Dementia Flashcards

Question

Declarative Memory

Answer 1

all about facts; semantic, episodic, lexical

Answer 2

all about motor and cognitive (skills), habits, priming, conditioned responses and reflexes

Answer 3

think concepts (letter B on lichteim’s diagram)

Answer 4

words, spelling, ect.

Answer 5

- acuity change after the fourth decade; will most likely see a decrease in visual field - light sensitivity requires 3x as much light as young after age 70 - dark adaptation or adjustment of vision when moving from bright to dim light - color sensitivity decreases w/age: change in blue color starts at 40-50y; change in green starts in the 60’s - perception: more difficult w/figure-ground discriminations and visuospatial skills (size, distance and position) - visual memory (more effective at all ages than auditory memory) - light on dark for testing/reading; focus on high contrast vs. low contrast

Answer 6

- stay away from smoking and limit alcohol consumption - maintain high levels of physical activity; EXERCISE - facilitates muscle flexibility, strength and mood - routine medical care - maintain cardiovascular health - extensive social support network

Answer 7

those most likely to be in need of age-specific, multidisciplinary approaches “frailty” suggests a diminished ability to carry out important practical and social aspects of daily living

Answer 8

``` polypharmacy dementia delirium incontinence (both fecal and urinary) arthritis visual and hearing deficits pressure ulcers malnutrition osteoporosis high risk of falls ```

Answer 9

- functional status is commonly defined by a person’s ability to perform ADL’s - to be able to live alone without help, a person must be able to perform ADL’s independently - pt must be able to complete self-care, self-maintenance and physical activities independently - common ADLs include: bathing, dressing, toileting, transferring, continence, and feeding

Answer 10

Katz index of independence in activities of daily living “Katz ADLs” functional status questionnaire functional independence measure (FIM)

Answer 11

refers to the tendency of many older persons to be on numerous medications some numbers suggest that the elderly are ~12% of the population, however receive 32% of prescriptions on average, an elderly individual may have 2-6 prescription drugs + 1-3.4 OTC medicines

Answer 12

``` every drug has side effects ibuprofen can cause: gastric ulceration (sometimes w/bleeding) kidney impairment edema liver enzyme elevation drowsiness and dizziness, etc ```

Answer 13

- 6% when the pt is taking 2 medications - 50% when the pt is taking 5 medications, and - 100% when the pt is taking 8+ medications supporting the facts that ADRs are serious is the statistic that 20-25% of hospital admissions for persons 65+ is due to an ADR

Answer 14

HTN, diabetes, poor nutrition and social isolation (primary factors) heart disease family history of dementia psychological factors such as stress and depression

Answer 15

Delirium Dementia Mild cognitive impairment Confusion

Answer 16

``` disorientation impaired attention span distractibility purposeless activity anxiety; apprehension fright; fear; agitation verbosity confabulations dependent behavior ```

Answer 17

``` attention seeking behaviors withdrawal belligerence combativeness statement of confusion memory loss personality change inability to complete ADLs change in person’s usual behaviors ```

Answer 18

sudden severe confusion with rapid changes in brain function | a disturbance of consciousness accompanied by a change in cognition

Answer 19

- changes in alertness (usually more alert in the morning, less alert at night) - changes in feeling (sensation) and perception - changes in level of consciousness or awareness - changes in movement (may be inactive or slow moving) - changes in sleep patterns, drowsiness - confusion (disorientation) about time or place

Answer 20

``` decrease in STM and recall unable to remember events since delirium began unable to remember past events disrupted or wandering attention inability to think or behave with purpose problems concentrating disorganized thinking incoherent speech ```

Answer 21

``` anger anxiety apathy depression euphoria irritability ```

Answer 22

- most often caused by physical or mental illness and is usually temporary and reversible - drug abuse - infections such as UTIs and pneumonia - persons already with CVA or dementia - poisons - fluid/electrolyte or acid/base disturbances - pts w/more severe brain injuries are more likely to get delirium from another illness

Answer 23

- loss of ability to function or care for self - loss of ability to interact - progression to stupor or coma - side effects of medications used to treat the disorder

Answer 24

MCI - development of cognitive and memory issues that are not severe enough to be dx’d as dementia - symptoms are more pronounced that the cognitive changes associated w/normal aging - the more impaired a person is with MCI, the greater the likelihood he/she will develop dementia (perhaps AD) - a dx of MCI does not imply that a person is not capable of functioning independently in most situations

Answer 25

- dementia is a syndrome and not a disease - a syndrome is defined as a constellation of signs and symptoms According to the APA (American Psychiatric Association) the necessary features for a true diagnosis of dementia include: [1] erosion of recent and remote memory [2] impairment of one or more of the following functions -language (ex: aphasia) -motor activity (apraxia) (although physical ability is intact) -recognition (agnosia) (although sensory ability is intact) -executive functions *deficits must be sufficient enough to interfere w/functioning pts must have difficulty w/cognition, memory, language, visual-spatial skills, emotion, personality dementia is not a normal part of the aging process

Answer 26

there are reversible and irreversible dementia etiologies all possible etiologies for reversible dementia must be exhausted and ruled out prior to a pt being given a diagnosis of irreversible dementia

Answer 27

The reversible causes of dementia are treatable The reversible causes of dementias include: - infection, drug toxicity, vitamin deficiency, tumor, depression - normal pressure hydrocephalus, renal failure, CHF - thyroid disease, hypoglycemia, syphilis

Answer 28

- pseudodementia or geriatric depression is classified as a reversible dementia in some diagnostic models - some suggest that ≤10% of dementias are reversible with more than 2/3’s of them resulting from drug toxicity, depression or metabolic disorder - pts with pseudodementia present w/cognitive impairments, difficulty sleeping, appetite changes and decreased affect - drug tx is generally successful in improving affect and cognitive symptoms

Answer 29

``` alzheimer’s disease pick’s disease frontotemporal dementia or PPA creutzfeldt-jakob’s disease huntington’s disease multiple infarctions vascular disease wilson’s disease parkinson’s disease lewy body disease binswanger’s disease HIV PSP ```

Answer 30

``` cortical dementias subcortical dementias progressive dementias primary dementia secondary dementia ```

Answer 31

- getting lost in familiar places - repetitive questioning - odd or inappropriate behaviors - forgetfulness of recent events - repeated falls or loss of balance - personality changes - decline in planning and organization - changes in diet/eating habits - changes in hygiene - increased apathy - changes in language abilities, including comprehension - dx of dementia is not usually given if there is no impairment in social functioning and independent living

Answer 32

- communication is the sharing of information by means of an arbitrary symbol system - communication is a manifestation of cognition - persons w/dementia have difficulty w/intentional communication because they have multiple cognitive deficits - in pts w/dementia, the degree of language impairment is often proportionate to the deterioration of other mental functions

Answer 33

``` cortical dementias subcortical dementias progressive dementias primary dementia secondary dementia ```

Answer 34

- getting lost in familiar places - repetitive questioning - odd or inappropriate behaviors - forgetfulness of recent events - repeated falls or loss of balance - personality changes - decline in planning and organization - changes in diet/eating habits - changes in hygiene - increased apathy - changes in language abilities, including comprehension - dx of dementia is not usually given if there is no impairment in social functioning and independent living

Answer 35

- communication is the sharing of information by means of an arbitrary symbol system - communication is a manifestation of cognition - persons w/dementia have difficulty w/intentional communication because they have multiple cognitive deficits - in pts w/dementia, the degree of language impairment is often proportionate to the deterioration of other mental functions

Answer 36

Sounds: used correctly Words: may omit a meaningful word, usually a noun when talking in sentences; may report anomic issues; vocabulary is shrinking Grammar: generally correct Content: may drift from topic; reduced ability to generate series of meaningful sentences; difficulty comprehending new information; may be vague Use: knows when to talk but may talk too long on a subject; may be apathetic, failing to initiate conversation appropriately; difficulty w/humor, analogies, sarcasm and indirect/non-literal statements

Answer 37

Sounds: used correctly Words: difficulty w/thinking of words in a category; anomia in communication; difficulty naming objects; vocabulary is noticeably diminished Grammar: sentence fragments and deviation common; difficulty w/complex grammatical sentences; Content: frequently repeats ideas; forgets topic; talks about events of past; few ideas Use: knows when to talk; recognizes questions; may fail to greet; loss of sensitivity to communicative partners; rarely corrects mistakes

Answer 38

Sounds: generally used correctly; errors are not uncommon Words: marked anomia; poor vocabulary; lack of word comprehension; neologisms; jargon Grammar: somewhat preserved; sentence fragments and deviations common; may lack comprehension of many grammatical forms Content: generally unable to produce sequence of related ideas; content is meaningless and bizarre; subject of most meaningful events is from the past; marked repetition of words and phrases Use: generally unaware of surrounding and context; little meaningful use of language; some pts will be mute; some pts will be echolalic