Dementia

Question 1

dementia is a clinical syndrome characterised by progressive loss of cognitive abilities resulting in ultimate loss of functional independence

Answer 1

WHO 2017

Question 2

DSM-V diagnostic criteria

Answer 2

APA 2013

Question 3

what are the DSM-V diagnostic criteria

Answer 3

• evidence from clinical history and a cognitive assessment of decline in one of the following domains: learning & memory, language, complex attention, perceptuo-motor skills and social cognition
• impariment must be acquired and progressive
• must represent a significant decline from previous levels of functioning
• must not occur exclusively in the course of delirium

Question 4

64,000 people in Ireland living with dementia

Answer 4

HSE (2020)

Question 5

Alzheimer’s Disease is a progressive degernative condition in which memory loss is the hallmark symptom

Answer 5

Bourgeouis & Hickey (2009)

Question 6

Dementia Model of Care

Answer 6

National Dementia Office (2023)

Question 7

five principles of Dementia Model of Care

Answer 7

• citizenship
• person-centred approach
• integration
• personal-outcome focused
• timliness

Question 8

SLTs have gained recognition for their role in dementia care

Answer 8

RCSLT (2014); IASLT (2016)

Question 9

it’s recommended that people with dementia have access to SLT care at all stages of their journey

Answer 9

IASLT (2016)

Question 10

intervention in a progressive condition should focus on retained skills and preventing a loss of personhood

Answer 10

Hopper et al. (2001)

Question 11

risks of not intervening

Answer 11

IASLT (2016)

Question 13

what are the risks of not intervening

Answer 13

• being left out of the decision-making process
• not supported to maximise communication
• misinterpretation of communicative behaviours

Question 14

a treatment plan should include justification of therapy candidacy, a profile of functional strengths and limitations, identification of areas of need requiring intervention, functional goals and expected treatment duration and outcomes

Answer 14

Bayles & Tomeoda (1995); Bourgeois & Hopper (2005)

Question 15

different factors affect an individual’s ability to engage in intervention including grief regarding diagnosis, impact of a progressive illness, level of insight, personality changes and fatigue

Answer 15

Croot et al. (2009)

Question 16

goals should follow the SMART goal framework

Answer 16

Volkmer (2013)

Question 17

balance should be struck between easy and challenging goals

Answer 17

Volkmer (2013)

Question 18

challenging goals were found to boost self-esteem and condifence but unrealistic goals created stress

Answer 18

Guthrie & Harvey (1994)

Question 19

SLT intervention can be direct or indirect

Answer 19

Hopper (2001)

Question 20

cognitive-linguistic interventions aim to restore or preserve declining cognitive functions

Answer 20

Murrary & Clark (2015)

Question 21

cognitive-linguistic interventions lead to gains on trained tasks and tasks similar to trained tasks

Answer 21

Paek et al. (2016)

Question 22

due to lack of generalisation, cognitive-linguistic interventions should focus on personally-relevant and functional tasks (e.g., sustaining attention while cooking)

Answer 22

Kim et al. (2015)

Question 23

personally-relevant stimuli enhance motivation for intervention

Answer 23

Bier et al. (2015)

Question 24

perceived benefits of intervention is higher when the targets are personally relevant

Answer 24

Henry et al. (2013)

Question 25

gains of cognitive-linguistic interventions were maintained for approximately 4.5 months post-treatment conclusion

Answer 25

Sitzer et al. (2006)

Question 26

errorless learning aims to prevent incorrect responeses from being habitually reinforced

Answer 26

Paek et al. (2016)

Question 27

SRT has been demonstrated to be effective for mild-severe dementia types

Answer 27

Paek et al. (2016)

Question 28

SRT has been demonstrated to be effective for other dementia types | despite most research being conducted on AD

Answer 28

Bier et al. (2009)

Question 29

treatment effects of SRT are maintained over time

Answer 29

Bier et al. (2015)

Question 30

learned information and procedures can be enhanaced through booster SRT sessions

Answer 30

Cherry et al. (2009)

Question 31

this study found that partipants with severe dementia only demonstrated nominal responses to their errorless learning protocol

Answer 31

Gonzalez-Rothi et al. (2009)

Question 32

word-finding difficulties are pervasive across dementia types, can be an initial symptom of dementia and can negatively impact daily activities, social participation and quality of life

Answer 32

Mansur (2011); Murray & Clark (2015)

Question 33

word-finding difficulties in dementia are assumed to arise from deficits in semantic cognition or semantic memory

Answer 33

Paek et al. (2016)

Question 34

semantic-based interventions for word-finding difficulties have been shown to be successful across dementia types including AD and PPA

Answer 34

Henry et al. (2013); Paek et al. (2015)

Question 35

word-finding difficulty interventions in dementia typically aim to increase integrity of or access to semantic system, for example, SFA

Answer 35

Paek et al. (2015)

Question 36

social prescribing refers to referring individuals to non-clinical community supports to enhance their well-being

Answer 36

HSE (2020)

Question 37

memory aids are of significant benefit to people with dementia

Answer 37

Bier et al. (2015); Kim et al. (2015)

Question 38

while memory aids are very useful for people with mild-moderate dementia, they have limited benefits for those with severe dementia

Answer 38

Paek et al. (2016)

Question 39

this study found that memory books gad positive outcomes - reducing repetitveness and need for caregiver prompting, decreasing ambiguity in conversation, improved turn-taking and increasing information exchange

Answer 39

Bourgeois et al. (2009)

Question 40

reminisence therapy is a process of recalling personal past experiences

Answer 40

Kim et al. (2006)

Question 41

reminiscence therapy supports intrapersonal and interpersonal functioning which improves well-being

Answer 41

Kasl-Godley & Gatz (2000)

Question 42

rationale for reminisence therapy is twofold

Answer 42

Paek et al. (2016)

Question 43

rationale for reminisence therapy

Answer 43

1. captilises on retrograde memory (memories fro before dementia onset) which is more preserved in dementia than other memory stores 2. reminiscence uses many cognitive-linguistic skills (e.g., word-finding, episodic & working memory, sustained attention) and the continued use of these skills can slow their deterioration

Question 44

reminisence therapy benefits an array of dementia types and severities across a range of cognitive-communication and social-emotional outcomes

Answer 44

Paek et al. (2016)

Question 45

cognitive-communication outcomes of reminiscence therapy | Paek et al. (2016)

Answer 45

- improved attention - improved delayed and immediate recall - increased verbal output

Question 46

social emotional outcomes of reminiscence therapy | Paek et al. (2016)

Answer 46

- improved quality of life - reduced depression and social isolation

Question 47

life story worl helps a person with dementia retain their identity and assists caregivers in understanding their history and values

Answer 47

Alzheimer's Society of Ireland

Question 48

A systematic review of life story work which found positive outcomes for people with dementia (improved autobiographical memory and reduced depression), informal caregivers (decreased caregiver burden and improved quality of relationships) and formal caregivers (improved knowledge and attitudes)

Answer 48

Efrink et al. (2018)

Question 49

systematic review of life story work which supported Efrink et al. (2018)'s positive findings

Answer 49

Subranamium et al. (2021)

Question 50

there are challenges in caring for a person with dementia, partly due to communication breakdowns leading to increased caregiver stress levels

Answer 50

Bourgeois & Hickey (2009)

Question 51

high stress levels increase caregiver burden and are associated with negative emotions of the person with dementia

Answer 51

Bourgeois & Hickey (2009)

Question 52

Study found that after conversation partner training caregivers reported increased self-confidence which reduced stress and burden

Answer 52

Bourgeois & Hickey (2009)

Question 53

the MESSAGE approach aims to provide pratical strategies to compensate for the cognitive-linguistic deficits associated with dementia

Answer 53

Smith et al. (2011)

Question 54

MESSAGE aims to improve interpersonal relations between caregivers and people with dementia and incorporate conversation as part of care

Answer 54

Conway & Chenery (2016)

Question 55

MESSAGE approach leads to increased caregiver knowledge and positive outcomes in caregiver self-efficacy and preparedness to give care

Answer 55

Conway & Chenery (2016)

Question 56

MESSAGE principles

Answer 56

maximise attention - ensure attention and focus is directed before communicating expression and body language - ensure facial expression and body language is warm and inviting simple language - simple, short sentences support conversation - allow response time, help find words, assist with visual aids - gesture, body language, objects, pictures get their message - monitory nonverbal communication and make an effort to decode their message encourage and engage - engage in interesting, familiar topics

Question 57

diagnosis of PPA requires presenation of language impairment first in the absence of other signficant cognitive deficits, no focal lesion which could explain the language impairment and the language impairment must be insidious and progressive

Answer 57

Gorno-Tempini (2011)

Question 58

PPA affects 3 in 100,000

Answer 58

Marshall (2018)

Question 59

PPA is isolating

Answer 59

Pozzebon (2017)

Question 60

PPA has a signficant impact on communicative participation, social relationships and mental health

Answer 60

Ruggero (2019)

Question 61

peer support networks are essential for people with PPA and thei families to live well and have social relationships

Answer 61

Volkmer (2023)

Question 62

LPAA is a client-centred, success-oriented and activity-based approach which aims to optimise activity participation

Answer 62

Kimbarrow et al. (2007)