Dementia

Question 1

cog abilities ^ until age ___

Answer 1

30

Question 2

types of dementia:

Answer 2

alzheimer’s, vascular dementia, lewy body dementia, frontotemporal dementias, other

Question 3

how to diagnose dementia

Answer 3

med exam to rule out other causes, significant cognitive decline via neuropsych assessment, interference with independence, not due to delirium, not due to other mental disorder

Question 4

neurocog domains:

Answer 4

complex attention, executive function, learning and memory, language, perceptual-motor, social cognition

Question 5

most common type of dementia with memory decline predominant feature, plaques and tangles, impaired judgement/reasoning/language

Answer 5

alzheimer’s

Question 6

second most common type of dementia, damage to brain cells cuz stroke/TIA/damaged BV/circulation, executive function impairments, stepwise progression (cortical presentation, subcortical insidious)

Answer 6

vascular

Question 7

other dementias associated with:

Answer 7

parkinson’s, huntington’s, head trauma, HIV, alcohol, CJD, corticobasal degeneration, progressive supranuclear palsy

Question 8

3 variants of progression:

Answer 8

behavioural, progressive non-fluent, semantic

Question 9

lewy bodies are :

Answer 9

a protein (alpha-synuclein)

Question 10

dementia cuz lewy bodies characterized by:

Answer 10

fluctuating cognition, attention, hallucinations, parkinsonism, REM sleep disorder, antipsychotic sensitivity, frequent falls, excessive sleepiness

Question 11

typically young onset (<65), memory preserved, behavioural/language presentations, misdiagnosed as psychiatric

Answer 11

FTD (frontotemporal dementia)

Question 12

why need to know underlying cause?

Answer 12

treat symptoms and slow progression (although there is no cure)–>2ndary and tertiary prevention

Question 13

what does BPSD stand for?

Answer 13

behavioural and psych symptoms of dementia

Question 14

BPSD for alzheimers:

Answer 14

memory loss, cog impairments, decreased sense of smell, decreased oral health, repetitive actions, irritable/agitated, loss of appetite, dyspraxia

Question 15

BPSD of vasular

Answer 15

affective disturbances and agitation, apathy, depressive, low motivation, motor difficulties, paranoia/delusions, diurnal rhythm disturbance, emotional lability, irritability

Question 16

BPSD of lewy body disease

Answer 16

fluctuating cognition/alertness, sleep disturbances, issues with judgement, decreased concentration/attention, visual/auditory hallucinations, physical fx difficulties

Question 17

BPSD of frontotemporal lobar degeneration

Answer 17

eating disturbances such as binge eating, perseverated eating, overeating; change in taste preference to predominantly sweet flavor, disinhibition and socially inappropriate behaviour, poor judgement and impulsivity, difficulty with motor coordination, hyperorality and hyperphagia

Question 18

why wt loss common symptom?

Answer 18

damage to brain cause ^ energy expenditure and ^ pro-inflammatory cytokines, inflammation, oxidative stress; behavioural factors ; socioenviro factors

Question 19

clinical syndrome meeting 3+ of 5 criteria (weakness, slowness, low lvl activity, exhaustion, unintentional wt loss)

Answer 19

frailty phenotype

Question 20

cumulative deficits model

Answer 20

frailty index

Question 21

frailty is an _____ of dementia, and vice versa

Answer 21

independent predictor

Question 22

goals of nutr care and dementia

Answer 22

maintain quality of life, preserve fx, prevent decline

Question 23

how to monitor

Answer 23

wt, functional status, BPSD and impacts, quality of life, goal attainment scaling

Question 24

non modifiable risk factors for dementia

Answer 24

age, familial and genetic risk factors, family history of cognitive complaint

Question 25

modifiable risk factors

Answer 25

obesity, DM, cardiac disease, CKD, hypertension, hyperlipidemia, smoking, depression

Question 26

protective factors to prevent dementia:

Answer 26

physical activity, mediterranean style diet, veg/fruit consumption, cognitive activity, social activity

Question 27

what is MIND diet?

Answer 27

3+ servings whole grain a day, one dark green salad and one other vegetable each day, berries 2+ times a wk, 1 oz nuts each day, beans/legumes, poultry, fish, red wine, limit butter and replace with olive oil, limit cheese/fried/fast food, limit sweets