Dementia Flashcards
1
Q
Dementia
A
a cognitive decline from a previously higher level of functioning and manifested by impairment of memory and of two or more cognitive domains (orientation, attention, language, visuospatial functions, executive functions, motor control, and praxis), deficits should be severe enough to interfere with activities of daily living. –NINDS definition(National Institute of Neurological Disorders and Stroke)
2
Q
Alzheimer’s Disease
A
- The most common dementia by far.
- The cause is unknown
- Damage to cortical tissue
- Memory problems are the most common initial symptom
- Can train compensatory strategies as well as educate the family
- Slow, insidious onset.
- Memory problems expand into cognitive problems and confusion.
- In later stages, agitation, hallucination, delusions, and violent outbursts may be seen.
- Physical decline is seen in the later stages
- Typical progression is 10 years
- Early parkinsonian signs may indicate a more rapid progression
E.g., tremor, rigidity, other motor movements
3
Q
Frontotemporal Dementia (Pick’s disease)
A
- A degenerative dementia of unknown cause.
- Sometimes called “dementia of the frontal lobe type”
- Typically, personality changes precede intellectual decline
-Language abilities may be affected before memory As it is defined today, the symptoms of FTD fall into two clinical patterns that involve either (1) changes in behavior, or (2) problems with language.
- The first type features behavior that can be either impulsive (disinhibited) or bored and listless (apathetic) and includes inappropriate social behavior.
- The disease progresses steadily and often rapidly, ranging from less than 2 years in some individuals to more than 10 years in others.
- Eventually, some individuals with FTD will need 24 hr care and monitoring at home or in an institutionalized care setting.
4
Q
Creutzfeldt-Jakob disease
A
- A rare, fatal disease, causing degeneration of frontal and temporal lobes
- Cause is unknown, but may be the result of a protein called a prion
- Nearly all pt die within 1 year
- Early symptoms include memory and motor deficits, behavioral changes.
- Later symptoms include pronounced mental deterioration, involuntary movements, blindness, weakness, and coma
- There is no effective treatment
5
Q
Creutzfeldt-Jakob Disease cont.
A
- The leading scientific theory at this time maintains that CJD is caused by a type of protein called a prion.
- The harmless and the infectious forms of the prion protein are nearly identical, but the infectious form takes a different folded shape than the normal protein
- Researchers are examining whether the transmissible agent is, in fact, a prion and trying to discover factors that influence prion infectivity and how the disorder damages the brain.
- Using rodent models of the disease and brain tissue from autopsies:
- -Identify factors that influence the susceptibility
- -Discovering when in life the disease appears
6
Q
Parkinson’s disease
A
- A degenerative disorder of the basal ganglia and substantia nigra.
- Affects about 1% of the people over 65
- Characterized by tremor, bradykinesia, akinesia, muscle rigidity, and abnormal postural reflexes
- Often treated with L-dopa
- Deep brain stimulation is another treatment -Perhaps as many as 30% of people with PD show a dementia.
- Characterized by forgetfulness, slowing of the though process, apathy, and depression
- It is often difficult to tell if a PD pt actually has a co-occurring Alzheimer’s dementia, rather than “PD” dementia
7
Q
Huntington’s disease
A
- An inherited disease that causes the gradual degeneration of the cerebral cortex and basal ganglia.
- The first symptom is very subtle intellectual decline
- Eventually, chorea is present
- Progressive cognitive decline, hyper-kinetic movements, and personality changes are noted
8
Q
Progressive Supranuclear Palsy
A
- Rare disorders caused by degeneration of neurons in the basal ganglia and brainstem.
- Symptoms include gait disturbance, eye movement problems, and moodiness
- Includes many parkinsonian symptoms because the substantia nigra is affected.
- A mixed spastic-hypokinetic dysarthria is often present.
- A slowly progressive dementia is associated with PSP, usually leaving language abilities intact until the late stages of the disease
9
Q
AIDS encephalopathy
A
- About a third of AIDS pts develop a dementia
- Symptoms can be caused directly by the virus of by opportunistic infections and lymphomas in the brain
- Pts complain of decreased concentration, forgetfulness, and slowing of thoughts
10
Q
Multi-Infarct dementia
A
- Small, multiple strokes cause a stepwise decline in neurological function over time.
- Symptoms vary widely among pts, but memory and personality are usually not affected until late in the progression
- Can show early signs of depression, irritability, and emotional lability.
- A common dementia, accounting for 15 to 20% of all dementia cases.
- Control of vascular risk factors such as hypertension and cigarettes can alter the natural progression of the condition
11
Q
Lewy Body Dementia
A
- Memory impairments, visuospatial deficits, attentional difficulties, falls, muscle rigidity
- No cure
- Caused by proliferation of Lewy Bodies
- These are abnormal proteins that become deposited within neuron cell bodies
- Causes loss of dopamine and acetylcholine (neurotransmitters)
12
Q
Classification of Dementia
A
- Cortical (more language problems)
- -Alzheimer’s, Picks, (Primary Progressive Aphasia)
- Subcortical (more movement issues)
- -Parkinson’s, Huntington’s, Progressive Supranuclear Palsy, AIDS Encephalopathy
- Mixed
- -Vascular Dementia, Lewy Body Dementia, Frontotemporal Dementia
-Other
13
Q
Communication Changes in AD: Early Stage
Pragmatic Abilities
A
- unable to maintain conversations
- Some trouble giving instructions and storytelling
- Frequent requests for clarification
- May drift from topic of conversation
- Expresses appreciation or no expression of appreciation
14
Q
Communication Changes in AD: Early Stage
Semantic Abilities
A
- Word fluency and word finding are impaired
- Circumlocutions can be evident
- Difficulty comprehending abstract or complex concepts
15
Q
Communication Changes in AD: Early Stage
Syntactic and Phonological Abilities:
A
Usually there are no errors at this stage
