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Sam: IGEP > Dementia > Flashcards

Dementia Flashcards

1
Q

An acquired syndrome of decline in memory and other cognitive functions sufficient to affect daily life in an alert patient

A

Dementia

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2
Q

Is dementia an inherent part of aging?

A

No!

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3
Q

What percentage of people over the age of 65 have Alzheimer dementia? What about over the age of 85?

A

Greater than 65 – 6-8%

Greater than 85 – 45%

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4
Q

What is the most common type of dementia?

A

Alzheimer Disease

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5
Q

What is the second most common cause of dementia?

A

Lewy body dementia

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6
Q

this type of dementia is caused by amyloid plaques and tau neurofibrillary tangles

A

Alzheimer Disease

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7
Q

This type of dementia is caused by cytoplasmic alpha-synuclein inclusion bodies

A

Lewy body and Parkinson dementia

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8
Q

This type of dementia is caused tau or ubiquitin proteins

A

Frontotemproal dementia

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9
Q

What are some definite protective factors for dementia?

A

We don’t know!

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10
Q

What is the biggest risk factor for dementia?

A

Age

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11
Q

What are thought to be possible protective factors for Alzheimer disease?

A

NSAIDs, antioxidants, intellectual activity, physical activity, and statins

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12
Q

What chromosome is associated with dementia?

A

19

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13
Q

What are three key parts to a physical exam when assessing a dementia patient?

A

Neurologic status, mental status, and functional status

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14
Q

What are some routine labs that should be ordered when assessing a possible dementia patient?

A

CBC, Na+, BUN/Cr, fasting glucose, RPR, TSH, vitamin B12 level

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15
Q

When should you consider brain imaging as part of your assessment?

A

If onset occurs at age less than 65

Neurologic signs are asymmetric or focal

Clinical picture suggests normal-pressure hydrocephalus

Patient has had recent fall or other head trauma

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16
Q

What are some distinguishing signs that separate delirium from dementia?

A
  1. Acute onset
  2. Cognitive fluctuations over hours
  3. Impaired consciousness and attention
  4. Altered sleep cycles
17
Q

Is vascular dementia a gradual or sudden onset?

A

Can be either

18
Q

What is the difference between Lewy Body Dementia and Parkinson’s dementia?

A

The chronology of symptoms and pattern of cognitive deficits

If Parkinson disease has been diagnosed or has been present for 2 or more years before cognitive symptoms are seen, probably parkinson disease dementia.

If parkinsonian symptoms are present at the same time as cognitive symptoms, a diagnosis of dementia with lewy bodies should be considered

19
Q

Frontotemporal dementia is usually a gradual or sudden onset? are patients usually older or younger than 60?

A

Gradual onset

Usually age less than 60

20
Q

How many dementia stages are there?

A

7

21
Q

Individuals in this stage of dementia feel as if they are having memory lapses, especially in forgetting familiar words or names.

A

Stage 2

22
Q

When do friends and family members typically begin to notice signs of dementia?

A

Stage 3

23
Q

At what stage does some assistance with day-to-day activities become essential?

A

Stage 5

24
Q

At what stage do patients lose the ability to respond to their environment, speak, and lose control of movement?

A

Stage 7 – final stage

25
Q

What are some nonpharm treatments for dementia?

A

Cognitive rehabilitation, group therapy, physical and mental activity

Environmental modification– orientation and memory measures such as clocks, calendars, to-do lists, visual clues

26
Q

What class of drugs is commonly used to treat dementia?

A

Cholinesterase inhibitors – donepezil, rivastigmine, galantamine

27
Q

Do we recommend the use of cholinesterase inhibitors for the treatment of vascular dementia?

A

No

28
Q

Do we recommend use of cholinesterase inhibitors for the treatment of frontotemporal dementia?

A

No – often worsens agitation

29
Q

What are four common causes of behavioral disturbances that may present like dementia?

A
  1. Infection
  2. Dehydration
  3. Constipation
  4. Medication toxicity
30
Q

Have pharm or non-pharm treatments shown to be more effective for behavioral disturbances in dementia?

A

Non-pharm.

Always try non-pharm treatments before trying medication

31
Q

In patients with depression that lasts 2 weeks or more and results in significant distress, a trial of _______ should be strongly considered.

A

Antidepressants

32
Q

If depressive symptoms last longer than 2 months after behavioral therapy interventions have been implemented, treatment with _________ is warranted.

A

Antidepressant

33
Q

What medications can we use for manic symptoms?

A

Valproic acid and carbamazepine

34
Q

What two classes of medications should be avoided in dementia patients?

A

Benzo’s and anticholinergics

35
Q

What is the primary goal of dementia treatment?

A

Enhance quality of life and maximize function by improving cognition, mood, and behavior

Sam: IGEP (3 decks)

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