Dementia Flashcards
Dementia
progressive
irreversible
clinical syndrome
impairment of mental function
Types
Alzheimer's Vascular Dementia Mixed Frontotempotal dementia dementia with lewy bodies (DLB) Huntington disease Parkinsons diesease creutzfeldt-jakob korsakoff's
Alzheimer’s
Amyloid plaques between neurons and Neurofibrillary tangles inside cells build up resulting in a collapse of cell structures leading to a loss of connection between nerve cells and eventually death of nerve cells and brain tissue.
progressive, more symptoms more severe
most common not a single disease group of closely related diseases memory lapses short term memory loss damage to hippocampus communication difficulty visuospatial problems concentrating, planning and organisation problems orientation loss delusion hallucination agitated frail, weakness
Amyloid plaques composed of a peptide: amyloid beta-protein
fragment of much larger protein, Amyloid precursor protein (APP), encoded by gene on chromosome 21
People with familial AD have mutation of this gene
People with Downs syndrome have an extra chr. 21 and develop early AD
But some people with AD have mutations of genes on other chromosomes
Pathology
Neurons containing acetyl choline are prone to destruction in AD
Mainly affects neurons in basal forebrain
These neurons project to hippocampus and areas of cerebral cortex
Specific regions
medial temporal lobe hippocampus amygdala temero-parietal cortex frontal cortex
signs
cortical atrophy and ventricular enlargement cause by cell death and decrease in brain volume
clinical feature
gradual deterioration in memory, other cognitive and emotional function
Dementia with lewy
progressive cognitive decline
with Parkinson features
abnormal aggregates of protein that develop inside nerve cells found throughout the brain
associated eith psychiatic disturbance eg visual, halllucinations, delusion, apathy
vascular dementia
caused recurrent CVA or small vessel diseaseassociated side effects of stroke
management aimed at preventative of further deterioation
2nd most common
caused by reduced blood supply to the brain due to diseased or damaged blood vessels
Vascular dementia clinical features
death of brain cells due to insufficient blood supply can cause: problems with memory thinking and reasoning slower speed of thought problems concentrating language visuospatial problems mood changes abrupt onset presence of vascular disease elsewhere nocturnal confusion emotional lability
brain reserve capacity
amount of damage that canbe sustained before reaching threshold for clinical expression
Symptoms
ADL Difficulties -personal care -domestic chores -social activities disorientation emotional problems difficulty problem solving sleep disturbance apathy perceptual issue memory loss depression communication
Pharmacological management
cholinesterase inhibitor
NMDA receptor agonist
Non-pharmacological management
aim to promote and amintain independence and mobility
- consistent staffig
- flexibility
- familiar environment
- OT input (ADL)
- PT input (EXERCISE)
Reality orientation
result in frustration, anxiety, depression and lowered self esteem
person-centered manner
therapist enter reality
not focus on negatives
