Dementia Flashcards
Cognition is _____1_____ without _____2_____. There are 3 components to cognitive function, disruption of any can result in ____3____. [List the 3 components]
- Thinking
- Language
- Dementia
[Components = cognition, memory, language]
1 = how things work
- = data storehouse
3 = “story” of memory
- Cognition
- Memory
- Language
Area:
- Knowledge acquisition
- Comprehension
- Thinking
- Knowing
- Remembering
Temporoparietal areas
Area:
- Judgement
- Problem Solving
- Imagination
- Planning
Frontal areas
In those with dementia ____1____ memory fails first. They can usually get by in their surroudings with their ____2____ memory. However, once they are put in a new environment their ____3____ memory can no longer be relied on and they are forced to use their ____4____ memory which is no longer functioning. This can lead to a drastic can in _____5_____.
- Explicit
- Implicit
- Implicit
- Explicit
- Function
1 = What is it?
2 = How does it relate to me?
3 = How do I feel about it?
4 = What do I think about it?
- Occipital Lobe
- Temporal Lobe
- Limbic System
- Frontal Lobe
**Occipital function tends to stay intact, the other areas tend to slowly deteriorate in dementia**
Brain aging begins between ____1____ years of age. There is an ____2____ risk for brain injury and reliance on ____3____ memory. Decisions are replaced by ____4____ and ___5___.
- 20-30
- Increased
- Procedural
- Routine
- Ritual
Changes in the Brain with Aging (5)
- Decreased capillary/arteriole density
- Decreased BF
- Decreased brain weight
- Increased ventricular volume
- Increased subarachnoid space
Type of Cognitive Impairment:
- Distrubance of consciousness
- Change in cognition
- Acute onset [transient]
- Fluctuating sympomts
- Evidence of medical etioogy
Delirium
List the 2 hallmarks of delirium
- Acute onset [transient
- Fluctuating symptoms
Delirum is a strong predictor of poor _____1_____ and ____2____ satus in the year following hospital admission.
- Functional
- Cognitive
Describe how delirium is diagnosed
Using the Confusion Assessment Method (CAM). In order to be diagnosed you look at the following criteria
- Acute onset and fluctuating course
- Altered level of consciousness
- Inattention
- Disorganized thinking
Dx = 1, 2, 3, OR 1, 2, 4 OR 1, 2, 3, 4
Type of Cognitive Impairment:
- Impairments in thinking and memory that do NOT interfere with everyday activities
Mild Cognitive Impairment
List the 2 types of mild cogntive impairment
- Amnestic-type [memory only]
- Multi-domain [judgement and/or language]
Type of Cognitive Impairment:
- Forgets names
- Loses objects
- Forgets items on a list
- Forgets multiple tasks
- Forgets phone numbers
- Unable to recall info. after distraction
Mild Cognitive Impairment
What is one hallmark of mild cognitive impairment
Unable to recall info after distraction
Detection of mild cognitive impairment (8)
- Reaction time
- Dual-task performance
- Word fluency
- Category fluency
- Delayed verbal recall
- Narrative recall
- Name-face pair recall
- Complex figure copying
Type of Cognitive Impairment:
- Syndrome of impairment in memor and at least on other cognitive ability [language, visuospatial function, executive function]
Dementia
Term: Recognition of common objects
Visuospatial function
Term: Motor function, abstract and complex thought, and/or judgement
Executive function
Type of Cognitive Impairment:
- Forgetfulness
- Confusion
- Weight loss
- Sleep disturbance
- Gait abnormalities
- ADL deficits
Dementia [early signs]
Early Signs of Dementia (6)
- Forgetfulness
- Confusion
- Weight loss
- Sleep disturbance
- Gait abnormalities
- ADL deficits
Type of Cognitive Impairment
- Degenerative
- Irreversible
- Ultimately fatal
- 70% of all dementia
Alzheimer’s Disease
Describe the pathology of AD (3)
- Beta amyloid protein accumulation OUTSIDE neurons [plaques]
- Tau protein accumulation INSIDE neurons [tangles]
- Genetic Mutation [ApoE4 = incresed risk]
Stage of AD:
- 2-4 yrs
- Repeats questions
- Anhedonia
- Word finding problems
- Frequently loses items
- Personality changes
Stage 1
Stage of AD
- 2-10 yrs
- Becomes lost easily
- Confusion over recent events
- ADL impairments
- Argumentative
- Pacing
- Anxiety/Depression
- Delusions
Stage 2
Stage of AD:
- 1-3 yrs
- Impaired speech/comprehension
- Unable to recognize family/friends
- Unable to recognize self
Stage 3 [Terminal]
Diagnostic Criteria for AD (5)
- Deficit in memory and at leat one other cognitive domain
- Decline from previous function that interferes w/social or occupational functioning
- Gradual onset and continuous decline (>6 mo)
- Not due to other systemic, CNS, psychiatric, or drug induced condition
- Consciousness remains unaltered
Type of Dementia:
- Little stroke over time resulting in cognitive loss with sx similar to AD
- Subdivided into: cortical, subcortical, strategic, hypoperfusion, hemorrhagic, mixed
- 2nd most common
Vascular Dementia
Type of Dementia:
- Hemiparesis
- Visual deficits
- Incontinence
- Pseudobulbar signs [Uncontrolled laughing/crying]
- Executive deficits
- Psychomotor impairment
- Personality / mood change
- Hyperreflexia [No seen in AD]
- Gait disturbance
Vascular dementia
List the 3 types of vascular dementia
- Multi-infarct demenita
- Binswanger’s disease [subcortical, psychomotor deficits]
- CADASIL [linked to migraines]
List the 3 types of frontotemporal dementia
- Orbitofrontal [monitoring affected]
- Anterior cingulate [motivation affected]
- Dorsolateral prefrontal [executive function affected]
Type of Dementia:
- Characterized by pick bodies and cells
- Anbormal formation/accumulation of tau without associated plaques
- Agressive, inappropriate behavior
- Incontinence
Pick’s Disease [frontal/temporal lobes]
____1_____ may occur with parkinsonianism.
Pick’s disease
Type of Dementia:
- Associated with left temporal dysfunction
- Loss of semantic memory and knowledge
- Initial sparing of epidosic memory and other cogntive functions
- Impairment of language syntax, phonoly may occur
- Progresses to full FTD in 5-10 years
Semantic Dementia
Type of Dementia:
- Loss of expressive languate
- Comprehension often spared, esp. in early stages
- Most prgress to full FTD
- Similar to PD without motor symptoms
Primary Progressive Aphasia (PPA)
Type of Dementia:
- Accumulation of alpha-synucleim protein inside neural nuclei
- Close association with PD and AD
- 3rd most common form of dementia
Lewy Body Dementia
Type of Dementia:
- Striking fluctuations in cognition
- Visual hallucinations
- Bradykinesia
- Parkinsoniam posture and gait
- Overlaps with AD
Lewy Body Dementia
3 things people with cognitive impairment cannot due in their environment
- Comprehend their environment
- Adapt to the environment
- Cope with the environment
Strategies for working with those with cognitive impairment (5)
- STAY CALM
- Use familiar/personal items when possible
- Non-stressful environment
- Provide orientation and structure
- Avoid boundary violations
