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Hcoll > Dementia > Flashcards

Dementia Flashcards

1
Q

Definition of dementia

A

Severe impairment/loss of intellectual capacity + personality integration due to the loss of neurones in the brain, leading to a loss in congnittion beyond what you would deem acceptable from normal ageing

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2
Q

What are the most common symptoms of dementia

A

Memory Loss
Cognitive impairment
Problem Solving
Language

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3
Q

What criteria is used to diagnose dementia + whata re its components

A

DSM-5 criteria

At least 1 of:
1. Language impairment
2. Apraxia (decreased mental planning of speech/motor processes)
3. Agnosia (inability to interpret sensations/recognise)
4. Impairment of executive function
with impairment of function

Must be a minimum 6-month onset and no other medical/psychiatric explanation

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4
Q

What are some differentials that may present similarly to dementia

A 
Delirium
Infection
Medications 
Increased plasma sodium
Intoxication
Depression
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5
Q

What is the best early indicator of dementia

A

a cognitive decline

Decline in formal memory testing scores associated with a 10-15% chance of dementia in 1 year

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6
Q

How do you classify dementia

A

Primary –> not due to alternate causes
Secondary –> due to physical disease/injury
Cortical –> Decline in memory/language/thinking/social skills
Subcortical –> emotions, movements, memory problems

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7
Q

What are the types of dementia with their prevalence in %

A 
Alzheimers (62%) 
Vascular (17%) 
Mixed (10%) 
Lewy Body (4%) 
Rare causes 3% (CJD, Huntingtons, Karsakoff-Wernickes)
Frontotemporal (2%) 
Parkinsons (2%)
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8
Q

What is the pattern of deterioration for Alzheimer’s disease compared to vascular dementia

A 
Alzheimers = slow progressive decline
Vascular = Stepwise decline, with plateaus and sudden drops in function
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9
Q

What causes Alzheimers (as far as we know)

A

Neurofibrillary Tangles and beta amyloid plaques interrupting neuronal contact

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10
Q

What are the 2 most common forms of vascular dementia

A

Stroke

Small vessel disease

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11
Q

How do you differentiate between parkinsonian dementia and lewy body dementia

A

Both have parkinsonism but if the movement symptoms develop AFTER the dementia symptoms it is LEWY BODY DEMENTIA

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12
Q

What is the cause of Karsakoff-Wernickes dementia

A

chronic excessive alcohol consumption/ acute alcohol withdrawal

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13
Q

What is the presentation of frontotemporal dementia

A 
Decreased inhibitions 
Compulsive behaviour
Decreased empathy
Poor judgement 
Mood swings 
Memory Loss
Speech difficulty

Very particular symptom = compulsive binge eating

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14
Q

What symptoms indicate temporal lobe damage

A

Memory/emotional disorders

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15
Q

What symptoms indicate parietal lobe damage

A

Co-ordination, speech, language

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16
Q

What symptoms indicate occipital lobe damage

A

Visual

17
Q

What symptoms indicate frontal lobe damage

A

Personality/ Executive function

18
Q

What genes are implicated in early onset Alzheimers involvement

A

Amyloid precursor gene
Presenilin Gene -1
Presenilin Gene-2

19
Q

What is a risk factor for early-onset Alzheimers (30-40)

A

1+ of the associated genes

20
Q

What indicates genetic screening for Alzheimers

A

2+ close relatives developing Alzheimers below the age of 60

21
Q

What genes are linked to late onset Alzheimers

A

Apolipoprotein E (APO-E) subtype 4 has the biggest increase in risk (1 copy = 4x, 2 copies = 10x)

22
Q

What proportion of Alzheimers patients present late

A

99%

23
Q

What is the risk of dementia by 50 for Trisomy 21 sufferers

A

50%

24
Q

What is the risk of dementia in people with huntingtons’ offspring

A

50%

25
Q

What is the common presentation for Alzheimers

A 
Misplacing items
Repetitive speech
Fogetting names/people/places
Confusion about TOD
Getting lost 
Mood issues
Problems with word finding
26
Q

What is the common presentation for vascular dementia

A

Problem with planning
Difficulty following directions
Problems concentrating

27
Q

What is the common presentation for Lewy Body dementia

A

Hallucinations
Mood swings
Inattention
Parkinsonism

28
Q

What are risk factors for dementia

A 
Smoking
Excessive alcohol intake
Atherosclerosis 
Increased cholesterol 
Age
Genetics
Mild cognitive impairment
29
Q

What is the management of Alzheimers dementia

A

1st line: Acetylcholinesterase inhibitors (Donepizil, Rivastigmine, Galantamine)
2nd line: NMDA Antagonists (Memantine)

Only slow progression/manage symptoms, patient will not get better

30
Q

What is the management of Vascular Dementia

A

Manage vascular risk factors

31
Q

What is the management of Lewy body dementia

A

AChE-is

32
Q

Side effects of AChE-is

A

Abdominal pain
Anorexia
Bradycardia
Extrapyramidal Side Effects (EPSE)

33
Q

Side effects of Memantine

A

Balance Disorders
Contipation
Dizziness

34
Q

Prognosis of Dementia

A

around 7 years (12 in FTD)

Hcoll (15 decks)

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