Dementia Flashcards
what is anosognosia?
the pt doesn’t feel that they have any problems with their memory - lack of insight about their condition
give some examples of brief cognitive tests that are done for dementia
6CIT (6 item cognitive impairment test) Mini Mental State examination Montreal Cognitive Assessment Addenbrooke's cognitive examination GPCog Abbreviated mental test
Which of the cognitive assessments are multi domain tests?
Montreal Cognitive Assessment
Addenbrooke’s cognitive examination
what are the components of the 6CIT?
What year is it? What month is it? Give an address with 5 parts (John, Smith, 42, High, St, Bedford) Count 20-1 Say months of year in reverse Repeat address
what are the disadv of the brief cognitive examinations?
someone with high intelligence and well educated may pass the test despite cognitive impairment, so may miss early cases
some people may fail the test due to poor sleep, or anxiety cannot differentiate between different types of dementia
what are the adv of the Montreal cognitive assessment?
tests different cognitive functions eg frontal, temporal and parietal lobe, whereas the MMSE focusses mainly on memory and recall
the MoCA is better at detecting mild impairment and early Alzheimer’s disease as it is more sensitive and more difficult
but has high false positive rate
name 2 components of the addenbrookes test and what lobe this corresponds to
letter fluency - name as many words as you can beginning with the letter P = frontal lobe
animal - name as many animals as you can = temporal lobe, semantic memory
in AD, do they name more animals or more words beginning with P?
they name more words beginning with P - normal people tend to do the opposite
how does someone with dementia speak?
speech is empty
rambling
use of high frequency words
may not remember an exact time when they have forgotten something, and will not be able to describe it
what is the commonest cause of dementia?
Alzheimer’s disease
describe the course of AD
slow onset
progressive
what are the typical pathological lesions observed in AD?
Amyloid plaques neurofibrillary tangles (composed of Tau - a microtubule associated protein that becomes hyperphosphorylated and cross linked)
what is the first part of the brain to be affected with pathological changes?
the enterohinal cortex
what are the Braak staging/ pathological stages of AD?
mild stage 1 - transentorhinal
moderate stage 2 - limbic
severe stage 3 - neocortex
what is the problem with the pathological definition of AD?
high-pathology non-demented controls or individuals with asymptomatic AD
