Dementia

Question 1

cortical association areas

Answer 1

prefrontal association cortex
limbic cortex (emotional response)
heteromodal association cortex

Question 2

limbic association areas

Answer 2

hippocampus (memory)
limbic cortex (personality, behavior, mood, motivation)

Question 3

dementia-definition

Answer 3

a progressive deterioration in mental function that INTERFERES WITH ADLs appropriate for one’s age and background
disease of aging

Question 4

most common cause

Answer 4

alzheimer disease
vascular disease
alcoholism
parkinson-related dementias
drug/medication intoxication

Question 5

cognition

Answer 5

the mental functions involved in attention, thinking, understanding, learning, remembering, solving problems, and making decisions

Question 6

cognitive aging

Answer 6

a process of gradual, ongoing, yet highly variable changes in cognitive functions that occur as people get older
a lifelong process, not a disease

Question 7

cognitive health

Answer 7

exemplified by an individual who maintains his or her optimal cognitive function with age

Question 8

does exercise protect the brain?

Answer 8

pretty clear evidence that exercise can dec the risk of dementia
shown to improve cognition

Question 9

criteria for diagnosis

Answer 9

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

Question 10

domains involved in diagnosis

Answer 10

• 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

Question 11

alzheimer disease

Answer 11

• 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

Question 12

alzheimer time line

Answer 12

• gradual, progressive decline
• insidious onset, usually beginning with memory deficits
• 7-10 yrs

Question 13

alzheimer-impairments

Answer 13

cognitive: memory, language, orientation to time and place, judgement, reasoning, and attention and concentration
non-cognitive: changes in personality and mood, and behavioral changes

Question 14

alzheimer-risk factors

Answer 14

increasing age
vascular disease
family history
genetically heterogeneous (APOE4, abnorm proteins)

Question 15

alzheimer-treatment

Answer 15

no cure
drug therapies
four pillars of Dementia care

Question 16

stages of alzheimers

Answer 16

MCI
mild AD-still independent
mod AD-some supervision
severe AD-constant supervision
death usual from secondary causes

Question 17

four pillars of dementia care

Answer 17

1. treat the disease
2. treat symptoms
3. support the pt
4. support the caregivers

Question 18

mild cognitive impairment (MCI)

Answer 18

syndrome not a disease

transitional state between norm cognitive function and AD

Question 19

MCI-diagnosis

Answer 19

concern regarding a change in cognition
impairment in one or more cognitive domains
preservation of independence in functional abilities
not demented
evidence of change

Question 20

cognitive screening instruments

Answer 20

mini-mental state exam (easier)

montreal cognitive assessment (more of a screening tool, harder)

Question 21

vascular dementias

Answer 21

• dementia caused by cerebrovascular disease, possibly involving strokes
• diagnosis requires temporal association between onset/progression of dementia and strokes

Question 22

parkinson-related dementias

Answer 22

parkinson-plus syndromes
dementia with Lewy bodies
parkinson disease dementia
huntington’s disease

Question 23

frontotemporal dementias

Answer 23

severe and selective atrophy of frontal and temporal lobes
language impairments
behavioral impairments
slightly younger onset

Question 24

normal pressure hydrocephalus

Answer 24

excessive fluid accumulation in brain: inadequate resorption of CSF
wide-base magnetic gait
causes: prior subarachnoid hemorrhage, meningitis, tumor, surgery
treated with shunting