Dementia Flashcards
Definition of dementia
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
What are the most common symptoms of dementia
Memory Loss
Cognitive impairment
Problem Solving
Language
What criteria is used to diagnose dementia + whata re its components
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
What are some differentials that may present similarly to dementia
Delirium Infection Medications Increased plasma sodium Intoxication Depression
What is the best early indicator of dementia
a cognitive decline
Decline in formal memory testing scores associated with a 10-15% chance of dementia in 1 year
How do you classify dementia
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
What are the types of dementia with their prevalence in %
Alzheimers (62%) Vascular (17%) Mixed (10%) Lewy Body (4%) Rare causes 3% (CJD, Huntingtons, Karsakoff-Wernickes) Frontotemporal (2%) Parkinsons (2%)
What is the pattern of deterioration for Alzheimer’s disease compared to vascular dementia
Alzheimers = slow progressive decline Vascular = Stepwise decline, with plateaus and sudden drops in function
What causes Alzheimers (as far as we know)
Neurofibrillary Tangles and beta amyloid plaques interrupting neuronal contact
What are the 2 most common forms of vascular dementia
Stroke
Small vessel disease
How do you differentiate between parkinsonian dementia and lewy body dementia
Both have parkinsonism but if the movement symptoms develop AFTER the dementia symptoms it is LEWY BODY DEMENTIA
What is the cause of Karsakoff-Wernickes dementia
chronic excessive alcohol consumption/ acute alcohol withdrawal
What is the presentation of frontotemporal dementia
Decreased inhibitions Compulsive behaviour Decreased empathy Poor judgement Mood swings Memory Loss Speech difficulty
Very particular symptom = compulsive binge eating
What symptoms indicate temporal lobe damage
Memory/emotional disorders
What symptoms indicate parietal lobe damage
Co-ordination, speech, language
What symptoms indicate occipital lobe damage
Visual
What symptoms indicate frontal lobe damage
Personality/ Executive function
What genes are implicated in early onset Alzheimers involvement
Amyloid precursor gene
Presenilin Gene -1
Presenilin Gene-2
What is a risk factor for early-onset Alzheimers (30-40)
1+ of the associated genes
What indicates genetic screening for Alzheimers
2+ close relatives developing Alzheimers below the age of 60
What genes are linked to late onset Alzheimers
Apolipoprotein E (APO-E) subtype 4 has the biggest increase in risk (1 copy = 4x, 2 copies = 10x)
What proportion of Alzheimers patients present late
99%
What is the risk of dementia by 50 for Trisomy 21 sufferers
50%
What is the risk of dementia in people with huntingtons’ offspring
50%
