Dementia

Question 1

What is dementia?

Answer 1

Dementia is a syndrome due to disease of the brain, usually of a chronic or progressive nature, in which there is disturbance of multiple higher cortical functions, including memory, thinking, orientation, comprehension, calculation, learning capacity, language and judgement

Question 2

Is consciousness clouded in dementia?

Answer 2

No

Question 3

What are some symptoms/signs of dementia?

Answer 3

Global cognitive decline
Mood disturbance
Personality change
Psychosis

Question 4

What is the pharmacological management of Alzheimer’s?

Answer 4

Cholinesterase inhibitors

Memantine

Question 5

What cholinesterase inhibitors are in use for Alzheimer’s currently, and what do they do?

Answer 5

Donepezil, rivastigmine and galantamine
Slow cognitive decline by increasing cholinergic transmission
Used for mild-moderatr Alzheimer’s

Question 6

What is used for moderate to severe Alzheimer’s?

Answer 6

Memantine

Question 7

What score can be used to differentiate between Alzheimer’s disease and vascular dementia?

Answer 7

Hachinski Ischaemic Score
<=4 Alzheimer’s
>=7 Vascular Demenia

Question 8

What is included in the Hachinski Ischaemic Score?

Answer 8

Abrupt onset 2
Stepwise deterioration 1
Fluctuating course	2
Nocturnal confusion 1
Preservation of personality 1
Depression 1
Somatic complaints 1
Emotional incontinence	 1
History of hypertension	 1
History of stroke 2
Associated atherosclerosis 1
Focal neurological symptoms 2
Focal neurological signs 2

Question 9

How is Lewy Body Dementia and Dementia in Parkinson’s Disease distinguished clinically?

Answer 9

By the timing of symptoms

Neurobiology is different