Dementia

Question 1

What is dementia?

Answer 1

A progressive and largely irreversible clinical syndrome that is characterised by widespread impairment of mental function.

Question 2

Types of dementia

Answer 2

Alzheimer’s - 50-70%, short term memory loss, word finding difficulties, reasoning, judgement, visual spatial loss (getting lost)

Vascular - 25%, caused by injury to blood vessels, including strokes, symptoms depend on which area of brain affected

Lewy body - 15%, primary symptoms are hallucinations and Parkinson like symptoms due to protein inclusion in neurones

Question 3

Dementia pathology

Answer 3

Senile plaques - insoluble deposits of beta amyloid peptide around neurones Neurofibrillary tangles - masses of protein fibres inside neurones and loss of synapses Loss of neurones that contain ACh- neurones in basal forebrain, hippocampus, cerebral cortex Neural death (atrophy) - medial temporal lobe, hippocampus, amygdala, tempero-parietal cortex and frontal cortex

Question 4

Clinical features of dementia

Answer 4

1. Disorientation
2. Emotional problems
3. Problem solving
4. Sleep disturbance
5. Memory loss
6. Perceptual problems
7. Depression
8. Communication problems

Question 5

Dementia risk factors

Answer 5

1. Age Sex F>M
2. Genetics
3. PMH - vascular disease
4. Mental activity