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.
State an aim of dementia treatment.
Treat associated disorders e.g. chest infection. Address functional problems e.g. reminders to take medication. Carer support and advice. Manage risk factors e.g. vascular dementia.
