dementia Flashcards
how many people have dementia approx?
700,00 in the UK
1 in 85
35% of over 65 in-stay patients
how many predicted by 2050
2 million
types
over 50% alzehimers disease,
25% vascular dementia
15% lewy body
mixed Alz, vascular
discuss classifications
alz - build of beta amyloid peptide causing neuronal damage and loss of acetylchline and grey and whitematter
95% have signs of vasculae dementia
vascular dementia- accumulation of multiple small strokes
sudden onset
stepwise deteriotation
lewy body dementia- visual hallucinations, signs of mild Parkinson, sleep disorder
risk factors
vascular disease or signs- diabetes, hyperlipidaemia, hypertension first degree relative downs syndrome depression lack of physical or cognitive activity
presentation
memory loss over months years anxiety, mood disturbances, hallcunations agitation irritability mood swings aggression wandering lethargy
the four As and what they mean
amnesia - Memory
Apraxia - movement/activity
Aphagia- language speech
Agnosia- sensation/senses
investigations
full history and exam - may need collateral history from rels
AMTs assessment Min mental state exam 6 item cognitive impairment test general practitioner assessment 7 minute screen test your memory test -TYM test
what to examine in an examinations
the four As attention concentration language short and long term memory
other investigations
bloods
Vitamin B12
folate
FBC, ESR CRP TSH LFTs
imaging -CT/MRI/EEG
treatment and management
supportive and medication wise
supportive - provide family with information for lifestyle management e.g. care packages, carers support groups music , art and pet therapy create a routine for the patent massages
medication wise -AchE inhibitors
N metyl D aspartate antagonist as a 2nd line
supplements to be given
folic acid
vitamin bs
other considerations
capacity
power of attorney
patients wishes
DNACPR
if depression is present
SSRI-citalopram
name of AchE inhibitors
galantamine
donepezil
rivastigamine
