Dementia Flashcards
what is dementia?
- loss of memory
- loss of judgement
- loss of reasoning
- changes in mood
- changes in behaviour
- change in communication abilities
** these issues cause difficulty in day to day function
- Medical term that describes progressive declines in cognitive function
- broad term that includes groups of brain disorders characterized by decline in cognitive abilities
Is dementia a disease?
no, it is a group of symptoms which may accompany certain diseases or conditions
Common stereotypes of dementia
- aggressive 2. empty
types of dementia
- reversible
- non reversible
what is Non-reversible Dementia?
- Alzheimer’s disease (most common type)
- Vascular Dementia
- Lewy body dementia
- Fronto-Temporal Lobe dementia
*medically diagnosed diseases and syndromes that cause progressive and degenerative changes in the brain.
*Has a unique underlying cause and physical course
* no cure is known
what is alzheimers?
retrograde memory loss
types of Alzeimer’s
- Sporadic Alzeimer’s disease
- Familial alzeimer’s disease
what is sporadic Alzeimer’s disease?
- ** most common - 93-96% of all known cases - unknown cause - greatest risk factor is age
What is Familial Alzembers disease?
-in 5-7% of case - directly linked to genetics and inherit - symptoms show earlier than 65 years of age
what is Vascular Dementia?
** non reversible**
- cells of the brain are impaired or damaged due to lack of O2
- common cause = Strokes, progessive narrowing of vessels
- stepped progression from occurence or strokes
- affects some areas of the brain more than others (ie. memory, vision, or language)
- can co exist with alzheimer’s (called mixed dementia)
Lewy Body Dementia
- Non reversible dementia**
- progressive brain disease identified by protein deposits that disrupt normal brain functioning
- the proteins can be found in the brain stem and other areas.
- similar to the plaques and tangles of Alzheimer’s disease
- dont know the cause
Symptoms of Lewy Body Dementia
- visual hallucinations
- change in awareness
- rigidity
- tremors
- shuffling movements
symptoms of Alzeimer’s diease
…
Fronto- Temporal lobe Dementia
- Non reversible**
- group of uncommon disorders that primarily affect the frontal and temporal lobes
- result in behaviour and language changes
- occurs at a younger age then alzeihmers
- no identified risk factors of causes
* loss of social compass and morality. Social and cultural filter loss
Reversible Dementia
conditions that left untreated result in the same symptoms of dementia
symptoms are
- memory loss
- imparied jugdement
- communication challenges
** leads to permanent damage but if treated can be reduced in severity or rid of
Examples of reversible dementia
- nutritional deficiencies and dehydration
- metabilic disorders, ie. vit B12 deficidency
- depression
- delirium
Limbic system
- center of the brain
- role in forming and retrienving memories
- emotions
what happens when the limbic system is damaged?
- mood swings
- forgettfulness
Temporal Lobes
- play a role in retrieval of memories
- primary centers of language
- expressing yourself and understanding others
what happens when the temporal lobes are damaged?
- difficulty with short term memory
- long term memory later
- difficulty finding the right words
- difficulty understanding words
Frontal Lobe
- helps plan and orgazine activities of daily life
- provides initiative to start/stop activities
- judgement and reasoning
- regulates social interactions
what happens with damage to frontol lobe?
- act out of character
- do something social inapprorpate
- poor judgement and reasoning (ie. might go out in cold whether which improper clothing)
- change in normal self (usually saves money.. and doesnt now)
- loss of initiative (wont get up from the couch)
Parietal Lobe
- analytical center of the brain
- helps us understand where we are in a room
- recognize other people, sights, sounds and objects
- sequence activities
what happens with Damage to the Parietal Lobe
- difficulty doing steps for a task (fork to eat soup, or dressing wrong)
- difficutly recognizing people or what an object is used for
Occipital lobe
- processes visual images
- takes in info on: colour, shape and movement
- percieving the world around us
what happens with damage to the occipital lobe?
- poor or distorted visual image (poor depth perception)
Alzeimer’s disease affects what abilities?
- physical abilities
- cognitive abilities
- functional abilities
warning signs of dementia
early stages
- loss of abstract thinking (hard to follow recipes, give the wrong change to buy coffee)
- missplacing things (left in odd places ie. fridge. harder to find)
- Change in mood and behaviour (anger, cry easily)
- change in personailty (do something out of character, ie. become withdrawn)
- loss of interest or initiative (passive)
- Memory loss (recent events)
- trouble with ADLs
- Communication decrease (challenge in expression, loss of words)
- disorientation (wont recognize familiar places)
- Loss of good judgement (scissors to cut bread, poor dressing for cold weather)
how to avoid dementia?
- brain workout
- avoid stress
- sleep lots
- find humor
- socialize
- stayed informed on underlying diseases
- exercise (increase brain blood and O2)
- protect your head (helmets)
Person-centered approach to care
- treat them like a person
- with dignity
- respect
- treat them as unqiue and complex
- recognize strengths and abilities
- recognize there interests
** focus on the person
dementia is characterized ..
Important**
- combo of function and cognitive decline
- as memory loss and one or more of the following
- Aphasia (loss of expression and understanding of language)
- Apraxia (inability to do purposeful movements, cant identify the key in their hand))
- Agnosia (cant process sensory info)
- Disturbance of executive functioning (markers: leaving the stove on, cant call 911)
- gradual onset with continued decline
- not caused by any other medical condition
assessment tools
- MoCa
- MMSE
- ADLs and IADLS
- assess if it is a progressive change
- look for medical conidtions to see if it is a delirium
- family assessment
- meds
- family hisotroy
- past medical hisotry
types of dementia (disorders)
- Alzheimer’s Disease
- Vascular dementia
- Frontotemporal lobe dementia
- Parkinson’s disease
- Lewy body dementia
- Normal pressure hydrocephalus
- Wernicke-Korsakoff Syndrome
3 stages of Dementia (need to know )
- mild (MCI, mild congnitive impairment, still functions at home, can delay impairment at this stage)
- moderate (can function at home with assistance,assess caregiver for burn out!!**)
- severe
Common dementia behaviours
Behaviour
- ** **aggitation
- aggression
- screaming
- cursing *
- freqent repetition *
- wandering *
- sexual disinhibition
- hoarding *
- urination/defecation *
Psychological
- personality change
- anxiety
- depression
- pathological crying
- hallucinations
- delusions
- apathy * (lack of care)
(*)= cant be fixed with medications
what is wernickes- korsakoff syndrome
tends to be related to alcohol consumption..
what is normal pressure hydrocephalus
what is parkinsons?
Parkinson’s disease dementia is a decline in thinking and reasoning that develops in someone diagnosed with Parkinson’s disease at least a year earlier. Common
symptoms include:
- Changes in memory, concentration and judgement
- Trouble interpreting visual information
- Muffled speech
- Visual hallucinations
- Delusions, especially paranoid ideas
- Depression
- Irritability and anxiety
- Sleep disturbances, including excessive daytime drowsiness and rapid eye movement (REM) sleep disorder
neuroplasticity
the physiological ability of the brain and neural circuits to change and develop in response to environmental stimuli
Onset and course of Alzheimer’s disease
Insidious onset
diagnosis is often made retrospectively
slowly progressive over 5-10 years
Manifestations of Alzheimer’s Disease
- Initial memory loss followed by gradual loss of other cognitive and communication abilities
- Confusion
- disorientation
- loss of executive function
- Behaviour and personality changes
- depression
- irritability
- indifference
Vascular Dementia Onset and Course
- Abrupt onset
- stepwise decline over 5 years
- histroy of vascular risks ie stroke or HTN
Manifestations of Vascular Dementia
- Congruent with area of the brain it is affecting
- aphasia
- memory impairment
- apathy
- depression
- gait changes
- emotional changes
- sengsory and motor deficits
Lewy body Dementia onset and course
Insidious onset with a progressive decline in cognitive, behavioural, and motor symptoms
Manifestations of Lewy Body Dementia
significant cognitive impairment; fluctuating levels of cognition, parkinsonism, hallucinations, sleep disturbances, loss of postural stability, highly sensitive to nerleptic medications
Frontotemporal Dementia onset and course
Gradual onset between the age of 45 to 65; family history common; progressive decline in functioning
Manifestations of Frontotemporal dementia
- Early and progressive personality changes
- language impairment
- behavioural distrubances
- impulsive
- lack of empathy
- repetitive behaviours
what test do you do to check for dementia?
Mini mental status exam
