Dementia Flashcards
What is meant by dementia?
Cognitive decline e.g. memory, thinking, orientation, learning, language, accompanied by deterioration in day to function.
State 3 common characteristics of dementia.
Memory deficit - recent events. Language deficit - simplified use of language, less use of abstract terms. Higher motor functions - inability to performs acts despite intact sensory system (dressing, eating). Perceptual deficit (agnosia) - inability to understand significance of sensory stimuli.
Give 3 symptoms of dementia.
Hallucinations. Delusions. Depression. Apathy. Behavioural disturbance. Sleeping disturbances.
What is meant by a hallucination?
Seeing, hearing or smelling something that is not there.
What is a delusion?
False belief - things misplaced are thought stolen.
What is the difference between dementia and delirium?
Dementia - chronic brain failure (gradual in onset, months to years). Delirium - acute brain failure (acute in onset, couple of hours to days).
Give 2 common causes of delirium.
Acute insult e.g. infection, electrolyte imbalance, change in medication. Psychiatric condition e.g. schizophrenia, major depression.
State 3 irreversible causes of dementia.
Alzheimer’s Disease. Vascular Dementia. Fronto-temporal dementia (Pick’s Disease). Parkinson’s Disease Dementia. Lewy-body Dementia. Huntington’s Disease. Creutzfeldt-Jakob Disease.
State 2 reversible causes of dementia.
Alcohol dependence. Medical conditions e.g. hypothyroidism, vitamin B12 deficiency, syphilis (treated with penicillin). Normal pressure hydrocephalus (NPH) - venous drainage of CSF (back-up of fluid with the brain).
State 2 ways to diagnose dementia.
Vitamin B12 test. TSH level test. Rapid plasma reagin test (RPR) - check for syphilis. MRI - look at ventricles.
State a characteristic of Alzheimer’s Disease.
Gradual loss of memory. Cognitive functions decline over-time - language, visuospatial, executive functions.
State a causes Vascular dementia.
Manifestations of atherosclerosis e.g. hypertension, diabetes, coronary artery disease.
State a characteristic of Vascular dementia.
Gait abnormality. Neurological defect - speech, vision problems.
State 2 behavioural changes of Frontotemporal Dementia.
Personality changes. Impaired judgment. Apathy (lack of enthusiasm). Disinhibition (lack of restraint).
What is a cause of Frontotemporal Dementia?
Atrophy of frontal + temporal lobes.
What’s the difference between Parkinson’s Disease Dementia and Lew-body Dementia?
Parkinson’s Disease - symptoms of Parkinsonism first, dementia later on. Lewy-body dementia - dementia first, parkinsonism later.
State 2 characteristics of Lewy-body Dementia.
Recurrent visual hallucinations. Fluctuating episodic deficits of attention and alertness (confused with delirium).
State a symptom of Huntington’s Disease.
Chorea - involuntary, purposeless movements. Dementia.
What causes Creutzfeldt-Jakob Disease?
Prions - infectious, abnormally folded intracellular proteins.
State a symptom of Creutzfeldt-Jakob Disease.
Myoclonus - jerking movement of muscle group
What is Chronic Traumatic Encephalopathy?
Dementia following head trauma - veterans/victims of domestic abuse.
State a symptom of HIV-Associated Neuro-cognitive Disorder (HAND).
Impaired function. Impaired attention. Changes in personality. Changes in behaviour.
State 3 treatments for dementia.
Acetylcholinesterase inhibitors e.g. donepezil, galantamine, rivastigmine. NMDA antagonists e.g. memantine. Medication for symptoms e.g. depression, hallucinations, agitation, sleep disturbance. pharmacological approach - reminiscence therapy.
State an acetylcholinesterase inhibitor.
Donepezil. Galantamine. Rivastigmine.
