Dementia

Question 1

Definition

Answer 1

a group of symptoms affecting memory, cognitive and emotional abilities severe enough to interfere with ADL’s and Qol

Question 2

causes

Answer 2

• Alzheimer’s disease
• Vascular dementia
• Dementia with Lewy bodies

Question 3

Risk factors for Alzheimer’s disease (50-70%)

Answer 3

• Genetic
• Down syndrome
• History of head trauma with loss of consciousness
• Cardiovascular risk factors intensify severity of symptoms

Question 4

Risk factors for Vascular dementia (15-20%)

Answer 4

-Stroke

Associated risk factors

• Hypertension
• Diabetes
• Coronary artery disease
• Smoking

Question 5

the most common subtype: 50-70% of all dementia

Answer 5

Alzheimers disease

2nd most: Vascular dementia (15-25%)

Question 6

__-__% of New Zealanders aged 65 and over, and __% of people older than 80 yrs have dementia

Answer 6

5-8 %. 20%

Question 7

Pathophysiology of Alzheimers disease
Brain structure ____due to _____ caused by formation of ______and __________, and significant chemical changes occur in the cortex and ______.

Answer 7

shrinks
neuronal loss
plaques 
neurofibrillary tangles
hippocampus.
[Hippocampus ... consolidation of short term memory into long term memory occurs - STM - Declarative learning]

Question 8

Pathophysiology of Vascular dementia

Answer 8

Loss of oxygen and nutrients due to stroke can lead to sudden onset of cognitive changes.

Question 9

Pathophysiology of Dementia with Lewy bodies

Answer 9

Dense tissue displaces normal tissue in nerve cells in corrtical and subcondral regions causing cell death

Question 10

Alzheimer’s disease: early stage

Answer 10

2-3years

• Short term memory significantly impaired
• difficulties with word finding
• Starting to get lost in familiar places
• difficulty making decisions
• mood changes, social withdrawl
• depression

Question 11

Alzheimer’s disease: middle stage

Answer 11

2-10years

• Decline in memory but less anxiety about this
• Disoriented in place and time and wanders
• unusual anger
• repeated questioning
• increased dependence
• Hallucinations

Question 12

Alzheimer’s disease: Late stage

Answer 12

8-12years

• Becoming completely dependent and inactive
• difficulty recognising close family or familiar objects
• incontinece
• reduced muscle strength and voluntary movement
• difficulty walking, eating, swallowing, communicating
• sleep disturbance

Question 13

Diagnosis: Three diagnostic criteria

Answer 13

-Memory impairment and related changes in another cognitive domain (such as language, judgment)
-Severe enough to affect social and occupational functioning
-Decline from previously higher level of functioning
[memory impairment, severe social and occupational impact and decline from previous level of function from neuronal loss (MRI can detect)]

Question 14

Diagnosis

Answer 14

MRI detects early Alzheimer’s disease changes of neuronal loss

Question 15

Medical management: Alzheimer’s disease

Answer 15

• cognition enhancing medications e.g. acetylcholine boosting medications
• short term psychotropic medication for behavioral problems woth caution due to adverse effects