Dementia

Question 1

What is dementia?

Answer 1

A severe, acquired progressive cognitive decline which affects more than one brain region

Question 2

How might problems with memory manifest in a patient with dementia?

Answer 2

Repetitive questions or conversations
Misplacing personal belonings
Forgetting events or appointments
Getting lost on a familiar route

Question 3

How might problems with executive function manifest in a patient with dementia?

Answer 3

Poor understanding of safety risks
Inability to manage finances
Poor decision making abilities
Inability to plan complex or sequential activities

Question 4

How might problems with visuospatial function manifest in a patient with dementia?

Answer 4

Inability to recognise faces or common objects
Inability to find objects in direct view despite good acuity
Inability to operate simple. implements
Inability to orient clothing to the body

Question 5

How might problems with language manifest in a patient with dementia?

Answer 5

Difficulty thinking of common words whilst speaking
Other speech difficulties
Spelling errors
Writing / grammar errors

Question 6

What tests can be conducted at the bedside to assess the patient’s. mental state in suspected dementia?

Answer 6

Holstein MMSSE

Addenobrrokes

Question 7

How are attention/concentration assessed in the addenbrookes test?

Answer 7

Orientation

Serial 7s

Question 8

What pathological process can effect episodic memory?

Answer 8

Alzheimer’s disease

Limbic encephalitis

Question 9

Which region of the brain is affected first by Alzheimer’s disease?

Answer 9

Temporal lobe

Question 10

Describe the progression of loss of Brian function which is typically seen in Alzheimers

Answer 10

Episodic memory dysfunction then visuospatial dysfunction then language dysfunction

Question 11

What results will be seen in the addenbrookes tests for patients with semantic dementia?

Answer 11

Reduction in verbal fluency

Impairment of irregular words

Question 12

How is executive function tested in the addenbrookes test?

Answer 12

Proverbs
Verbal fluency
Estimates
Planning activities

Question 13

How can visuospatial function be assessed in the addenbrooke’s test?

Answer 13

Ask patient to draw interlocking pentagons, cubes, 3D letters and to count dots

Question 14

How is language function assessed in the addenbrookes test?

Answer 14

Naming
Repetition
3 stage command
Reading

Question 15

Describe semantic aphasia

Answer 15

Poor confrontation naming
Impaired single word compregension
Poor object/person recognition
Surface dyslexia
Repetition is spared

Question 16

Describe logopenic aphasia

Answer 16

Impaired single word retrieval
Impaired repetition
Speech sound errors
Spared object/person recognition and single word recognition

Question 17

What pathology can cause logopenic aphasia?

Answer 17

Alzheimer’s disease

Question 18

Describe non-fluent aphasia

Answer 18

Effortful, halting speech with phonemic error

Spared object/person/single word recognition

Question 19

What are the cut-off scores for dementia in the Addenbrookes test?

Answer 19

<88 dementia unlike
>83 supports diagnosis of dementia
In patients with score 83-88 the diagnosis can be uncertain