Dementia Flashcards
What is dementia?
Refers to a progressive decline in higher cortical function
Leads to a global impairment of memory, intellect and personality
What are the causes of dementia?
Alzheimer’s disease
Dementia with Lewy-bodies
Vascular dementia
Fronto-temporal dementia
Which causes of dementia are the most and least common?
Most common - Alzheimer’s disease
Least common - fronto-temporal dementia
What are the signs and symptoms of dementia?
Memory deficit
Behavioural changes
Physical difficulties
Language disorder
Visuospatial disorder
Apraxia
What is the most common symptom of dementia?
Memory deficit
What are the features of memory deficit in dementia?
Short-term memory loss
Then progresses to long-term memory loss
What are the features of behavioural changes with dementia?
Altered personality
Disinhibition of abnormal behaviour
Fluctuating emotions
Wandering
What are the features of physical difficulties with dementia?
Incontinence
Difficulty swallowing
What are the features of language disorder with dementia?
Anomic aphasia
Difficulty understanding language
What is anomic aphasia?
Can speak fluently and describe what they mean but cannot name it
What is apraxia?
Difficulty with motor planning, inability to perform learned purposeful movements
Why is there such a wide range of signs and symptoms with dementia?
Due to any of the lobes of the brain being affected
How is dementia diagnosed?
Full history, mini mental state examination, collateral history from family
Full neurological examination
Blood tests
CT/MRI head
Memory clinic follow up
How does the mini-mental state examination work?
Four types of cognitive function tested
Give points based on their response
Add up points to get total
Result is baseline of cognitive function
What are the uses of the mini-mental state examination in dementia?
Part of diagnosis of dementia
To classify into mild, moderate or severe dementia
Monitor rate of cognitive decline, and hence progression of dementia
Why is a full neurological examination done in patients with dementia?
To rule out other causes
What blood tests are done for patients with dementia? Why?
Thyroid function tests
Vitamin B12
To rule out thyroid disorder, vitamin deficiency, as these can present with an acute reversible cognitive decline
What is used to distinguish between delirium and dementia?
Confusion assessment method CAM