia?
Agitation, Psychosis, Affective symptoms, Disinhibition, Behavioural issues
What characterizes the early presentation of Alzheimer’s dementia?
Early impairment of memory and executive function
What is the typical progression of Vascular dementia?
Step-wise decline with sudden changes
What are common symptoms of Lewy body dementia?
Visual hallucinations, fluctuations, Parkinsonism, increased sensitivity to antipsychotics
What are the key features of Frontotemporal dementia?
Personality change, emotional blunting, speech disorder, neuropsychology changes
What are the pathogenesis features of Alzheimer’s dementia?
Amyloid plaques, tau tangles, neuron death, reduction in Acetylcholine
What is the most common cause of dementia?
Alzheimer’s dementia (62%)
What are some uncommon causes of dementia?
Frontotemporal dementia, Alcohol-related brain damage, Subcortical causes, Prion protein diseases
What are reversible causes of dementia?
Delirium, Normal pressure hydrocephalus, Subdural haemorrhage, Tumours, Vitamin B12 deficiency
What is the typical duration of dementia onset?
6 months duration and usually progressive
What are the differential diagnoses of dementia?
Delirium, Depression, Other causes of dementia
What should be included in the diagnosis of dementia?
History, Cognitive testing, Physical examination, Brain imaging
What type of brain imaging is used for Alzheimer’s and Frontotemporal dementia?
SPECT imaging
What is the purpose of a DATscan?
To show reduced dopamine uptake in Lewy Body dementia
What is the Mini-Mental State Examination (MMSE) used for?
To score dementia severity
What are the five questions for assessing capacity?
- Understand information?
- Retain information?
- Communicate decision?
- Weigh up information?
- Believe information?
What are the 6 C’s of Capacity?
Capacity, Consent, Compliance, Coercion, Certification, Common sense
Who can make decisions in cases of loss of capacity?
Power of Attorney (POA) or Guardianship
What is the systematic approach to managing Alzheimer’s Disease in primary care?
Case-finding, Clinical assessment, Differential diagnosis exclusion, Specialist referral
What are some agents used for symptomatic control in dementia?
Antipsychotics, Antidepressants, Anxiolytics, Hypnotics, Anticonvulsants
What is the treatment for Mild-Moderate Alzheimer’s dementia?
Acetylcholinesterase inhibitors
What is a treatment option for Severe Alzheimer’s dementia?
Glutamate receptor antagonist (e.g., Memantine)
What is an important non-pharmacological approach to managing dementia distress?
Communication and distraction
What should be done regarding driving fitness in dementia patients?
Notify DVLA at diagnosis
