Dementia

Question 1

Where is Vascular Dementia affects?

Answer 1

Depends on where the insult is.

Can Affects
Gait
Dysarthria, dysphagia
Incontience

Question 2

Alzheimer’s Treatment?

Answer 2

Symptomatic treatment:
Hallucinations
Brady Cardia

Question 3

Most common dementia in Australia?

Second most common?

Answer 3

Alzheimer’s

Vascular Disease

Question 4

Common causes of Dementia?

Answer 4

Alzheimer’s
Vascular
Parkinson’s, Lewy Body

Question 5

Why get collateral?

Answer 5

Confirm function/previous levels

Ask if it’s sudden

Question 6

Most common risk factors for dementia?

Answer 6

Age
Education level

Genetics (more for younger onset dementias)
CVD risk factors: DMII, HTN, Obesity
Depression

Question 7

3 Frontal lobe sections

Answer 7

Inferior: inhibitory
Anterolateral: planning, organization
Interhemispheric fissure: motivator.

Question 8

What bloods to look for in Dementia?

Answer 8

B12, Renal, UEC, Na+,
Glucose - not well controlled
Heart failure meds taking etc?
TSH

Question 9

Protective factors for Dementia

Answer 9

Physical activity
Social and cognitive engagement
Education level

Question 10

Main difference with Delirium?

Answer 10

pathological
Impairment of consciousness (can be subtle)
Hard to pay attention: fluctuating

Question 11

How to test attention?

Answer 11

Count backwards from 20. Ppl with dementia can do it usually

Question 12

Dementia, big 3 things to look out for?

Answer 12

Cognitive Impairment
Change in previous level
Functional decline

Question 13

Do you need memory impairment to have dementia?

Answer 13

Nope

Big feature in Alzheimer’s but not necessary for other dementias

Question 14

Causes of delirium

Answer 14

Infections

Withdrawal

Question 15

Alzheimer’s Dx?

Answer 15

2 years between initial symptoms and Dx

Question 16

Investigations for Dementia?

Answer 16

MMSE
Neurological examination
CT head - prev. Strokes, atrophy
Bloods -

Question 17

what can Masquerading dementia?

Answer 17

Depression
Language
Educational attainment
Sensory impairement: vision/hearing

Question 18

MMSE scores cut offs?

Answer 18

28 normal

Question 19

Cognitive function def’n?

Answer 19

Remembering
Language
Praxis
Internal function of organism to allow it to interface with the environment

Question 20

Who gets MCI?

Answer 20

Depressed
INtellectual disability
small TIA

Question 21

Aged 60-90, how does dementia risk change?

Answer 21

Doubles every 5 years

Question 22

Drugs that can cause dementia?

Answer 22

Anticholinergics
L-dopa
Steroids

Question 23

DDX for dementia?

Answer 23

Delirium
Depression
DRUGS -

Question 24

Focal symptoms like speech etc. causes?

Answer 24

Focal Lesions:
Stroke
Head injury

Question 25

Alzheimer's NEurological assessment findings?

Answer 25

Quite normal gait, reflexes, tone.

Question 26

Alzheimer's Starts where in brain? | How does it present?

Answer 26

Medial hippocampus to the temporal parietal Memory loss: clues and prompting doesn't help Language: word finding Praxis: coordinating, copying diagram. Dressing apraxia.

Question 27

Lewy Body Dementia features? 3 important.

Answer 27

Visual and auditory Hallucinations Parkinsonian Features Marked Fluctuation - can lose attention.

Question 28

Other less common dementias?

Answer 28

Alcoholic FroNto-temporal Lewy Body Parkinson'

Question 29

What drug helps with lewy-body dementia?

Answer 29

Cholinesterase inhibitors

Question 30

How to differentiate Lewy Body Dementia and delirium?

Answer 30

Chronicity

Question 31

What does cognitive impairment 4 areas

Answer 31

- memory - Apraxis - agnosia - executive function

Question 32

Does MMSE examine frontal lobe?

Answer 32

Nope

Question 33

Mild cognitive impairment (MCI) is?

Answer 33

Between normal MCI (12-15%) dementia (8%)

Question 34

Delirium features?

Answer 34

``` Often reversible Consciousness - fluctuating alertness Sudden onset Attention: count backwards from 20 Hallucinations ```

Question 35

Vascular dementia?

Answer 35

Sudden Deteriorate step wise Infarction on imaging

Question 36

Vascular Dementia presentation?

Answer 36

Stepwise decline with each insult, could be nebulous | CVD risk factors

Question 37

Difference in MCI?

Answer 37

Still functioning well | But decrease cognition

Question 38

Onset of dementias?

Answer 38

``` Acquired Insidious Chronic progressive Generally age related Change from PREVIOUS level. Impact on FUNCTION Collateral ```