Dementia

Question 1

Dementia - DSM IV

Answer 1

Acquired syndrome of decline in memory and at least one - language, judgment, executive function
Functional decline - social/occupational

Question 2

Dementia - DSM V

Answer 2

Major neurocognitive disorder (NCD) - Dementia - Alzheimers NCD

Question 3

NCD - Dementia - DSM 5 Dx criteria

Answer 3

Evidence of substantial cognitive decline

Cognitive deficits are sufficient to interfere with independence

Question 4

Mild NCD-MCI DSM 5

Answer 4

Evidence of modest cognitive decline

Cognitive deficits are insufficient to interfere with independence

Question 5

Causes of NCD Dementia

Answer 5

Reversible and Non reversible

Question 6

Nonreversible Causes of NCD Dementia

Answer 6

Alzheimers
Vascular
Frontotemporal
Mixed (vascular and alzheimers)
Lewy body (DLB)

Question 7

Other types of NCD

Answer 7

TBI, Parkinsons, HIV infection, Huntingtons..

Question 8

Reversible causes of Dementia

Answer 8

Drugs
Emotional illness-depression
Metabolic/endocrine disorders
Eye/ear/environment
Nutritional/neurologic
Tumors/trauma
Infection
Alcoholism/anemia/atherosclerosis

Question 9

Drugs that may cause memory loss

Answer 9

Antianxiety drugs
Narcotics 
Sleeping aids
Incontinence drugs (Anticholinergic)
Antihistamines 
Cholesterol drugs
Antidepressant drugs
Hypertension drugs

Question 10

AD - diagnostic criteria DSM IV

Answer 10

Memory impairment AND One or more of following 
Aphasia
Apraxia
Agnosia
Disturbance in executive function

Question 11

What is Alzheimers Disease

Answer 11

Progressive, neurodegenerative disease

Avg life span = 7-10 yrs

Question 12

Barriers to early detection of AD

Answer 12

Social skills often maintained early on
Misidentification as normal aging process
Reluctance to report symptoms - stigma
Lack of definitive screening tools

Question 13

Red flags for AD detection

Answer 13

Repetition (not normal in 7-10 min conversation)
Tangential, circumstantial responses
Frequently deferring to family
Unexplained weight loss
Inattentive to appearance
Unable to adapt to stressful circumstances

Question 14

Established risk factors to AD

Answer 14

Age
Family History
Downs Syndrome
APOE-E4 (whites)
A fib

Question 15

Possible risk factors for AD

Answer 15

Low education
Lack of physical activity
Lack of social interaction
High stress levels
Previous head trauma
Smoking
Alcohol
Hormone replacement therapy
Health conditions

Question 16

Risk factors for AD - possible - health conditions

Answer 16

Stroke
Hypertension
Diabetes
Hyperlipidemia
Obesity
Depression

Question 17

Treatment options for dementia

Answer 17

Acetyl Choline Esterase Inhibitors and NMDA antagonist
Counseling
Brain Wellness

Question 18

Acetyl Choline Esterase Inhibitors and NMDA antagonist - cholinesterase inhibitors

Answer 18

Aricept
Exelon
Razadyne

Question 19

Counseling - Dementia tx

Answer 19

Regarding safety concerns
Regarding risk of driving
Care giver education and support

Question 20

Behavioral and Psychological SYmptoms of Dementia - psychotic and nonpsychotic features

Answer 20

Psychotic - delusions and hallucinations

Non - agitation and depression

Question 21

Goals of therapy

Answer 21

Identify and treat primary illness
Specify target behaviors
Maintain functioning

Question 22

Primary illness

Answer 22

Discomfort
Pain
Medication adverse effects
Environmental precipitants

Question 23

Nonparmacological tx

Answer 23

Structural routines, reassurance and socialization
Environmental safety
Education and support to the caregivers