Dementia Flashcards
How is dementia defined?
A progressive decline in higher cortical function leading to a global impairment of memory, intellect and personality which affects the individuals ability to cope with daily living.
What are the different causes of dementia?
Alzheimers disease
Fronto temporal dementia
Dementia with lewy bodies
Vascular dementia
Rare causes- CJD
How does dementia present?
Memory deficit- struggles to learn new information, short term memory loss
Behavioural- altered personality, disinhibition, wandering
Physical- incontinence, reduced oral intake, difficulty swallowing
Language disorder- anomic aphasia, difficulty understanding language
Visuospatial disorder- unable to identify visual and spatial relationships between objects
Apraxia- difficulty with motor planning resulting in inability to perform learned purposeful movements.
What investigations might you perform on someone presenting with symptoms of dementia?
Full history + mini mental state examination
Full neurological examination
Blood tests for reversible causes eg electrolytes, vit B12
CT/MRI head
Memory clinic follow up.
How do you tell apart delirium from dementia?
Use the confusion assessment method- CAM score
Is there acute change or fluctuating mental status?
Is there altered consciousness- hypo or hyper active?
Do they have inattention?
Is there disorganised thinking?
What will be detected on CT and MRI scan in someone with dementia?
Cortical atrophy and ventricular enlargement.
What is the difference in pattern of decline for vascular dementia, alzheimers dementia and lewy body dementia?
Vascular dementia has a stepwise decline
Alzheimers has a steady progressive decline
Lewy body has variations in mental state but overall trend is downwards
What are the 3 stages of alzheimers disease?
Mild- 2-4 y, minor memory loss.
Moderate- 2-10 years. Withdrawal, confusion, difficulty in self care.
Severe- 1-3 years. Patients retreat into themselves, will not eat unless fed. Patients may not speak and dont recognise people.
What is the pathophysiology of dementia with lewy bodies?
Lewy bodies accumualte in cortex and substantia nigra
What are the key symptoms of lewy body dementia?
Subtantial fluctuations in degree of cognitive impairment over time
Parkinsons symptoms- bradykinesia, resting tremor, rigidity
Visual hallucinations
Frequent falls
What are the key symptoms of frontotemporal dementia?
Alteration of social behaviour and personality- agitation, depression
Impaired judgement and insight- eg gambling, taking of clothes in public
Speech output falls eventually to nothing.
What is the management for dementia?
It is a holistic approach- Therapies such as pets and babies Memory aids Social care support Drugs- cholinesterase inhibitors
