Dementia Flashcards
cortical association areas
prefrontal association cortex
limbic cortex (emotional response)
heteromodal association cortex
limbic association areas
hippocampus (memory) limbic cortex (personality, behavior, mood, motivation)
dementia-definition
a progressive deterioration in mental function that INTERFERES WITH ADLs appropriate for one’s age and background
disease of aging
most common cause
alzheimer disease vascular disease alcoholism parkinson-related dementias drug/medication intoxication
cognition
the mental functions involved in attention, thinking, understanding, learning, remembering, solving problems, and making decisions
cognitive aging
a process of gradual, ongoing, yet highly variable changes in cognitive functions that occur as people get older
a lifelong process, not a disease
cognitive health
exemplified by an individual who maintains his or her optimal cognitive function with age
does exercise protect the brain?
pretty clear evidence that exercise can dec the risk of dementia
shown to improve cognition
criteria for diagnosis
when cognitive and behavioral symptoms:
1. interfere with functions and ADLs
2. represent a progressive decline, not acute
3. involve at least two of the domains
definitive only possible with brain biopsy
domains involved in diagnosis
- impaired memory
- impaired reasoning, poor judgement, and deficits in ability to carry out complex tasks
- impaired visuospatial abilities
- impaired language functions
- changes in personality, behavior, comportment
alzheimer disease
- most common presentation is “amnestic”
- cause unknown, but appears to involve abnormal production of certain proteins (deposition of amyloid plaques) that make up neurons
- end result: degeneration and death of neurons leading to cerebral atrophy
alzheimer time line
- gradual, progressive decline
- insidious onset, usually beginning with memory deficits
- 7-10 yrs
alzheimer-impairments
cognitive: memory, language, orientation to time and place, judgement, reasoning, and attention and concentration
non-cognitive: changes in personality and mood, and behavioral changes
alzheimer-risk factors
increasing age
vascular disease
family history
genetically heterogeneous (APOE4, abnorm proteins)
alzheimer-treatment
no cure
drug therapies
four pillars of Dementia care
stages of alzheimers
MCI mild AD-still independent mod AD-some supervision severe AD-constant supervision death usual from secondary causes
four pillars of dementia care
- treat the disease
- treat symptoms
- support the pt
- support the caregivers
mild cognitive impairment (MCI)
syndrome not a disease
transitional state between norm cognitive function and AD
MCI-diagnosis
concern regarding a change in cognition
impairment in one or more cognitive domains
preservation of independence in functional abilities
not demented
evidence of change
cognitive screening instruments
mini-mental state exam (easier)
montreal cognitive assessment (more of a screening tool, harder)
vascular dementias
- dementia caused by cerebrovascular disease, possibly involving strokes
- diagnosis requires temporal association between onset/progression of dementia and strokes
parkinson-related dementias
parkinson-plus syndromes
dementia with Lewy bodies
parkinson disease dementia
huntington’s disease
frontotemporal dementias
severe and selective atrophy of frontal and temporal lobes
language impairments
behavioral impairments
slightly younger onset
normal pressure hydrocephalus
excessive fluid accumulation in brain: inadequate resorption of CSF
wide-base magnetic gait
causes: prior subarachnoid hemorrhage, meningitis, tumor, surgery
treated with shunting
