Dementia Flashcards
Dementia Cause
permanent degeneration and damage to nerve cells in the brain
Dementia symptoms
Loss of memory, Judgment, Language, Object recognition, Motor skills, Decreased perceptual skills, Personality changes, Impaired executive function,Planning, organization, abstract reasoning
Non-modifiable RF
Genetics, Advanced age, Chronic illness
Modifiable RF
Heavy alcohol use, Obesity, Hyperlipidemia, Smoking, Depression, Head injury, Diabetes, Stroke, Cardio pulmonary conditions, Lack of social stimulation, Drug toxicity
Delirium
• Disturbance in consciousness with reduced ability to sustain attention & cognition
• Develops over short period of time and fluctuates
Caused by a medical condition: Dehydration, drug toxicity, blood pressure changes, blood sugar changes, anesthesia REVERSIBLE
DSM criteria:
Must have memory impairment and at least one of the following:
– Aphasia: Difficulty speaking
– Apraxia: Difficulty with motor planning
– Agnosia: Difficulty recognizing objects
– Disturbance in executive functioning: Planning, problem solving, sequencing…
Early onset
before age 65
Most common form dementia
Alzheimer 60-80% Progressive, degenerative disease of brain tissue
Stage 1: Alzheimer
Very mild to mild cognitive deficits (1-3 years)
Angry outbursts, personality changes, denial , preference for familiar settings
Memory loss, greater for recent events
Decline complex cognitive tasks, decision making, planning, attention, initiation
Stage II: Alzheimer
Mild to moderate decline (5-7 years)
Questioning, wandering, pacing, rummaging
Chronic recent memory loss, difficulty with written and spoken language
Needs assist with ADL’s more difficulty with familiar tasks
Stage III:Alzheimer
moderate to moderately severe decline (2-3 years)
Repititious movement or sounds
Misidentificaiton of familiar objects, decreased vocab need HOH assis
ADL dependent, incontinence, diff eating, impaired gait increase falls
Stage IV: Alzheimer
Severe cognitive deficits & physical decline (average 3 months- 1 year)Terminal stage, fleeting attention, may respond to touch or music
Utters vs. saying words, decreased visual tracking, contracture/skin integrity
Bed or w/c dependent, TOT dependent in self-care, dysphasia, loss of appetite
Need to evaluate:Person with dementia,
Cognition, orientation, safety awareness, visual perceptual abilities, Hearing, touch, strength, ROM, Functioning in daily activities, The caregiver(s), Medications, routines, The contexts, Home assessment, fall risk, supports and barriers leads to memory loss and problems
Structural changes Alzheimer
Beta amyloid plaques Twisted strands tau protein (tangles) Nerve cell damage and death Acetylcholine (ACh) transmission reduction/Reduction of AChR
• Secondary dementia
2nd most common dementia
Vascular dementia 20-30% of cases Multi infarct/post CVA
Post CVA
Confusion, disorientation, global aphasia, vision loss
Multi infarct (small strokes or vascular issues) –
Gradual changes as damage accumulates
– Impaired planning , attention, problem solving and judgment, emotional lability, word finding deficits, impaired social functioning
Dementia with Lewy Bodies
(usually seen with PD) Structural changes
Abnormal aggregations of protein alpha-synuclein Disrupts dopamine projections to frontal cortex and basal ganglia Dementia/cognitive decline Parkinsonian motor disturbances Shuffling gait, tremor, mask like appearance, rigidity, flexed posturing
Frontotemporal dementia
Group of disorders caused by progressive cell degeneration in frontal and/or temporal lobes 10-15% all cases Diagnosed earlier ages (50’s to 60’s) Family history ALS
Sub-types:-Behavioral Variant (bvFTD)-
Primary Progressive Aphasia-
FTD Movement Disorders
Corticobasal degeneration
Progressive supranuclear palsy
FTD Symptoms:
- Behavioral changes often earliest symptom
- Deficits in spatial orientation
- Speech deficits: word finding, increased generalized speech, difficulties with written expression.
- Hallucinations and delusions uncommon
Secondary to other medical conditions
Creutzfeldt-Jakob Disease: transmissible spongiform encephalopathy caused by abnormal proteins (prions), rapidly fatal.
Wernicke-Korsakoff Syndrome: Severe B-1 deficiency. Most common cause ETOH abuse, creates chronic memory dysfunction.
Huntington’s Disease progression
Parkinson’s Disease progression
HIV/AIDS Related
Medication induced dementia Symptoms persist when substance is withdrawn, 12% of persons diagnosed with dementia,
Result of: Substance abuse, Medication, Toxic exposure
Aggressive behaviors
Hitting, biting, screaming, pacing
Strategies: Be calm, stay out of reach, redirect
Hallucinations and delusions
Auditory, tactile, visual, olfactory
Most common involve theft or spouse (unfaithful or imposter) Strategies: Distraction
