Dementia Flashcards
What is dementia?
Progressive, acquired loss of cognition which interferes with the ADLs
The 5 Types of Dementia
1) Alzheimers (50%)
2) Lewy Body Dementia (10%)
3) Vascular (25%)
4) Mixed
5) Frontotemporal dementia (Picks Disease)
Describe pathology and features of Alzheimers
Visible features
Global dementia, focussing on temporal lobes
Amyloid Plaques and Tau protein Tangles in the brain, cause neuronal destruction, so ACh decreases.
Global atrophy of brain tissue, hippocampal deterioration.
Loss of gyri
Describe pathology and features of Vascular Dementia
Visible features
Stepwise deterioration of cognition due to microvascular events causing ischaemia
Fluctuating symptoms but don’t improve
Can see infarcts in MRI
Describe pathology and features of Lewy Body Dementia
Visible features
Dementia that affects the SN. Accumilation of abnormal proteins- Alpha synuclein (lewy bodies) in the substantia nigra of the brain.
Causes bradykinesia, rigidity, resting tremor
Causes a loss of cognition (problem solving, fine motor co-ordination)
Can get visual hallucinations
Symptoms fluctuate daily
Onset of dementia within 12 months of parkinsonian symptoms
Do an DAT scan to see loss of Dopamine neurones
Describe pathology and features of FT Dementia
Pick’s Disease
Affects young people (40-50)
Affects just the mentioned lobes
Causes personality change, loss of memory, echolalia, emotional blunting, mutism, loss of insight
Treatment of Vascular Dementia?
Prevent progression Minimise CVS risk factors: Statins Anti-coagulants Anti-platelets Anti-hypertensives
Treatment of Alzheimer’s Disease?
Side Effects
Treat with.. They slow progression but don't treat them Acetylcholinesterase inhibitors (galantamine)
NMDA receptor agonists (memantine)
Cause everything to run: Salivate, Sweat, Tremor, Diarrhoea, Incontinence
Treatment of Lewy Body Dementia?
AChE i (Galantamine) or NMDA r A
Anti-parkinsonian medication
Synthetic Dopamine- Levidopa
Prevent peripheral breakdown - Carbidopa
Cause: psychosis, headaches, low prolactin, tremor, loss of sleep
Other types: (increase impulsivity, punding)
Treatment of Vascular Dementia?
Prevent progression Minimise CVS risk factors: Statins Anti-coagulants Anti-platelets Anti-hypertensives
Treatment of Pick’s Disease?
No treatment
Can use SSRIs or antipsychotics for the disinhibition
Treatment of Mixed Dementia?
Treat as both Alzheimer’s and Vascular dementia
Stages of Alzheimers?
Early: Loss of short term memory, become forgetful , loss of concentration
Middle: Aggression and confusion increases, loss of facial recognition and longer term memory
Late: Loss of function
What do most Alzheimers Patients die of?
Infection
Risk factors for Dementia?
Age CVS risk (for A and V) FHx of dementia Delerium Trauma Genetics (mutations, Down's) Low IQ Women
