Dementia Flashcards
def
syndrome which encompasses progressive deficits in cognition over months to years
what should considered with progressive cognitive deficit over days
stroke/infection
what should be considered with progressive cognitive deficit over weeks
depression
aetiology
1 alzhiemers disease 2 vascular dementia 3 lewy body dementia 4 fronto-temporal (Picks) dementia 5 others -alcohol/drug abuse -repeated head trauma
what is the most common cause of dementia
alzhiemers
what is vascular dementia
2nd most common cause of dementia
it is the combined effects of many small strokes
what is lewy body dementia
3rd most common cause of dementia
fluctuating cognitive impairment
detailed visual hallucinations
what is fronto-temporal (picks) dementia
frontal + temporal atrophy without alzheimers histology
changes in behavioural or personality, disinhibition, hyperorality, emotional unconcern
epi
increases with age
history
a good history would involve both patient and someone who knows them well (spouse, offspring etc.)
determine timeline of progression of impaired cognition/memory (dementia will progress over months to years)
depression is common in dementia
may present with agitation or anxiety, aggression, hallucinations or ‘wandering’ as indicated by family member
examination
cognitive testing -a dementia screen such as AMTS -plus short verbal recall mental state examination -for anxiety, depression, hallucinations physical examination -for cause or risk factors (e.g. vascular dementia) -parkinsonism
investigations
1 bloods
2 CT/MRI
-exclude vascular damage or haemorrhage
what are the ameliorable (improvable) causes of dementia
1 low T4 or low B12/folate
2 low thiamine (alcohol causes malabsorption)
3 tumours (meningioma)
4 parkinsons
