Dementia Flashcards
What are the 6 Types of Dementia?
- Alzheimer’s Dementia
- Vascular Dementia
- Dementia w/ Lewey Bodies
- Frontotemporal Dementia (FTD)
- Normal Pressure Hydrocephalus (NPH)
- Depression
What are the 2 clinical manifestations of Alzheimer’s?
- Memory impairment
2. Dementia
Age w/ Alzheimers?
Usually greater than 60
Incidence and prevalence of AD increases w/ age
What is the earliest manifestation in AD?
Memory impairment
What is declarative memory?
Facts and Events (memory of recent events)
What type of memory is impaired in early AD?
Memory that is served by the hippocampus and medial temporal lobes
What are other deficits that may appear in AD patient? (5)
- Language (verbal disfluency and anomia)
- Visuospatial skills (misplacement of items, difficulty navigating)
- Insight (reduced insight into deficits)
- Apraxia (difficulty performing learned motor tasks)
- Executive Function (less motivated/engaged)
How do patients w/ Frontotemporal Dementia typically present?
- usually w/ behavioral issues
- at first appear subdued, then become disinhibited and impulsive ….. (some accompanying memory issues)
What does MRI scan show for FD?
Atrophy of the frontal and temporal lobes
Gene pattern for FD?
Autosomal dominant inheritance pattern 10-25%
What is Lewey Body Dementia?
Type of degenerative dementia
How can you distinguish Lewey Body Dementia? (2 Clinical features)
- Early appearance of visual hallucinations
- Parkinsonism:
a. rigidity
b. stooped posture
c. gait imbalance
How do patients w/ vascular dementia present?
Memory loss and associated vascular diagnoses (TIA or Stroke)
What is the most common form of Vascular Dementia?
Small Vessel Ischemic Disease (white matter disease… seen on MRI)
What are the 4 Vascular risk factors pts w/ Vascular Dementia have?
HTN
Hyperlipidemia
DM
Tobacco Use
What is the pathology of Normal Pressure Hydrocephalus (NPH)?
Enlarged ventricular size w/ a “normal” pressure (no increased intracranial pressure)
What is the classic triad for Normal Pressure Hydrocephalus (NPH)
WET, WACKY, WOBBLY
- WET - Urinary incontinence
- WACKY - Dementia
- WOBBLY - Gait distrubance …. magnetic gait (steps are short w/ decreased stride length, a broadened base, diminished cadence)… feet appear to be “stuck” to the floor
NPH most commonly occurs in what age group
Greater than 60
What does MRI show on NPH pts?
Ventriculomegaly
What is the treatment for NPH?
Shunt (59% improvement)
Define pseudodementia.
When patients present w/ symptoms of memory loss, but the real problem is depression
Treat the depression….
…memory improves!!!!
