Dementia

Question 1

What is not affected in dementia?

Answer 1

Consciousness

Question 2

Aetiology? (6)

Answer 2

Degenerative (Alzheimers, Pick’s, PD, MS, Lewy Body) Intacranial (tumour, head trauma, subdural haematoma) Infection (CJD, neuro-syphillis) Endocrine - hypothyroidism, Cushing’s, Addison’s Secondary - VASCULAR, alcohol induced Mental Health - pseudo-dementia in severe depression

Question 3

Common symptoms of dementia? (7)

Answer 3

Amnesia Impaired thinking Language impairment (dysphasia/aphasia) Deterioration in personal functioning (social functioning & self care) Altered personality behaviour (emotionally labile/apathetic & irritable Perceptual abnormalities (agnosia, psychosis) Motor impairment

Question 4

http://oscestop.com/Collateral_history.pdf

Investigations:

Cognitive assessment (MMSE)/AMTS
Physical examination
Blood: FBC, U&E’s, glucose, calcium, LFT’s, TFT’s
Midstream urine test (rule out delirium)
CT (cortical atrophy espc. parietal and temporal)
MRI (grey matter atrophy atrophy of cerebral cortex, amygdala and hippocampus)

Question 5

MMSE scores:

24-30- no cognitive impairment (i.e. most likely depression)

18-23- mild cognitive impairment

0-17- Severe cognitive impairment

<24 = cognitive impairement