Dementia

Question 1

Define dementia

Answer 1

A chronic and progressive deterioration of cognitive function due to organic brain disease. It is irreversible and consciousness is not impaired.

Question 2

Explain the aetiology/risk factors of dementia

HINT; do it by types of dementia

Answer 2

• TYPES of Dementia:
○ Alzheimer’s disease (50%) - degeneration of the cerebral cortex, with cortical atrophy and reduction in acetylcholine production

○ Vascular Dementia (25%) - brain damage due to several incidents of cerebrovascular disease (e.g. strokes/TIAs)

○ Lewy Body Dementia (15%) - deposition of abnormal proteins (Lewy bodies) within the brain stem and neocortex

○ Frontotemporal Dementia - specific degeneration of the frontal and temporal lobes

Question 3

Summarise the epidemiology of dementia

Answer 3

• Prevalence increases with age

* Prevalence of 20% in patients aged > 80 yrs

Question 4

Recognise the presenting symptoms and signs of dementia

Answer 4

• Alzheimer’s disease - insidious onset
• Vascular dementia - step-wise decline
• Lewy Body dementia - fluctuating levels of consciousness, hallucinations, falls and Parkinsonian symptoms
• Frontotemporal dementia - behavioural changes and intellectual changes
• All forms of dementia are associated with a progressive loss of memory and cognitive function

Question 5

Identify appropriate investigations for dementia

Answer 5

• Diagnosis is based on the HISTORY
• Ensure no treatable cause is missed (e.g. hypothyroidism, vitamin B12/folate deficiency, space-occupying lesion, normal pressure hydrocephalus)